“…To our knowledge, this is the first study to indicate that family dynamics may mediate or moderate overdose risk. Scientific plausibility of this relationship draws upon empirical studies establishing family environment influences on problem drinking (El-Sheikh & Buckhalt, 2003), drug use (Barrera, Chassin, & Rogosch, 1993) and intentional drug overdose (Al-Jahdali et al, 2004; Al Ansari et al, 2001; Orford, 2005), with or without genetic predisposition for problems (Jacob et al, 2003; Stice, Barrera, & Chassin, 1993). In a companion study conducted in St. Petersburg, we found that recent personal and witnessed overdoses among IDU were associated with family conflict, further suggesting family influence risk context (Grau et al, 2008).…”