Bottom Line: Adults who survive an opioid overdose are at high risk of dying during the year after the incident of substance use-associated diseases, suicide and other medical conditions.
Why The Research Is Interesting: There is interest in understanding the subsequent risk of death, not just from overdoses, in patients after a nonfatal opioid overdose because the number of those patients has increased.
Who and When: 76,325 Medicaid beneficiaries who experienced nonfatal opioid overdoses; there were 5,194 deaths in the first year after nonfatal opioid overdose
What (Study Interventions and Outcomes): Crude mortality rates in the first year after nonfatal opioid overdose and standardized mortality rate ratios for death from any cause and specific causes compared with the general population
How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control for all the natural differences that could explain the study results.
Authors: Mark Olfson, M.D., M.P.H., of Columbia University, New York, and coauthors
Results: In the year after surviving an opioid overdose, the most common causes of death for adults were substance use-associated diseases, diseases of the circulatory system and cancer. These adults also were more likely than those in the general population to die of, especially, drug use-associated diseases, human immunodeficiency virus (HIV), chronic respiratory disease, viral hepatitis and suicide, particularly suicide among women.
Study Limitations: The study was based on data from 2001-2007. Since then, opioid use, naloxone reversal, medication-assisted treatment and other drug use patterns have changed, along with the composition of patients with opioid overdose, and that may have changed their subsequent risks of death.
To Learn More: The full study is available on the For The Media website.
(doi:10.1001/ jamapsychiatry.2018.1471)
Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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Journal
JAMA Psychiatry