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NIDA Research Identifies Groups With Increased Rates of Intentional Overdose Deaths
While the number of suicides by intentional drug overdose have decline overall in recent years, new data from the National Institutes of Health (NIH) show an increase among young people between the ages of 15 and 24, older people ages 75 to 84, and non-Hispanic Black women. Researchers also found that women were more likely than men to die by intentional drug overdose, with the highest rates recorded among women 45 to 64. Time of year, length of day, and day of week were also identified as factors associated with intentional overdoses.
Findings from the research, conducted by investigators at the National Institute on Drug Abuse (NIDA), were published this month in the Journal of Psychiatry.
Of the 92,000 overdose deaths in the US in 2020, NIDA estimates about 5% to 7% are intentional, a figure that NIH said is a conservative projection, as determining overdoses to be intentional is difficult.
“The distinction between accidental and intentional overdose has important clinical implications, as we must implement strategies for preventing both,” NIDA Director Nora Volkow, MD, the study’s senior author, said in a news release. “To do so requires that we screen for suicidality among individuals who use opioids or other drugs, and that we provide treatment and support for those who need it, both for mental illnesses and for substance use disorders.”
While overdose deaths overall have soared in recent years, researchers found that intentional overdose deaths have declined. Among women, intentional overdose deaths dropped from 1.7 to 1.5 per 100,000 people from 2015 to 2019; among men, the decline per 100,000 was 1.6 in 2012 to 1.2 in 2019.
The following subcategories of the US population did see rates of intentional overdose deaths:
- Young men ages 15 to 24 (from 0.6 per 100,000 people in 2015 to 0.8 in 2019)
- Young women ages 15 to 24 (from 0.6 per 100,000 people in 2014 to 1.0 in 2019)
- Older men ages 75 to 84 (from 0.7 per 100,000 people in 2001 to 1.6 in 2019)
- Older women ages 75 to 84 (from 0.8 per 100,000 people in 2001 to 1.7 in 2019), and
- Non-Hispanic Black women (from 0.4 per 100,000 people in 2013 to 0.7 in 2019)
NIDA investigators also found that intentional overdose rates were highest on Mondays (and lowest from Friday through Sunday), and that rates were also higher in late spring and summer, while the month with the lowest rate recorded was December.
The study authors theorized that higher intentional overdose rates recorded in May through August—months with more daylight hours—could be related to seasonal changes in the availability of mu opioid receptors in the brain, which influence mood and behaviors and are targets of opioid drugs.
Study author Emily Einstein, PhD, NIDA Science Policy Branch chief, said the findings underscore the importance support structures and environmental factors when assessing an individual’s suicide risk, and that clinicians may need to assess patients’ suicide risk at multiple points in time.
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