Common Causes of Death Following Nonfatal Opioid Overdose Identified

Common causes of death among adults following a nonfatal opioid overdose have been identified, with substance use-associated disease being the most common cause, according to new research.

These findings emerged from 76,325 adults aged 18 to 64 years who had experienced nonfatal opioid overdoses. Data for 2001 to 2007 were obtained from the US Centers for Medicare and Medicaid Services, and death record information was gathered via the National Death Index.
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The researchers calculated crude mortality rates per 100,000 person-years in the first year following a nonfatal opioid overdose, and estimated standardized mortality rate ratios (SMR) for all-cause and selected cause-specific mortality.

Ultimately, data obtained for the study spanned 66,736 person-years of follow-up. A total of 5194 deaths occurred during the first year following a nonfatal opioid overdose, with a crude death rate of 778.3 per 10,000 person-years and an all-cause SMR of 24.2.

Substance use-associated disease (26.2%), diseases of the circulatory system (13.2%), and cancer (10.3%) were among the most common immediate causes of death.

The researchers noted that SMRs were significantly increased for every cause of death examined, especially for the following causes:

• Drug use-associated diseases (SMR 132.1)
• HIV (SMR 45.9)
• Chronic respiratory diseases (SMR 41.1)
• Viral hepatitis (SMR 30.6)
• Suicide (SMR 25.9), especially among women (SMR 47.9)

“In a US national cohort of adults who had experienced a nonfatal opioid overdose, a marked excess of deaths was attributable to a wide range of substance use-associated, mental health, and medical conditions, underscoring the importance of closely coordinating the substance use, mental health, and medical care of this patient population,” the researchers concluded.

—Christina Vogt

Reference:

Olfson M, Crystal S, Wall M, et al. Causes of death after nonfatal opioid overdose [Published online June 20, 2018]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2018.1471