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More Than a Fifth of Overdose Decedents Had Non–Substance Mental Health Disorder
In 2022, 1 in 5 overdose deaths in the United States involved people with mental health disorders (MHD) unrelated to substance use, according to a study published in Morbidity and Mortality Weekly Report.
“MHDs and SUDs [substance use disorders] frequently co-occur and have shared risk factors and bidirectional associations (eg, persons with certain MHDs might use substances to cope with their symptoms, and persons with SUDs might be at greater risk for other MHDs),” wrote a research team from the Centers for Disease Control and Prevention (CDC) Division of Overdose Prevention, Atlanta, Georgia. “This finding suggests the need to screen for SUDs and other MHDs, which is consistent with US Preventive Services Task Force recommendations for adults in primary care settings, and the need to link and integrate treatments to prevent overdose and improve mental health.”
In 2022, approximately 108,000 people died from drug overdose in the United States. The year before, roughly 107,000 people died from the same cause, researchers explained. The study used data from the CDC’s State Unintentional Drug Overdose Reporting System to assess the characteristics of people who died from unintentional or undetermined intent drug overdose and had any MHD. The study included data from 2022 for 43 states and the District of Columbia.
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Among the 108,000 overdose deaths that year, 21.9% involved people with a reported MHD, according to the study. Depressive (12.9%), anxiety (9.4%), and bipolar (5.9%) disorders were most common.
Overall, 82.2% of overdose deaths involved illegally manufactured fentanyl, fentanyl analogs, or other opioids, the study found. Deaths involving antidepressants, benzodiazepines, and prescription opioids occurred at higher rates among people with an MHD (9.7%, 15.3%, and 16.0%, respectively) compared with those without an MHD (3.3%, 8.5%, and 11.6%, respectively).
Some 24.5% of people with an MHD who died of overdose, compared with 14.6% of decedents without an MHD, had at least 1 opportunity for potential intervention in the month before their death. The most common potential intervention opportunities for people with an MHD were release from an institutional setting (11.2%), treatment for substance use disorder (10.1%), emergency department or urgent care visit (9.5%), and nonfatal overdose (4.1%).
“Expanding efforts to identify and address co-occurring mental health and substance use disorders (eg, integrated screening and treatment) and strengthen treatment retention and harm reduction services could save lives,” researchers advised.
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