Periods of altered risk for non-fatal drug overdose

The risk of an individual overdosing is influenced by a range of, often overlapping circumstances. Factors such as incarceration, mental and physical health conditions, and the treatments prescribed for these conditions can all affect the risk of overdose.

This study, published in The Lancet Public Health, aimed to: 

1. describe the patterns of incarceration, hospital admissions, emergency department use, medications for opioid use disorder use, and the use of other medications in people who had a non-fatal overdose resulting in medical care
2. examine the association between these factors and non-fatal overdose resulting in medical care.

The researchers identify individuals who had a non-fatal overdose resulting in medical care and details of factors such as periods of incarceration, admission to hospital, emergency department care, and supply of medications for opioid use disorder (MOUD), opioids for pain relief, benzodiazepines, and antipsychotics. 

Results found that compared with unexposed periods the incidence of non-fatal overdose was higher on:

• the day of admission to prison
• at 1–2 weeks and 3–4 weeks after release from prison 
• 1–2 weeks after discharge from hospital
• when being dispensed opioids for pain or benzodiazepines
• and from 3 weeks after discontinuing antipsychotics

The incidence of non-fatal overdose was reduced during use of medications for opioid use disorder and when in prison.

Authors interpretation

Increasing access and support for medication for the management of opioid use disorder, improving continuity of care when transitioning between service systems and sensitive monitoring of prescribing processes is critical in decreasing the numbers of non-fatal overdose.