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Current Treatment Options in Psychiatry

, Volume 5, Issue 3, pp 323–333 | Cite as

Risk Factors for Opioid Overdose

  • Thokozeni Lipato
  • Mishka TerplanEmail author
Substance Use Disorders (FG Moeller, Section Editor)
  • 122 Downloads
Part of the following topical collections:
  1. Topical Collection on Substance Use Disorders

Abstract

Purpose of Review

Opioid overdoses have risen starkly over the last two decades in the USA and are now among the leading causes of overall mortality. This review summarizes the current literature on risk factors for overdose as well as public health solutions.

Recent Findings

Although opioid overdose mortality is highest among men and non-Hispanic whites, the rate of death is rising more rapidly now among women and non-Hispanic blacks. Incarceration remains a significant risk factor for overdose death, especially in the first weeks upon reentry reflecting the absence of treatment in prisons and jails despite strong evidence for the benefits of pharmacotherapy integration into these settings. Pharmacotherapy with either methadone or buprenorphine greatly reduces the risk of overdose; however, treatment discontinuation leads to an increase risk of death.

Summary

Naloxone distribution both through co-prescribing and community-based opioid overdose prevention programs remains the fundament of the public health response. Both are effective and cost-effective in reducing overdose; however, uptake is hampered due to variance in state naloxone access and Good Samaritan laws. Supervised injection facilities are a promising innovation to address overdose, especially in communities with high overdose rates.

Keywords

Opioids Overdose Mortality Risk factors 

Notes

Compliance with Ethical Standards

Conflict of Interest

Thokozeni Lipato declares that he has no conflict of interest. Mishka Terplan declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of General Internal MedicineVirginia Commonwealth University School of MedicineRichmondUSA
  2. 2.Departments of Obstetrics & Gynecology and PsychiatryVirginia Commonwealth University School of MedicineRichmondUSA

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