Risk Factors of Drug Overdose

The primary objective of this systematic review was to identify risk factors of drug overdose. Based on previous research, we identified three principal risk factors. Specifically, we examined educational background, sociodemographic factors, and personal beliefs about drug use and intent. These factors were then analyzed to determine their association with unintentional drug overdose deaths among adults.

A literature search was conducted using the Internet, scholarly databases, and published sources. In line with previous research, we categorized risk factors for unintentional overdoses based on importance, sociodemographic characteristics, and changeability. In stage 1, basic information on risk factors was reviewed through literature review and categorized into three categories: universal risk, controlled risk, and unidirectional (personal) risk factors. Second, post-diagnosis, prospective clinical trials, and demographic data were reviewed in light of the literature to determine the prevalence of potentially modifiable and controllable risk factors. Finally, prescription drug overdoses during 2021 were analyzed through a 2-stage expert survey to determine the national prevalence of potentially modifiable and controllable risk factors.

Overall, there was an overall increase in unintentional deaths from drugs, especially from prescription medications. The majority of drug overdoses were from non-prescription pain relievers and most (more than 90%) of drug users injected the drugs. Prescription drug overdoses were the largest single cause of unintentional deaths of drug users.

Most drug overdoses occurred among long-term drug users who had a history of substance abuse. These users are the most at risk for unintentional overdoses because they are unaware of the serious health consequences of their use. Long-term drug users are more likely to suffer from complications that can result from unintentional overdoses, including organ failure and death. In addition, many drug users do not seek treatment when their drug addiction has progressed to the point where they need it, and they do not follow program instructions.

Risk factors associated with unintentional overdoses can be divided into three categories: biological, behavioral and social environment. Biologically, these factors include genetics, metabolism, environmental exposure, family history, withdrawal, and other factors. For example, a gene called AKA ( ankaline phosphoribosyltransferase) that is responsible for the breakdown of glycogen in liver cells may cause glycogen depletion, which may result in liver failure and/or death. A family history of alcoholism or drug addiction is another example of a risk factor. The environment includes factors such as drug availability, abuse, social settings, age, and neighborhood where drug use occurs.

Behaviorally, recent drug use can be associated with depression, anxiety, irritability, cravings, lack of interest in activities and boredom. These symptoms are commonly displayed by users who are taking drugs for the first time and/or experimenting with new drugs. They may also develop tolerance and physical dependence on certain drugs over time. Psychological risks are common among long term drug users, including feelings of hopelessness, confusion and mental instability, intense cravings, insomnia and panic attacks.

The social environment is one of the strongest risk factors of drug overdose because of the accessibility of illegal drugs. Many people who inject drugs do so in public, under the influence of other people, and most deaths from drug overdoses are caused by intravenous drug users who were uninsured, self-negligent or careless of the risks they were taking. Illicit drug use is also associated with higher incidences of overdose than other forms of drug use. In addition, people who use prescription drugs are more likely than others to acquire hepatitis and other serious health problems from using contaminated needles and syringes. Those who use heroin are at particular risk of homicide, suicide, and infections caused by needle use.

The environment is also a significant risk factor for the overdose of drug users. Many people who inject drugs do so in public, under the influence of others, and those who use heroin are at greater risk of contracting diseases and infections brought on by unsafe injection practices. Those who use cocaine are at higher risk of dying from complications related to pregnancy or needle use, especially in women. The most common method of consumption is inhalation of the drug aerosol, but there are those who inject cocaine as well. Other risk factors include socioeconomic status, ethnicity, and family history.

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