Risks of Mortality Following Nonfatal Intentional and Unintentional Opioid Overdoses
Mark Olfson, Michael Schoenbaum, Sidra Goldman‐Mellor
Abstract
Rising rates of unintentional and intentional opioid overdose deaths 1 have sharpened interest in probing their association with each other. 2 A unified perspective encompasses unintentional and intentional overdoses within self-injury 3 and emphasizes shared biological (eg, impulsivity) or social (eg, economic insecurity) risk factors. By contrast, a psychological perspective distinguishes the motivation of overdoses as unintentional, intentional, or undetermined intent. To evaluate these competing perspectives, we examined mortality following nonfatal opioid overdoses of intentional, unintentional, and undetermined intent. We hypothesized that patients with nonfatal intentional overdoses would be more likely to die by suicide than patients with unintentional overdose while patients with nonfatal unintentional overdoses would be more likely to die of unintentional overdose than suicide.