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Heightened mortality risk after a non‐fatal opioid overdose: Risk factors for mortality in the week following emergency treatment
Open accessAbstract
Aims: To measure all‐cause mortality risk after an ambulance‐attended non‐fatal opioid overdose and associations with number of days following attendance, and individual and clinical characteristics. Design: A prospective observational study. Setting: Oslo, Norway. Participants: Patients treated with naloxone for opioid overdose by Oslo Emergency Services between 1 June 2014 and 31 December 2018. Measurements: Medical records were linked to the national Cause of Death Registry (1 June 2014–31 December 2019). Crude mortality rates (CMR) and incidence risk ratios (IRR) with 95% confidence intervals (CI) were estimated for the time periods (0–7 days, 8–31 days, 32–91 days, 92–183 days, >183 days) using multivariate Poisson regression analysis. IRR were estimated for sex, age, Glasgow Coma Scale (GCS), respiration rate, place of attendance and non‐transportation following treatment. Robust variance estimates applied due to multiple risk periods. Standardized Mortality Rates (SMR) were estimated. Findings: Overall, 890 patients treated for 1764 overdoses contributed to a total time at risk of 3142 person‐years (PY). Median number of attendances was 1 (range 1–27). The majority were male (75.5%) and the mean age was 37.7 years. In total, 112 (12.6%) died; 5.2% within 183 days and 2.2% between 184 and 365 days. Acute poisoning was the most common single cause of death (52.7%). The CMR was 3.6 (95% CI = 3.0–4.2) per 100‐PY. The women had a SMR of 32 (95% CI = 15.8–57.9) and the men 24.9 (95% CI = 17.7–34.2). The CMR (22.2, 95% CI = 10.6–46.8) was particularly high in the first 7 days, and significantly higher than in the following periods. However, this finding was only valid for those with severe overdose symptoms (GCS score = 3/15 and/or respiratory rate ≤6/min). Except for increasing age, no other indicators were associated with the mortality risk. Conclusion: Patients treated by Oslo Emergency Services between June 2014 and December 2018 for a non‐fatal opioid overdose with severe overdose symptoms at attendance had an overall high mortality risk compared with the general population, but particularly during the first 7 days after attendance.
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“Jadhav et al. [51] reviewed the metabolism of butonitazene, isotonitazene, and protonitazene in vitro and identified multiple metabolic pathways for all three compounds.”
From Nitazenes: review of comparative pharmacology and antagonist action (2025) · cites this paper as [51]
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Nitazenes: review of comparative pharmacology and antagonist action
Stangeland, M., Dale, O., & Skulberg, A. K. (2025) · Clinical Toxicology · doi:10.1080/15563650.2025.2504133 · Cited by 34
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Metadata
- Authors
- Eide, D., Gjersing, L., Danielsen, A. W., Skulberg, A. K., Dale, O., Braarud, A., Heyerdahl, F., & Tylleskar, I.
- Affiliations
- University of Oslo (NO)
- Norwegian Institute of Public Health (NO)
- Oslo University Hospital (NO)
- Norwegian University of Science and Technology (NO)
- Division of Prehospital Services Oslo University Hospital Oslo Norway
- Department of Circulation and Medical Imaging Norwegian University of Science and Technology Trondheim Norway
- Corresponding author
- Eide, Desiree
- ORCID
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2024-08-26
- Volume
- 119
- Issue
- 12
- Pages
- 2131-2138
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W4401891970
- Cited by
- 6
- References
- 1
- Citations by year
- 2026: 2 · 2025: 4
- FWCI
- 2.49
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Addiction (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Oslo universitetssykehus HF
- Senter for rus- og avhengighetsforskning, Universitetet i Oslo
- Norges Teknisk-Naturvitenskapelige Universitet
- St. Olavs Hospital Universitetssykehuset i Trondheim
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- opioid overdose, non-fatal overdose, all-cause mortality, naloxone, emergency medical services, ambulance attendances, acute poisoning, mortality risk factors, Glasgow Coma Scale, sex differences, time since treatment, opioid use disorder, harm reduction, cause of death registry, standardized mortality rate
- MeSH terms
- Opiate Overdose, Adolescent, Adult, Aged, Ambulances, Emergency Medical Services, Emergency Treatment, Female, Humans, Male, Middle Aged, Naloxone, Narcotic Antagonists, Norway, Prospective Studies, Registries, Risk Factors, Young Adult, Drug Overdose
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- Eide, D., Gjersing, L., Danielsen, A. W., Skulberg, A. K., Dale, O., Braarud, A., Heyerdahl, F., & Tylleskar, I. (2024). Heightened mortality risk after a non‐fatal opioid overdose: Risk factors for mortality in the week following emergency treatment. Addiction. https://doi.org/10.1111/add.16632
