ArticleDrug and alcohol dependence2023
Overdose and mortality risk following a non-fatal opioid overdose treated by Emergency Medical Services in King County, Washington.
Article in Drug and alcohol dependence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
10 citing papers in PubMed, 13 citations in OpenAlex.
- The effectiveness of the communities that HEAL intervention on reducing non-fatal opioid overdoses: A prespecified secondary analysis of a waitlist cluster control randomized controlled trial.The International journal on drug policy · 2025Trial
- Higher prevalence of non-fatal overdose with opioid and stimulant use compared to use of opioids alone.Drug and alcohol dependence · 2026Article
- Locations of emergency medical services attended non-fatal opioid-involved overdoses, 888 counties, USA, 2022-2024.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2026Article
- Defining nonfatal opioid overdoses using administrative health data in the United States and Canada: A scoping review.Preventive medicine reports · 2026Review
- Article
- Naloxone Use, 911 Calls, and Emergency Visits After Nonfatal Overdose.JAMA network open · 2025Article
- Non-fatal Overdose and Associated Factors Among People Who Use Opioids: Findings From a Cross-sectional Study.Journal of community health · 2025Article
- Overdose response centering inequity and diversity study: a protocol for assessing the population-level and equity impact of the emergency medical services system changes using critical race theory.Frontiers in public health · 2025Article
- Emergency Medical Services-Led Outreach Following Opioid-Associated Overdose: Frequency, Modality, and Treatment Linkage.Prehospital emergency care · 2025Article
- Whole body physiology model to simulate respiratory depression of fentanyl and associated naloxone reversal.Communications medicine · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundEmergency Medical Services (EMS) agencies respond to hundreds of thousands of acute overdose events each year. We conducted a retrospective cohort study of EMS patients who survived a prior opioid overdose in 2019-2021 in King County, Washington.
methodsA novel record linkage algorithm was applied to EMS electronic health records and the state vital statistics registry to identify repeat overdoses and deaths that occurred up to 3 years following the index opioid overdose. We measured overdose incidence rates and applied survival analysis techniques to assess all-cause and overdose-specific mortality risks.
resultsIn the year following the index opioid overdose, the overdose (fatal or non-fatal) incidence rate was 23.3 per 100 person-year, overdose mortality rate was 2.7 per 100 person-year, and all-cause mortality rate was 5.2 per 100 person-year in this cohort of overdose survivors (n=4234). Overdose incidence was highest in the first 30 days following the index overdose (43 opioid overdoses and 4 fatal overdoses per 1000 person-months), declined precipitously, and then plateaued from the third month onwards (10-15 opioid overdoses and 1-2 fatal overdoses per 1000 person-months). Overdose incidence rates, measured at 30 days, were highest among overdose survivors who were young, male, and experienced a low severity index opioid overdose, but these differences diminished when measured at 12 months.
conclusionsAmong EMS patients who survived an opioid overdose, the risk of subsequent overdose is high, especially in the weeks following the index opioid overdose. Non-fatal overdose may represent a pivotal time to connect patients with harm-reduction, treatment, and other support services.
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