Observational studyAddiction (Abingdon, England)2026
Heat exposure and drug overdose mortality in the USA.
Observational study in Addiction (Abingdon, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Socioenvironmental disasters and the dialectics of overdose mortality.The International journal on drug policy · 2026Article
- Commentary on Dennett et al.: When heat and the opioid epidemic collide - implications for climate-resilient public health strategies.Addiction (Abingdon, England) · 2026Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
BACKGROUND AND
aimsUnderstanding the relationship between heat and drug overdose mortality is critical given the ongoing overdose crisis and rising global temperatures driven by climate change. Evidence from local jurisdictions in the United States (US) and Canada indicates that exposure to heat is associated with increased drug overdose fatalities, but the widespread impact of heat on national drug overdose deaths is undetermined. We aimed to determine the effect of heat exposure on drug overdose mortality in the US.
designAn observational study using monthly, county-level data from 1999 to 2020 and a fixed effect model estimated with linear regression. The model accounts for time-invariant county-month factors and state-level time-specific shocks.
settingAll counties in the continental US during the months of June to September from 1999 to 2020.
participantsDecedents in the National Center for Health Statistics restricted Vital Statistics mortality data with a cause of death of a drug overdose, aggregated to county-level mortality rates. MEASUREMENTS: All drug overdose mortality rate per 100 000 population. The monthly average maximum heat index (measured in degrees Celsius) was collected from the Centers for Disease Control and Prevention National Environmental Public Health Tracking Network.
findingsA one-degree Celsius increase in the heat index was associated with an increase in all drug overdose mortality by 0.0098 deaths per 100 000 population [95% confidence interval (CI) = 0.0057-0.014, P < 0.001], with significant effects for deaths related to opioids (0.0060 deaths, 95% CI = 0.0026-0.0095, P < 0.001), cocaine (0.0028 deaths, 95% CI = 0.0012-0.0045, P < 0.001) and psychostimulants (0.0028 deaths, 95% CI = 0.0015-0.0041, P < 0.001). In further analyses, larger impacts were observed after 2013, in counties with greater levels of social vulnerability and in suburban and urban counties. Estimates suggest that approximately 150 excess drug overdose deaths occurred per year during the hottest periods due to heat exposure.
conclusionsExposure to heat appears to be associated with increases in drug overdose deaths in the United States in recent decades.
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Registered trials
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