In 2023, the US reported approximately 108,000 deaths from overdose. Intentional overdoses, sometimes referred to as self-inflicted or suicide-related overdoses, occur when an individual deliberately consumes a harmful amount of drugs with the intent to self-harm or end one’s life. Overdoses classified as unintentional often result from accidental consumption of drugs in excessive quantities. While intentional overdose deaths have decreased since the mid-2010s, unintentional overdose deaths have increased sevenfold between 2001 and 2022. However, determining the intent in overdose cases remains a complex and nuanced process.
In a study in the Journal of Substance Use and Addiction Treatment, Veer Vekaria, health data scientist, and colleagues from the Department of Population Health Sciences and Department of Psychiatry, used electronic health record (EHR) data to describe the profiles of patients who experienced intentional versus unintentional drug overdoses. Researchers compared individuals with intentional or unintentional drug overdoses based on demographic characteristics, past-year diagnoses of mental and physical health conditions, and the number and types of substances involved.
The analysis used EHRs from the INSIGHT Clinical Research Network, derived from five health systems across NYC, comprising data for 9,622 patients. Of these individuals, 1,737 experienced an intentional overdose, and 7,885 experienced an unintentional overdose. Intentional overdoses often featured younger patients with mental health conditions and substance use disorders, with women accounting for two-thirds of intentional overdoses. Unintentional overdoses often featured older patients with chronic health conditions, implying potential mismanagement of medications.
“Our findings show that intentional and unintentional overdoses involve two different patient groups with distinct risks and needs,” said Vekaria. “Recognizing those differences is key to designing interventions that both prevent overdoses and address the underlying drivers, whether that’s mental health conditions, substance use, or chronic illness.”
There is an increased risk of suicide death following a nonfatal intentional overdose. Understanding the mechanisms that drive overdose intent can allow for more informed evaluations of patients presenting with overdose, as well as tailored interventions. “This work also raises important questions about how health systems document and interpret intent in overdose cases,” Vekaria said. “If we can capture that information more clearly, it could help clinicians identify patients at higher risk of suicide and connect them with the right support.”
- Highlights