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Research Letter
May 20, 2020

Risks of Mortality Following Nonfatal Intentional and Unintentional Opioid Overdoses

Author Affiliations
  • 1Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
  • 2Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland
  • 3School of Social Sciences, Humanities, and Arts, Department of Public Health, University of California, Merced
JAMA Psychiatry. Published online May 20, 2020. doi:10.1001/jamapsychiatry.2020.1045

Rising rates of unintentional and intentional opioid overdose deaths1 have sharpened interest in probing their association with each other.2 A unified perspective encompasses unintentional and intentional overdoses within self-injury3 and emphasizes shared biological (eg, impulsivity) or social (eg, economic insecurity) risk factors.4 By contrast, a psychological perspective distinguishes the motivation of overdoses as unintentional, intentional, or undetermined intent.5 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.

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