Certain Health Care Workers Are At Increased Risk For Drug Overdose Death

Registered nurses, social or behavioral health workers, and health care support workers in the U.S. were at increased risk for drug overdose death. Compared with those for non-health care workers, the adjusted hazards of total drug overdose death were significantly increased for social or behavioral health workers (155% higher), registered nurses (122% higher), and health care support workers (60% higher). In comparison, the risks were lower for physicians (39% lower), other treating or diagnosing health care workers (7% lower), and health technicians (just 13% higher) than non-health care workers.

Results were generally similar for opioid-related overdose deaths and unintentional overdose deaths. Over a follow-up period of more than 10 years, approximately 0.07% of both health care workers, and non-health care workers died of drug overdose. For health care workers, 84.5% of drug overdose deaths were opioid-related and 75.8% unintentional. For non–health care workers, 76.3% were opioid-related and 84.6% were unintentional.

The increasing number of drug overdose deaths in the United States, mostly involving opioids, has prompted efforts to identify high-risk populations and offer preventive interventions. Health care workers regularly prescribe or administer medicines, experience job stress, and engage in physically strenuous tasks that could put them at risk for musculoskeletal injury that could result in opioid dependency.

These findings were presented in “Fatal Drug Overdose Risks of Health Care Workers in the United States,” by Mark Olfson, M.D., MPH; Candace M. Cosgrove, MPH; Melanie M. Wall, Ph.D.; and Carlos Blanco, M.D., Ph.D. The researchers analyzed a prospective cohort of 176,000 health care workers (HCWs) aged 26 years and older between 2008 and 2019. The authors evaluated six HCW groups: physicians, registered nurses, other diagnosing and treating health care workers, health technicians, health care support workers, and social or behavioral health workers. The goal was to estimate risks for drug overdose death among health care workers relative to non-health care workers.

The full text of “Fatal Drug Overdose Risks of Health Care Workers in the United States” was published August 8, 2023, by Annals of Internal Medicine. An abstract is available online at https://www.acpjournals.org/doi/10.7326/M23-0902.

For more information, contact: Mark Olfson, M.D., MPH, Elizabeth K. Dollard Professor of Psychiatry, Vagelos College of Physicians and Surgeons at Columbia University, Mailman School of Public Health at Columbia University, and the New York State Psychiatric Institute, 1051 Riverside Drive, New York, New York 10032; Email: Mark.Olfson@nyspi.columbia.edu; Website: https://www.columbiapsychiatry.org/profile/mark-olfson-md