Heat exposure and drug overdose mortality in the USA.

IF 5.3 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2025-10-06 DOI:10.1111/add.70191

Julia M Dennett, Daniel Carrión, David A Fiellin, Gregg S Gonsalves

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引用次数: 0

Abstract

Background and aims: Understanding 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.

Design: An 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.

Setting: All counties in the continental US during the months of June to September from 1999 to 2020.

Participants: Decedents 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.

Findings: A 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.

Conclusions: Exposure to heat appears to be associated with increases in drug overdose deaths in the United States in recent decades.

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热暴露和药物过量死亡率在美国。

背景和目的：考虑到持续的药物过量危机和气候变化导致的全球气温上升，了解热量与药物过量死亡率之间的关系至关重要。来自美国和加拿大地方司法管辖区的证据表明，暴露于高温与药物过量死亡人数增加有关，但高温对国家药物过量死亡人数的广泛影响尚不确定。我们的目的是确定热暴露对美国药物过量死亡率的影响。设计：一项观察性研究，使用1999年至2020年每月县级数据和线性回归估计的固定效应模型。该模型考虑了时间不变的县月因素和州级特定时间的冲击。背景：1999年至2020年6月至9月期间美国大陆的所有县。参与者：国家卫生统计中心的死者限制了生命统计死亡率数据，死因是药物过量，汇总到县级死亡率。测量：每10万人中所有药物过量死亡率。月平均最高热指数（以摄氏度计）是从疾病控制和预防中心国家环境公共卫生跟踪网络收集的。研究结果：高温指数每升高1摄氏度，所有药物过量死亡率就会增加0.0098 / 10万人[95%置信区间(CI) = 0.0057-0.014, P]。结论：近几十年来，暴露在高温下似乎与美国药物过量死亡率的增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.