person with opioid overdose being loaded into an ambulance
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Summary: What happens after a non-fatal opioid overdose depends on what the individual does next: in general, people who seek professional support for addiction or mental health report more favorable outcomes than those who don’t.

Key Points:

The Opioid Crisis: A Ray of Hope

In the first 20 years of the opioid addiction and overdose crisis, all the news we received was bad. Year over year, overdose fatalities increased. Between 2001 and 2022, public health officials reported increases of over 750 percent. However, between 2022 and 2024, we’ve seen a reduction of 36 percent. We won’t call any news about overdose good, per se, because every overdose is a preventable tragedy, but that news shows that we’re moving in the right direction.

We’ll call that new promising, as well as news about the following four states that reported decreases of over fifteen percent from 2022 to 2023.

  • Nebraska: 28% decrease
  • Kansas: 14% decrease
  • Indiana: 20% decrease
  • Maine: 18% decrease

Those results are good news, but we have to receive the news in context, because while fatal overdose rates decreased nationwide, three states reported increases between 2022 and 2023.

  • Alaska: 28% increase
  • Washington: 11% increase
  • Oregon: 22% increase

Here’s an important fact anyone reading this article needs to understand: overdose fatalities are preventable. People who experience an overdose are at heightened risk of a subsequent overdose in the 12 months following the initial overdose. However, the likelihood of a second overdose decreases when they seek treatment in medication-supported recovery (MAT) with medication for opioid use disorder (MOUD).

The Year Following a Non-Fatal Opioid Overdose: How Many People Get the Help They Need?

In the article “Overdose, Behavioral Health Services, and Medications for Opioid Use Disorder After a Nonfatal Overdose” a group of researchers from the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institute on Drug Abuse (NIDA), the Centers for Disease Control (CDC), and the Centers for Medicare & Medicaid Services collaborated to learn about trends in treatment utilization and overdose in the twelve months following a non-fatal opioid overdose.

Here’s how they defined the goal of their research:

To examine receipt of medications for opioid use disorder (MOUD), naloxone, and behavioral health services in the 12 months after an index nonfatal drug overdose and the association between receipt of these interventions and fatal drug overdose.

Researchers analyzed data from insurance claims, mortality rates, and demographic factors for 2020 and 2021, collected from the CMS, the CDC, and additional reputable sources. Here’s what they found:

During 2020:

  • 136,762 people reported a non-fatal overdose

In the 12-month period following the overdose:

  • 23, 815 reported at least one additional nonfatal drug overdose
    • 17.4%
  • 1,323 died of overdose
    • 1.0%
  • 955 of those fatalities involved opioids
    • 72.2%

In the 12-month period following the initial overdose:

  • 5,556 received medication for opioid use disorder (MOUD)
    • 4.1%
  • 8530 filled a prescription for the overdose reversal drug, naloxone
    • 6.2%
  • 121,000 received behavioral health support
    • 89%

The data show clearly that despite the fact that treatment with MOUD can significantly reduce rates of opioid use disorder (OUD) and reduce complications associated with OUD, 95.9 percent of people who reported an initial overdose did not receive MOUD, and 97.8 percent did not fill a prescription for the overdose reversal drug, naloxone.

Therefore, in answer to the question in the heading of this section: Not enough people got the addiction support they needed. In fact, more than nine out of every ten people didn’t receive the best treatment available or engage in the types of support that mitigate risk of relapse.

What Factors Reduce Overdose Risk After a Non-fatal Overdose?

As treatment professionals, we know that the time immediately following a non-fatal overdose is critical: if people consent to and engage in treatment right away, we know outcomes improve. This study examined treatment utilization within one year in order to understand whether receiving treatment within that extended window made a difference, and if it did, which treatment components were most effective.

Based on the data above, the research team determined the following factors that decrease risk of subsequent overdose during the 12 months after an initial overdose:

  • Filling a prescription for naloxone:
    • Reduced risk by 30%
  • Engaging in methadone treatment
    • Reduced risk by 58%
  • Engaging in buprenorphine treatment
    • Reduced risk by 52%
  • Receiving an assessment for mental/behavioral health
    • Reduced risk by 75%
  • Receiving support/service during a health crisis
    • Reduced risk by 75%

Here’s how Dr, Allison Arwady, Director of the Injury Center at the CDC, characterizes these results:

“This study highlights that as a society, we are still missing many opportunities to prevent fatal overdoses, and we must continue to work together at all levels to save lives.”

That’s our primary takeaway from this research. While the figures for fatal overdose decreased between 2022 and 2023, we still have work to do, particularly in the time immediately following a non-fatal overdose. The more people we can get into treatment, and the more quickly we can get them support, the more lives we can save.