Non-Fatal Opioid Overdose and Associated Health Outcomes: Final Summary Report

Non-fatal opioid overdose (NFOO) is a significant cause of opioid-related morbidity in the United States. As the number of NFOOs continues to grow, it is important to understand the short- and long-term consequences of NFOO. This report examines the existing literature on the acute and chronic health and functional outcomes of individuals who experience NFOO, and also identifies differences in outcomes for NFOOs involving illicitly-manufactured fentanyl.

NFOO is a significant cause of opioid-related morbidity in the United States, and is of heightened interest to HHS Office of the Assistant Secretary for Planning and Evaluation given the sharp increase in fatal and non-fatal opioid overdoses as a result of the current fentanyl crisis. Compared to the first and second phases of the opioid epidemic, when the majority of opioid-related morbidity and mortality was associated first with prescription opioids and then with heroin, illicitly-manufactured fentanyl (IMF) is now the leading cause of fatal opioid overdoses (CDC, 2017; O'Donnell, Gladden, & Seth, 2017). People who consume IMF, either wittingly or unwittingly, are at higher risk for accidental overdose, experience comparatively atypical overdose-related side effects, have unique risk profiles, and are at higher risk for poorer health outcomes (Somerville, 2017). To our knowledge, no investigation has been conducted to examine whether the sharp increase in NFOOs over the last several decades is negatively impacting overdose victims' chronic physical and mental health outcomes. To investigate the status of the scientific literature regarding the consequences of NFOO on victims' physical and mental health, we conducted a scoping review of the existing knowledge in multiple stages: (1) publication identification; (2) selection of publications; and (3) data extraction, charting, and synthesis. Key findings from our review are presented below.

Findings from this scoping review confirm that NFOO is an important cause of morbidity among persons who misuse and abuse prescription and/or illicitly-manufactured opioids (e.g., heroin). The findings are summarily presented below and organized by three topics: (1) health outcomes associated with NFOO; (2) differing health outcomes for NFOOs that involve prescription opioids vs. heroin vs. IMF; and (3) the interaction between overdose victims' pre-existing health conditions and the health outcomes associated with NFOO.

Health Consequences of Non-Fatal Opioid-involved Overdoses

• Opioid-Induced Respiratory Depression
• Brain Injury
• Differences in Effects of Overdoses between Single, Multiple, and Recurring Opioid Overdose

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