What Risk Factors Contribute to an Overdose?

Having a History of Past Overdose

• If a person has overdosed before, they are more likely to overdose again. 

Injecting or Smoking the Drug

• A person’s risk of overdose can increase depending on how they consume the drug. The chart below shows how risk changes with how the drug is consumed (in order from lease risky to most risky). However, all of these ways to use the drug have a high risk of overdose, and naloxone should be carried regardless of route of use.

Using more potent or stronger drugs

• The strength of street drugs are unpredictable-the user doesn’t really know what’s in them or how strong they are. The more pure the drug, the greater the overdose risk.

The body’s tolerance/intolerance to different drug amounts

• A person’s body develops a tolerance, or gets used to a drug, the more they use it. That means a person will keep needing more of the drug to get the same effect over time.
• Sometimes people go through a time of not using the drug (e.g., when in jail or detox treatment). 
• During those times, their tolerance is lowered, and they can’t handle the same dose as before, putting them at a higher risk of an overdose. 

Having a history of certain health problems and other factors

• People who currently have, or have had, a history of these health issues are more likely to overdose:
  • Substance use disorder
  • Mental illnesses (bipolar disorder, schizophrenia, depression)
  • Respiratory conditions (COPD/asthma and sleep apnea)
  • Medical illness (liver, heart, kidney, heart disease, HIV/AIDS)

Mixing other drugs with opioids

• Any drug that slows down the nervous system mixed with opioids increases overdose risk. That includes:
  • Alcohol
  • Anti-anxiety medication like Xanax®, Ativan® and other benzodiazepines
  • Stimulants such as methamphetamine and cocaine