The Role of Comorbidities in Opioid Overdose Risk: A Systematic Review

Abstract

The opioid overdose crisis has escalated into an international public health emergency, with mortality rates continuing to rise, a trend that was further intensified during the COVID-19 pandemic. Individuals with mental health conditions such as anxiety, depression, and thought disorders are at a heightened risk of opioid overdose, yet the relationship between mental health diagnoses and opioid overdose remains poorly understood. This systematic review aims to assess existing studies that explore the link between opioid overdose risk and diagnosed mental health disorders in developed countries, including North America, Western Europe, and Australia. Following PRISMA guidelines, the review examines 28 studies investigating the prevalence of both fatal and non-fatal opioid overdoses among individuals with mental health disorders. The findings consistently reveal a positive association between mood disorders, particularly depression and anxiety, and an increased risk of opioid overdose. The bidirectional relationship between mental health issues and opioid misuse highlights the critical need for integrated treatment approaches that address both psychiatric and substance use disorders. Future research should focus on longitudinal studies and the development of dual interventions targeting mental health and opioid use disorder (OUD) prevention for at-risk populations. To effectively combat the ongoing opioid overdose crisis, comprehensive harm reduction strategies and mental health programs must be implemented in a unified manner.