An overdose is a medical condition that can happen to anyone who uses drugs, whether the substances are obtained illegally, prescribed by a healthcare provider, or used recreationally. While overdose risk is often associated with heavy substance use, there are certain situations and periods in a person’s life when the risk becomes significantly higher.
Understanding when a person is most vulnerable to an overdose can help individuals, families, and communities take steps to prevent overdose-related injuries and deaths. Awareness of these high-risk periods is especially important given the widespread presence of potent synthetic opioids such as fentanyl.
How an Overdose Happens
An overdose happens when an individual takes more of a substance than their body can safely process. During an overdose, the body will essentially shut down because it cannot manage the substance in such a high quantity. Various factors, like the type of substance and the individual’s overall health, impact the outcome, but an overdose can cause difficulty breathing, loss of consciousness, seizures, heart problems, organ failure, coma, and death. While overdoses can involve many substances, including alcohol, stimulants, and prescription medications, opioid overdoses remain a leading cause of overdose deaths.
The Highest-Risk Time: After a Period of Abstinence
One of the most dangerous times for overdose is after a person has stopped using drugs for a period of time and then returns to use. When someone regularly uses a substance, their body develops tolerance. Tolerance means larger amounts of the substance are needed to achieve the same effect. After days, weeks, or months without using, tolerance begins to decrease. If the individual returns to using the same amount they previously used before abstinence, their body may no longer be able to handle that dose. As a result, the risk of overdose increases dramatically.
Following Treatment
Many people assume the risk of overdose ends after completing treatment. In reality, the weeks immediately following treatment can be one of the most vulnerable periods.
Individuals leaving treatment often experience a reduced drug tolerance, which is potentially harmful on its own, but at the same time, the person may experience exposure to triggers and stressors. Treatment, especially in-patient treatment, can create a safety bubble, and when that routine ends, a person may fall back into old habits.
A strong aftercare plan and recovery support system will drastically reduce the risk of relapse and therefore overdose. This is why continuing care, therapy, and support groups are critical components of long-term recovery.
When Using Alone
Using substances alone significantly increases the likelihood that an overdose will become fatal.
If a person overdoses while alone:
- No one may recognize the emergency
- There is no one present to call emergency services
- Life-saving interventions may not happen in time
Many overdose deaths occur because there is no one present to respond when symptoms begin.
Mixing Substances
Combining substances, also known as poly-substance use, can dramatically increase overdose risk. The substances may interfere with one another. It’s also likely, when impaired, a person may take more of another substance, causing an overdose. Particularly dangerous combinations include:
- Opioids and alcohol
- Opioids and benzodiazepines
- Alcohol and benzodiazepines
- Multiple sedative medications
Even when an individual feels confident because they have combined multiple substances previously, it can be dangerous due to potency, health status, or tolerance.
When Potency is Unknown
It’s impossible to fully grasp the risk of the unknown, because you simply don’t know what you’re dealing with. Illicit drugs have become increasingly unpredictable because many drugs are now contaminated with fentanyl or other synthetic substances that are significantly more potent.
A person may think they know what they’re using and feel a sense of safety or understanding, because they’ve done this before without issue. If the substance contains fentanyl or other dangerous additives, that poses a huge unknown. This unpredictability has contributed to a sharp increase in accidental overdoses in recent years.
After a Significant Life Stressor
Major life events can increase overdose risk, especially among individuals with a history of substance use disorder. Everything from relationship problems, job loss, financial difficulties, grief and loss, and mental health crises can push someone to go back to using. Stress can increase cravings and contribute to relapse, which may place individuals at greater risk for overdose.
People With Co-Occurring Mental Health Conditions
Mental health conditions can elevate the overdose risk. Coping with two conditions simultaneously is very difficult. Integrated treatment specifically designed to address both substance use and mental health concerns can help reduce these risks.
How Overdose Risk Can Be Reduced
While overdose cannot always be prevented, understanding the dangers can help reduce risk. The most effective way to reduce the risk is to seek professional help for substance use disorders and participate in ongoing recovery support. It’s essential to avoid substance use after periods of abstinence and understand the dangers of mixing substances. Carrying opioid overdose reversal medications when appropriate allows you to help others experiencing an overdose.
Managing Risk
A person can be at risk of an overdose at many points during substance use. Some situations are especially dangerous. Understanding when a person is at risk can help you mitigate the danger and take the necessary steps if an overdose occurs. Many overdose deaths are preventable, giving individuals the opportunity to build healthier lives.
