Drug Overdose Affects Many Healthcare Workers

According to a soon-to-be-released study led by researchers at Columbia University Mailman School of Public Health and Columbia University Irving Medical Center, registered nurses, social workers, and other behavioral health workers, as well as those in health care support, are at significantly higher risk of drug overdose death than non-healthcare workers. Despite the unprecedented surge in recent drug overdose deaths in the United States, the hazards faced by health care professionals were unknown until today. The findings have been published online in Annals of Internal Medicine (link opens in a new window).

The researchers evaluated the risks of drug overdose death among health care workers and non-health care employees using a nationally representative cohort from the 2008 American Community Survey (ACS) tracked for mortality through 2019. The researchers analyzed data to determine drug overdose deaths for six health care worker groups, including physicians, registered nurses, other diagnosing or treating health care workers, health technicians, health care support workers, and social or behavioral health workers, versus non-health care workers, in order to estimate risks for drug overdose death among health care workers relative to non-health care workers.

After controlling for age and gender differences, social workers and other behavioral health workers were 112 percent more likely, health care support workers were 100 percent more likely, and registered nurses were 51 percent more likely to die from a drug overdose than non-healthcare workers. The results for opioid-related overdose deaths and unintentional overdose deaths were generally similar. Overall, 84.5 percent of drug overdose deaths among health care professionals were opioid-related, with the remaining 76 percent being unintentional. Non-health care employees experienced 76 percent opioid-related deaths, with 85 percent being unintended.

“Several factors could place health care workers at increased risk for drug overdose death,” said Mark Olfson, MD, MPH, professor of Epidemiology at Columbia Public Health and professor of Psychiatry, Vagelos College of Physicians & Surgeons. “Those who prescribe or administer medications have ready access to opioids and other controlled prescription drugs and also frequently have job stress and occupational burnout – all of which have been associated with increased risk for opioid use disorder, which in turn can increase the risk for overdose. Many health care workers also routinely do physically strenuous tasks that can lead to injuries that can result in opioid prescriptions to manage pain and attendant risks.”

Despite the heightened risks of health care worker groups, there is a scarcity of programs specialized to treating substance use disorders in health care professionals.

“Although recent progress has been made in developing specialized programs to provide substance use treatment for physicians, few programs exist for other health care professionals with substance use problems who were found in this study to be at increased risk,” observed Olfson, who is also a research psychiatrist at New York State Psychiatric Institute. “More generally, these new findings draw attention to the importance of identifying health care workers who may be struggling with substance use problems, helping them to access confidential and effective treatment. We further urge that subsequent research studies consider deeper, more granular details, including the specific nature of work within each occupational group that could contribute to overdose risk.”

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