Byregowda Himani, Susukida Ryoko, Amin-Esmaeili Masoumeh, Wilson Monique, Stratton Marie, Johnson Renee M
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Inj Prev. 2025 Sep 23;31(5):408-411. doi: 10.1136/ip-2023-045116.
Data on fatal and non-fatal overdose provide important information about the magnitude of the overdose crisis. We consider these metrics in tandem and estimated the ratio of opioid overdose-related emergency department (ED) visits to opioid overdose deaths. A lower ratio could indicate more fatal overdoses, fewer overdose reversals with naloxone or a combination of both.
Data are from the Maryland Vital Statistics Administration (opioid overdose deaths), the Health Services Cost Review Commission (non-fatal ED visits for opioid overdose). We generated 2020 annual rates of fatal and non-fatal opioid overdose deaths for the state of Maryland and its 24 jurisdictions and estimated the ratio of opioid overdose-related ED visits to deaths.
The 2020 visit-to-death ratio for Maryland was 1.7, and ranged from 0.9 to 3.8 across jurisdictions. We identified five counties that had above-median rates of opioid overdose-related ED visits and deaths, and low visit-to-death ratios.
Our findings indicate that there were nearly two ED visits for each opioid overdose death in Maryland, and there was substantial variation across counties. The visit-to-death ratio enables a better understanding of the relationship between fatal and non-fatal opioid overdose and is essential to averting deaths and evaluating overdose prevention efforts.
