Is there a Connection Between Cold Weather and Opioid Overdoses?

I saw an article in U.S. News that shed entirely new and unique light on addiction and drug overdoses. This news piece sought to determine the correlation between increasing overdose statistics and cold weather. Coming from the Midwest myself and having worked in addiction treatment centers in some of the coldest regions of the contiguous United States, I thought there might be something to this.

The Brown University research team studied the details of more than 3,000 opioid-related drug overdose deaths that occurred in Connecticut and Rhode Island between 2014 and 2017. While the research cannot prove that cold weather causes more overdoses, it certainly does seem from the research that opioid overdoses do increase immediately following a cold snap. We need to look at the factors that might contribute to that phenomenon. Is it just that the temperature dropped? Was that enough to cause more people to overdose? Were other factors involved? Is there a behavioral connection between cold weather and drug use?

The Details of the Research

The Brown University researchers worked with the Rhode Island Department of Health and the Prevent Overdose R.I. group to study the correlation between overdoses and cold weather. U.S. News has a good summary of the research paper, but a comprehensive examination of the research can be found at the Brown University website.

According to the Brown research, there was a 25 percent increase in fatal opioid overdoses in the days immediately following periods of freezing temperatures. To ensure accuracy, that data was compared to overdose rates on days where the average temperature was 52 degrees. Time and time again, fatal overdose rates peaked when the temperature dropped.

The researchers looked at the average temperatures in the regions studied on the days that people in those areas died from drug overdoses. According to Brown University’s publication: “They (the researchers) compared the average temperature on the day of each death—and up to two weeks before—to the average temperature of three reference days in the same month. They found that an average temperature of 32 degrees three to seven days prior to day of death was associated with a 25 percent increase in the risk of fatal overdose compared to periods with an average temperature of 52 degrees.”

There is a connection here.

In the U.S. News article, several reasons are given for why overdoses are occurring in greater proximity to cold weather. And we can arrive at these same conclusions just via logic, too. Here are some of the reasons why an addict might be more likely to die from an overdose during a cold weather spell:

• Opioids and cold weather both make breathing more difficult. A severe slow-down of breathing coupled with lowered heart rate is a crucial part of an opioid overdose and what ultimately ends up taking the person’s life. If a person is already taking too much of an opioid drug, the presence of cold weather could make an opioid overdose more likely.
• Cold weather also changes behavior. Many people become more depressed, more sullen, and more gloomy during cold weather. They are less active. They’re more likely to be alone, they’re more likely to be at home, and they’re more likely to be in a position where drug use seems appealing to them. And as opioids are a depressant drug (unlike the stimulant, party/designer drugs that are more common in the summer months) an individual might erroneously see a depressant drug as an excellent way to forget about a recent winter chill.
• Another factor is that, because people are more likely to be at home on their own in the wintertime, it is less likely that they will have someone around them who can administer naloxone to reverse an overdose, i.e., to prevent a fatal overdose from taking place.
• Historically, commerce slows down in the winter months, as does employment. If people in colder states lose their jobs or get laid off, it is more likely to be during the winter versus the summer, and that could lead to experimental drug use to cope with the fact that one does not have a job and is now facing a troubling financial situation.

What can we do with this information? It is a groundbreaking study, even if the “Correlation does not imply causation” rule applies. We might not be able to prove that cold weather causes more overdoses, but the fact that more overdoses are associated with severe weather gives us new information with which to battle the opioid crisis.

The Main Takeaway

If we step back for a minute, it doesn’t matter that we cannot prove one way or another if cold weather causes drug overdoses or not. Just the fact that overdoses are more prominent following cold weather is enough information to act on. We can use this data as a powerful incentive to get out there and work extra hard to prevent fatal overdoses during the winter months. This is a time to check on family members and loved ones, to volunteer for community efforts towards treating addicts and preventing drug overdoses, and to donate to non-profit groups that seek to rehabilitate addicts and prevent deaths.

“It is well known that opioids induce respiratory depression, and that’s what causes a fatal overdose. However, there may be a host of other risk factors that contribute to opioid overdose deaths which could be avenues for effective interventions.”

In the words of professor Brandon Marshall, an associate professor of epidemiology at Brown University’s School of Public Health and one of the study authors for the research: “It is well known that opioids induce respiratory depression, and that’s what causes a fatal overdose. However, there may be a host of other risk factors that contribute to opioid overdose deaths which could be avenues for effective interventions. Regardless of what is causing the correlation between cold weather and fatal overdoses, our findings suggest that agencies and organizations should consider scaling up harm-reduction efforts after a period of cold weather.”

There’s a lot of value in that statement. The main takeaway here is that drug overdoses increase following a cold snap. Regardless of the cause, that is the fact of the matter. Let’s take that information as inspiration to do everything we can to prevent overdoses, especially when Jack Frost comes to knock at our door.

Sources:

• https://www.usnews.com/news/health-news/articles/2019-06-19/fatal-opioid-ods-rise-as-temperatures-fall
• https://www.brown.edu/news/2019-06-17/cold-overdoses

Reviewed and Edited by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP