Non-Fatal Overdose: A Decade-Long Analysis of Inner-City Hospitals and Nationwide Trends Across Ireland (2011-2021)

Background

Non-Fatal Opioid Overdose (NFOD) represents a pressing public health concern, posing as a critical risk factor for subsequent fatal overdoses. Addressing NFOD comprehensively is pivotal in curbing the trajectory towards fatal outcomes and fostering a resilient public health landscape. The study's objective was to analyse the patterns and determinants of Non-Fatal Opioid Overdoses (NFODs) in two inner-city hospitals nationwide in Ireland from 2011 to 2021. The focus is on demographic trends, opioid usage patterns, temporal variations, and treatment modalities to identify factors contributing to regional disparities and inform targeted interventions for improved public health outcomes.

Method

The study employed a retrospective analysis of Non-Fatal Opioid Overdose (NFOD) data from two inner-city hospitals in the capital city and all other hospitals in Ireland from 2011 to 2021. Data examination focused on demographic attributes, opioid types, temporal patterns, and treatment interventions, providing a comprehensive understanding of NFOD dynamics.

Results

The inner city accounted for a significant one-third of all Non-Fatal Opioid Overdoses (NFODs), with 2020 experiencing the highest incidence, likely linked to pandemic-related factors. Despite the temporal distance, NFOD rates haven't reverted to pre-pandemic levels. A notable shift in opioid patterns was observed, marked by declining heroin overdoses in the inner city, now slightly trailing methadone-related NFODs, while "other opioids" cases increased. Outside the inner city, "other opioids" became the leading cause of NFOD, followed by heroin. Seasonally, NFOD incidents peaked in summer. Hospital stays decreased during the pandemic and haven't recovered. Treatment variations were evident, with inner-city hospitals favouring general health treatments, while mental health assessments were more common elsewhere (355 times vs five instances in the inner city from 2011-2021). These findings emphasise regional disparities, urging tailored interventions and policies addressing opioid types, temporal trends, and treatment modalities.

Conclusions 

The study highlights significant disparities in NFOD patterns between the inner city and the rest of Ireland. These findings underscore the need for targeted interventions and policy adjustments to address these variations in opioid types, demographic trends, and treatment modalities, thereby enhancing the effectiveness of healthcare strategies in mitigating NFOD incidents.