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Record W4414867069 · doi:10.1111/add.70191

Heat exposure and drug overdose mortality in the USA

2025· article· en· W4414867069 on OpenAlexaboutno aff
Julia Dennett, Daniel Carrión, David A. Fiellin, Gregg Gonsalves

Bibliographic record

VenueAddiction · 2025
Typearticle
Languageen
FieldEnvironmental Science
TopicClimate Change and Health Impacts
Canadian institutionsnot available
FundersNational Institute on Drug Abuse
KeywordsDrug overdoseDrugPoison controlInjury preventionMEDLINEOccupational safety and health

Abstract

fetched live from OpenAlex

BACKGROUND AND AIMS: Understanding the relationship between heat and drug overdose mortality is critical given the ongoing overdose crisis and rising global temperatures driven by climate change. Evidence from local jurisdictions in the United States (US) and Canada indicates that exposure to heat is associated with increased drug overdose fatalities, but the widespread impact of heat on national drug overdose deaths is undetermined. We aimed to determine the effect of heat exposure on drug overdose mortality in the US. DESIGN: An observational study using monthly, county-level data from 1999 to 2020 and a fixed effect model estimated with linear regression. The model accounts for time-invariant county-month factors and state-level time-specific shocks. SETTING: All counties in the continental US during the months of June to September from 1999 to 2020. PARTICIPANTS: Decedents in the National Center for Health Statistics restricted Vital Statistics mortality data with a cause of death of a drug overdose, aggregated to county-level mortality rates. MEASUREMENTS: All drug overdose mortality rate per 100 000 population. The monthly average maximum heat index (measured in degrees Celsius) was collected from the Centers for Disease Control and Prevention National Environmental Public Health Tracking Network. FINDINGS: A one-degree Celsius increase in the heat index was associated with an increase in all drug overdose mortality by 0.0098 deaths per 100 000 population [95% confidence interval (CI) = 0.0057-0.014, P < 0.001], with significant effects for deaths related to opioids (0.0060 deaths, 95% CI = 0.0026-0.0095, P < 0.001), cocaine (0.0028 deaths, 95% CI = 0.0012-0.0045, P < 0.001) and psychostimulants (0.0028 deaths, 95% CI = 0.0015-0.0041, P < 0.001). In further analyses, larger impacts were observed after 2013, in counties with greater levels of social vulnerability and in suburban and urban counties. Estimates suggest that approximately 150 excess drug overdose deaths occurred per year during the hottest periods due to heat exposure. CONCLUSIONS: Exposure to heat appears to be associated with increases in drug overdose deaths in the United States in recent decades.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.014
Threshold uncertainty score0.568

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.035
GPT teacher head0.315
Teacher spread0.279 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations3
Published2025
Admission routes1
Has abstractyes

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