Send to

Choose Destination
Drug Alcohol Depend. 2014 Jan 1;134:12-21. doi: 10.1016/j.drugalcdep.2013.10.007. Epub 2013 Oct 24.

Association between depression and non-fatal overdoses among drug users: a systematic review and meta-analysis.

Author information

Department of Surgery and Interdisciplinary Medicine, University of Milano Bicocca, Milano 20126, Italy.
Mental Health Sciences Unit, Faculty of Brain Sciences, University College London, W1W 7EJ, UK. Electronic address:
Department of Mental Health, San Gerardo Hospital, Monza 20900, MB, Italy.
Medical and Biological Sciences Building, University of St Andrews, North Haugh, St Andrews KY16 9TF, UK.
Division of Neuroscience, Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.



Assessing factors associated with non-fatal overdose is important as these could be useful to identify individuals with substance use disorders at high risk of adverse outcomes and consequences. Depression may play an important role in terms of overdose risk. We aimed to test if drug users suffering from a depressive disorder might have significantly higher risk of non-fatal overdose as compared with drug users without depression.


We conducted a systematic review and meta-analysis. PubMed, Embase and Web of Knowledge were searched. The pooled analyses were based on prevalence rates, risk difference (RD) and odds ratio (OR), reporting 95% confidence intervals (CIs). The combined estimates were obtained weighting each study according to random effects model for meta-analysis.


Seven articles, involving 12,019 individuals, and run in the US, Canada, Sweden, Norway, and Australia, were included. Pooled analyses comparing depressed with not depressed individuals highlighted a RD (95% CIs) for non-fatal overdose of 7.3% (4.8-9.7%) and an OR (95% CIs) of 1.45 (1.17-1.79). The subgroups analyses based on specific characteristics of included studies confirmed the association between depression and overdose.


Depressive disorders seem to be important factors associated to the risk of non-fatal overdose. Longitudinal studies might appropriately clarify causal inference issues. Future research should address the role of depressive disorders as predictors of subsequent non-fatal overdoses.


Depression; Drug overdose; Meta-analysis

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center