Healthcare workers are significantly more likely to die from fatal drug overdoses than those working outside the field, according to a study published Aug. 7 in the journal Annals of Internal Medicine.
Researchers at New York City-based Columbia University's Mailman School of Public Health performed a prospective cohort study of 176,000 healthcare workers and 1,662,000 employed, non-healthcare workers over age 26. Participants were first surveyed in 2008, then followed for cause of death through 2019.
During the follow-up period, 0.07 percent of the total sample population died from a fatal drug overdose. Healthcare workers were at a significantly higher risk — particularly registered nurses, healthcare support workers, and social or behavioral health workers. The non-healthcare population's total drug overdose rate per 100,000 person-years, standardized by age and sex, was 7.3. Social or behavioral health workers' ratio nearly doubled that figure at 15.5. Healthcare support workers' overdose rate was 14.6, while RNs' was 11.
Healthcare workers' high risk for drug overdose is often overlooked because of their low-risk sociodemographic profile, according to the study's authors. The field leans heavily toward women, higher educational achievement and higher income — factors rarely associated with drug use.
However, many healthcare workers encounter drugs on a daily basis and often undergo physical and psychological strain, which could potentially override their otherwise low-risk profile, per the authors.
"This observation raises concerns over the extent to which substance use among healthcare workers compromises not only the health of affected clinicians but also the quality, effectiveness, and safety of the care they provide," the authors wrote. "High risks for drug overdose death among health care workers underscore the need for new initiatives to reduce health care worker stress, prevent burnout, identify at-risk workers, and, when necessary, accelerate their access to confidential substance use evaluation and treatment."
Despite a higher overdose risk in the healthcare worker population as a whole, there were two professions with a lower overdose rate than the general population: physicians and other treating or diagnosing professionals. Physicians' overdose rate was 2.3 — five deaths per 100,000 below the non-healthcare worker average. The authors acknowledged that this may be surprising, as physicians are typically associated with an increased suicide rate. Although this is true for female physicians, male physicians die by suicide less frequently than the general male population, according to the authors.