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Considerable attention has been directed toward the epidemic of overdose deaths in patients who use opioids outside of a prescription. In a systematic review and meta-analysis of 124 publications addressing extramedical opioid use in 28 countries, researchers highlight the additional mortality associated with such use.
In analyses of standardized mortality ratios, users of illicit opioids had 10 times the expected mortality from all causes. The risk for death was highest in Southeast Asia and lowest in North America. Increased risk for death was noted for suicide (7.9 times that in the general population), accidents (6.9 times), interpersonal violence (9.8 times), AIDS (18.5 times), and cancer, cardiovascular disorders, and respiratory disea…