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Characterizing an intersection between heat-related illness and overdose deaths in Arizona: Analysis of data from the
Manuel Cano1, Charles Katz2, Jordan Batchelor2
1School of Social Work, Arizona State University, 411 N Central Ave, Phoenix, AZ 85004 USA.
Aims:
Extreme heat has been rising in cities worldwide, but relatively little is known about heat-related drug overdose deaths in the era of fentanyl and stimulants. Therefore, we examined overdose deaths with heat involvement recorded in one of the hottest US states-Arizona.
Method:
We analyzed data from the Arizona State Unintentional Drug Overdose Reporting System for all 12,384 Arizona unintentional/undetermined intent overdose deaths recorded in ages 15+, 2019-2023. The primary outcome was whether heat involvement was recorded as a cause of death. We examined monthly and yearly numbers of overdose deaths with heat involvement recorded and used logistic regression to test sociodemographic and toxicology correlates of heat involvement in overdose deaths.
Results:
Heat involvement was recorded in 7 % of Arizona overdose deaths (unintentional/undetermined intent, ages 15+) from 2019-2023 and 33 % of overdose deaths that occurred during July. Heat involvement was recorded in 3 % of overdose deaths in 2019 and 15 % of overdose deaths in 2023. Approximately 60 % of those who died of overdoses with heat involvement recorded were identified as experiencing homelessness. Among overdose deaths, adjusted odds of recorded heat involvement were higher in decedents with methamphetamine-positive toxicology (adjusted Odds Ratio [aOR] 3.58, 95 % Confidence Interval [CI] 2.61-4.92) and those experiencing homelessness (aOR 8.34, 95 % CI 6.74-10.32).
Conclusions:
Results document rising overdose deaths with heat involvement reported in Arizona, as well as key sociodemographic and drug-related risks overrepresented in these deaths, supporting the need for public health initiatives informed by intersectional risks of heat exposure, homelessness, and methamphetamine use.
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