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Temperature exposure and fatal overdose
Thanh T Lu1, Johanna Catherine Maclean2, Arnie Aldridge1
1RTI International Research Triangle Park, NC, United States.
Drug and Alcohol Dependence
|July 17, 2026
Summary
Extreme temperatures, both hot and cold, are linked to higher fatal drug overdose rates in the U.S. Opioid overdoses rose in cold weather, while stimulant overdoses increased in extreme heat.
Area of Science:
- Environmental Health
- Public Health
- Epidemiology
Background:
- Climate change presents health risks, including those from extreme weather events.
- Previous research linked temperature to physical and mental health outcomes.
- The association between temperature exposure and drug overdose risk was previously understudied.
Purpose of the Study:
- To investigate the relationship between ambient temperature exposure and fatal drug overdose rates in the United States.
- To determine if specific temperature ranges are associated with increased overdose mortality.
Main Methods:
- Utilized state-by-year and county-by-month fixed effect linear regressions.
- Analyzed fatal overdose data from the Multiple Causes of Death database (1999-2021).
- Derived temperature variables from NOAA Global Historical Climatology Network data, categorizing daily maximum temperatures.
Main Results:
- A significant association was found between temperature exposure and fatal overdose rates.
- Temperatures above 90°F were linked to a 0.2% annual increase in overdose rates compared to 70-80°F.
- Decreasing temperatures also correlated with increased overdose rates, ranging from 0.12% to 0.34%.
Conclusions:
- Both high and low ambient temperatures are associated with elevated fatal overdose rates.
- Opioid-related overdoses were linked to colder temperatures, while stimulant-related overdoses were associated with extreme temperatures.
- Further research into affected populations and physiological mechanisms is recommended for policy development.
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