Evaluating opioid overdose using the National Violent Death Reporting System, 2016

•Characteristics of victims differ significantly by type of opioid causing the death.•Efforts to curb opioid-related overdose should be specific to opioid type.•Interventions for pharmaceutical opioids should target females and older adults.•Interventions for illicit opioids should target younger audiences. Unintentional opioid overdose death rates have increased nearly 500% in Connecticut from 1999 to 2016, resulting in a major public health crisis. Two primary types of opioids have been implicated in these fatalities – illicit and pharmaceutical. The objective of this study is to describe the epidemiology of fatal unintentional opioid overdoses by type. Using the National Violent Death Reporting System, rates of unintentional opioid-related overdose death in Connecticut were calculated. Demographic and contextual characteristics (e.g., substance misuse, mental health issues), and concomitant drug use (e.g., benzodiazepines, cocaine) were compared by opioid type. In 2016, 867 victims of fatal unintentional opioid overdose were identified in Connecticut. The majority of deaths involved illicit opioids (79.6%). Overall, victims were mostly male, white, non-Hispanic, and aged 25–54 years. Victim sex, age, and contextual characteristics differed significantly according to opioid type. For illicit opioid deaths, victims were predominantly male, aged 44 and under, and more often had a history of substance misuse. In contrast, among pharmaceutical opioid deaths, the split between males and females was significantly less pronounced, victims were mostly aged 45 and over, and mental health diagnoses, a physical health problem and concomitant drug use were more prevalent. Based on our findings, efforts to curb opioid-related overdose should be specific to opioid type. Interventions pertaining to pharmaceutical opioids should target females and older adults, whereas interventions for illicit opioid use should target younger audiences.