Predictors of fatal and nonfatal overdose after prescription of opioids for chronic pain: a systematic review and meta-analysis of observational studies

Moderate- to high-certainty evidence supported large relative associations with history of overdose, higher opioid dose, 3 or more prescribers, 4 or more dispensing pharmacies, prescription of fentanyl, current substance use disorder, any mental health diagnosis, depression, bipolar disorder or pancreatitis, with absolute risks among patients with the predictor ranging from 2–6 per 1000 for fatal overdose and 4–12 per 1000 for nonfatal overdose.