b'RESEARCH HIGHLIGHTSDrug Overdose Out-of-Hospital Cardiac Arrest in the United States: Insights from CARES DataBy Ryan A. Coute, DO, Department of Emergency Medicine, University of Alabama at Birmingham Heersink School of MedicineThe opioid epidemic has contributed to a rise in out-of-hospital cardiac arrest (OHCA) cases throughout the United States. While OHCA has long been associated with underlying cardiac conditions, recent data from the Cardiac Arrest Registry to Enhance Survival (CARES) highlights that a substantial portion of OHCAs are attributable to drug overdose. Our research explored the epidemiology, survival outcomes, and economic burden of overdose-attributable OHCA (OD-OHCA) to help inform public health interventions and policy decisions.EPIDEMIOLOGICAL TRENDS AND SURVIVAL OUTCOMESBetween 2017 and 2021, the CARES dataset documented 29,500 cases of OD-OHCA, making up approximately 8% of all non-traumatic OHCAs. 1Compared to other causes of OHCA, OD-OHCA was found to disproportionately affect younger individuals, with a median age of 37 years, significantly lower than the 64-year median for non-overdose OHCA patients. Furthermore, these arrests were less likely to be witnessed, reducing the likelihood of immediate resuscitation efforts.Despite these challenges, OD-OHCA patients demonstrated higher survival rates and better neurological outcomes compared to non-OD-OHCA cases. The overall survival rate with a favorable neurological outcome for OD-OHCA patients was 15.2%, more than double the 6.9% observed in other OHCA cases. This discrepancy was particularly pronounced in patients presenting with non-shockable rhythms, where OD-OHCA cases had a significantly higher rate of survival with a favorable neurological outcome (9.6%) compared to non-OD-OHCA cases (3.1%) (P0.001) (Figure 1B). These findings suggest that while drug overdoses lead to respiratory compromise resulting in cardiac arrest, they may retain a higher degree of reversibility compared to other causes of OHCA.30'