b'Figure 1. Adjusted marginal probabilities of survival to hospital discharge with Cerebral Performance Category score (CPC)=1 or 2.Reproduced from Shekhar AC, Nathanson BH, Mader TJ, Coute RA. Cardiac Arrest Following Drug Overdose in the United States: An Analysis of the Cardiac Arrest Registry to Enhance Survival. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease. 2024;13(3):1. 2024 American Heart Association, Inc. Reproduced with permission. License obtained through the Copyright Clearance Center.ECONOMIC IMPACT OF OD-OHCABeyond the clinical implications, OD-OHCA poses a substantial economic burden. In a second study analyzing data from 2017 to 2020, OD-OHCA contributed to 11% of all disability-adjusted life years (DALYs) lost due to OHCA, despite accounting for only 6% of non-traumatic OHCA cases. 2 The economic impact is even more striking: the annual productivity loss per OD-OHCA case was approximately $64,000 in 2020, 30% higher than the $49,000 estimated for non-OD-OHCA. Over a lifetime, this difference is even greater, with OD-OHCA cases incurring an average lifetime productivity loss of $1.6 million, compared to $630,000 for non-OD-OHCA cases.This disproportionate economic impact is largely due to the younger age of OD-OHCA patients, whose premature deaths or long-term disabilities result in a greater loss of potential workforce contributions. If the opioid crisis continues to escalate, these costs will likely rise, underscoring the need for targeted public health initiatives.IMPLICATIONS FOR PUBLIC HEALTH AND POLICYThe findings from the CARES dataset emphasize the urgent need for improved strategies in both prevention and response to OD-OHCA. Enhancing community access to naloxone, increasing public awareness of opioid overdose symptoms, and expanding training for bystander CPR and naloxone administration are critical steps in mitigating the impact of OD-OHCA. Additionally, refining EMS protocols to optimize resuscitation efforts for overdose-related cardiac arrests can further improve survival outcomes. Furthermore, given the substantial economic burden, policymakers should prioritize harm reduction strategies and policies aimed at reducing opioid misuse and overdose risk.OD-OHCA represents a unique subset of OHCA cases with distinct epidemiological characteristics, survival outcomes, and economic consequences. While these patients have a higher likelihood of survival compared to other OHCA etiologies, the burden of disease and financial impact remain significant. By leveraging the insights gained from the CARES dataset, we can inform policy changes and public health initiatives that reduce the toll of drug overdose-related cardiac arrests on individuals, families, and society as a whole.1. Shekhar AC, Nathanson BH, Mader TJ and Coute RA. Cardiac Arrest Following Drug Overdose in the United States: An Analysis of the Cardiac Arrest Registry to Enhance Survival. J Am Heart Assoc. 2024;13:e031245.2. Coute RA, Nathanson BH, Shekhar AC, White CN, Kurz MC, Jackson EA, Mader TJ and Group CS. The Public Health and Economic Impact of Drug Overdose Out-of-Hospital Cardiac Arrest in the United States. Prehosp Emerg Care. 2024:1-7. 31'