Tropical cyclones, such as hurricanes and tropical storms, are associated with a rise in drug-related deaths for up to three months after landfall, according to a study by researchers at Columbia University Mailman School of Public Health. The findings, published in JAMA Network Open, highlight an underrecognized health consequence of climate change as storms become more frequent and severe.
The research is the first to measure the link between exposure to tropical cyclones and psychoactive drug–related deaths using demographic and socioeconomic data. It found that increases in drug-related death rates were most notable in higher-income, White communities and among younger people. In contrast, lower income communities of color showed little or no increase in risk; some estimates even suggested a reduction.
Researchers suggest that wealthier communities may see a spike in misuse or overdose when healthcare systems are disrupted by storms and prescriptions go unmonitored. Disrupted access to drugs like tranquilizers or stimulants may also push individuals toward more dangerous substances, including those containing fentanyl. Meanwhile, reduced purchasing power and interruptions in illicit drug markets may explain the lack of increased risk among lower income communities of color.
"Tropical cyclones, which have increased in strength, intensity, duration, and activity over recent decades, may exacerbate the ongoing crisis of drug overdoses. It is critically important that policymakers and public health authorities integrate substance use and mental health services into climate disaster preparedness and response planning," said Robbie M. Parks, PhD, assistant professor at Columbia Mailman and senior author of the study.
The effect was particularly strong among younger populations. For individuals aged 15 to 29 years old, each additional day of hurricane exposure was linked to a 30 percent increase in death rates during the month of exposure. Elevated risks were also seen among people aged 15 to 44 years after any tropical cyclone event. The authors note that young adults might be especially vulnerable due to employment instability or disruptions in access to care.
The study analyzed National Center for Health Statistics death records from 1988-2019 across mainland U.S. counties affected by at least one tropical cyclone during this period. County population data came from the US Census Bureau and NCHS datasets. Cyclone exposure was defined by days with sustained winds of at least 34 knots using wind field modeling from NOAA data.
Each extra day per month exposed to a tropical cyclone correlated with nearly a four percent rise in psychoactive drug–related deaths both during the storm month (3.84 percent) and the following month (3.76 percent). Risks remained elevated three months later (2.39 percent). Although results for hurricanes alone were not statistically significant, each additional hurricane-exposed day still corresponded with a seven percent increase in deaths during the exposure month.
Over the 31-year span studied across all affected counties, researchers estimated there were about 1,235 excess psychoactive drug-related deaths tied to cyclone exposure—averaging roughly 40 extra deaths annually.
"For every person who dies from drug-related causes in the days and weeks after a tropical cyclone, there are many others who may see other health-related impacts that accumulate over years. We haven't begun to explore those impacts that occur further down the line, say a year or five years after a tropical cyclone. That's something we'd like to investigate next," said Spriggs.
Robbie M. Parks has previously published work showing hurricanes have become deadlier over time—with most hurricane-related deaths now occurring in socially vulnerable counties—and on geographic patterns related to hurricane evacuation as well as links between temperature changes and hospital visits for substance disorders or violence.
Other contributors included Victoria D. Lynch, Yuanyu Lu, Lincole Jiang, Katherine M. Keyes, Diana Hernández, Anne E. Nigra (Columbia Mailman), Wil Lieberman-Cribbin (Northwell Health), Brooke Anderson (Colorado State University), Marianthi-Anna Kioumourtzoglou (Brown University).
Funding came from grants provided by the National Institute of Environmental Health Sciences and National Institute on Aging.
Keyes reported receiving consulting fees as an expert witness in national prescription opioid litigation during this research; Parks received consultancy fees from work with the International Food Policy Research Institute.
