Background
Drug overdose deaths remain a significant and understudied public health concern in Brazil. This study aimed to examine drug overdose death records from 2000 to 2020, focusing on the relationship between mood disorders and intentionality, along overall sociodemographic characteristics.

Methods
Data from the Brazilian Mortality Information System from 2000-2020 were analyzed. Records with causes of death coded as X40–X45 (accidental poisoning), X60–X65 (intentional poisoning), or Y10–Y15 (undetermined intentionality poisoning) were included. The dataset comprised 21,410 deaths, including 933 subjects with mood disorders (ICD-10 codes F30-F39). A descriptive analysis of sociodemographic variables, stratified by mood disorders, was conducted. Logistic regression models identified independent associations with intentional overdose deaths.

Results
People who died of a drug overdose were mostly men (61.55%), non-white (52.45%), and single (59.33%). Most drug overdose deaths were intentional (44.70%). Compared to overall overdoses, the subset with mood disorders included a higher share of women (67.95%), whites (63.88%), and intentional overdoses (75.24%). Female gender (OR 1.30), mood disorder (OR 2.0), non-white race (OR 0.56), high school graduates (OR 0.93), some college education (OR 1.28), and divorced or widowed (OR 0.73) were independently associated with intentional overdose deaths.

Conclusion
The sociodemographic characteristics of people who died of overdoses must guide national public policies. Strategies might involve conducting screenings for mental health disorders and drug-related problems in primary care.