People who survive an opioid overdose remain at increased risk of dying from a variety of causes, including drugs, other medical problems or suicide, according to a new study.

People who lived through an opioid overdose were 130 times more likely than the general population to die of drug-related causes in the following year, HealthDay reports. They also were 45 times more likely to die of HIV, 40 times more likely to die of chronic respiratory diseases, and almost 30 times more likely to die of viral hepatitis, the researchers report in JAMA Psychiatry. Their risk of suicide was 25 times greater than the general population.

“Adults who survive heroin or prescription opioid overdoses are a medically frail population,” said lead author Mark Olfson. “The study findings bring a new perspective to the health care needs of people who survive opioid overdoses. Instead of just focusing on treating their drug use problems, we also need to ensure that these patients receive necessary medical and mental health care.”