Abstract A multidimensional prediction model integrating genetic and socioeconomic factors was developed and validated to assess the risk of opioid overdose, aiming to facilitate individualized risk estimation and inform early clinical identification and preventive strategies. In this retrospective study, 340 patients with a history of opioid use were enrolled. Participants were randomly allocated to a training set (n = 238) or a validation set (n = 102) in a 7:3 ratio.