Impact of a shelter-in-place order during the COVID-19 pandemic on the incidence of opioid overdoses

Lucas, Nicole; Zandrow, Gregory; Satz, Wayne A.; Isenberg, Derek; D'Orazio, Joseph; Gentile, Nina; Schreyer, Kraftin E.

doi:10.1016/j.ajem.2020.12.047

Cited by 31 publications

(38 citation statements)

References 18 publications

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“…For example, an observational study of state emergency medical services found an increase in opioid overdoses following the declaration of a state of emergency in Kentucky, United States [62] . Similarly, a retrospective observational study of the incidence of opioid overdoses in US hospital system indicated that the pandemic was associated with an increase in the proportion of opioid overdoses within emergency de- partment visits [63] . Overdoses also seemed to be greater in marginalized communities e.g.…”

Section: Resultsmentioning

confidence: 99%

Substance, use in relation to COVID-19: A scoping review

Kumar

Janmohamed

Nyhan

et al. 2022

Addictive Behaviors

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Background We conducted a scoping review focused on various forms of substance use amid the pandemic, looking at both the impact of substance use on COVID-19 infection, severity, and vaccine uptake, as well as the impact that COVID-19 has had on substance use treatment and rates. Methods A scoping review, compiling both peer-reviewed and grey literature, focusing on substance use and COVID-19 was conducted on September 15 2020 and again in April 15 2021 to capture any new studies. Three bibliographic databases (Web of Science Core Collection, Embase, PubMed) and several preprint servers (EuropePMC, bioRxiv, medRxiv, F1000, PeerJ Preprints, PsyArXiv, Research Square) were searched. We included English language original studies only. Results Of 1564 articles screened in the abstract and title screening phase, we included 111 research studies (peer-reviewed: 98, grey literature: 13) that met inclusion criteria. There was limited research on substance use other than those involving tobacco or alcohol. We noted that individuals engaging in substance use had increased risk for COVID-19 severity, and Black Americans with COVID-19 and who engaged in substance use had worse outcomes than white Americans. There were issues with treatment provision earlier in the pandemic, but increased use of telehealth as the pandemic progressed. COVID-19 anxiety was associated with increased substance use. Conclusions Our scoping review of studies to date during COVID-19 uncovered notable research gaps namely the need for research efforts on vaccines, COVID-19 concerns such as anxiety and worry, and low- to middle-income countries (LMICs) and under-researched topics within substance use, and to explore the use of qualitative techniques and interventions where ap- propriate. We also noted that clinicians can screen and treat individuals exhibiting substance use to mitigate effects of the pandemic. Funding Study was funded by the Institution for Social and Policy Studies, Yale University and The Horowitz Foundation for Social Policy. DH was funded by a NIDA grant (R01DA048860). The funding body had no role in the design, analysis, or interpretation of the data in the study.

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Section: Resultsmentioning

confidence: 99%

Substance, use in relation to COVID-19: A scoping review

Kumar

Janmohamed

Nyhan

et al. 2022

Addictive Behaviors

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“…A spike in emergency department visits for nonfatal opioid overdoses was observed when comparing data from March to June of 2019 vs. 2020 [ 17 ▪ ]. However, Rosenbaum et al [ 18 ▪ ] found a reduction in opioid overdoses after Philadelphia's shelter in place order was put into effect vs. prior to its implementation.…”

Section: Overdose Riskmentioning

confidence: 99%

Converging public health crises: substance use during the coronavirus disease 2019 pandemic

Striley

Hoeflich

2021

Current Opinion in Psychiatry

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Purpose of review The international, public health crisis caused by the rapid spread of SARS-CoV-2 has resulted in unforeseen medical and psychiatric consequences. We reviewed publications from January 2020 to January 2021, given that earlier documents were not relevant, to review findings on changes in substance use and overdoses during the pandemic. Additionally, this review of the literature also documents advocacy efforts, health service modification and challenges, as well as COVID-related health complications associated with substance use. Recent findings Recent work focused on identifying changes in the distribution and use of substances as well as the unique challenges to promoting the health of persons who use substances in the current pandemic. Although COVID-19 has triggered unprecedented innovations in the organizational and public policy, the use of certain substances (alcohol, cannabis, cigarettes, fentanyl, heroin, and opiates) is increasing internationally. Unique associations between substance use and pandemic-related adverse health outcomes were identified. In addition, the pandemic precipitated significant barriers and disruptions to care. Summary Given increased overdose rates and infections among people who use drugs, continued surveillance and vigilance are needed to assess changes and reduce use and adverse consequences during the continuing COVID-19 crisis. Changes are urgently needed to reduce adverse health outcomes because of treatment barriers and lack of adequate treatment options. Additionally, integrative approaches are necessary to promote the public health of persons who use substances.

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“…Current evidence suggests the scale of the pandemic and lockdown procedures might have exacerbated overdose events. 7 By contrast, increasingly accessible treatment during COVID-19 could have the potential to reduce overdose deaths. 8 Community availability of naloxone and interventions at the first responder or emergency department level might also reduce fatal overdose events, in addition to treatment availability broadly (eg, buprenorphine and other opioid antagonists).…”

Section: Pushing the Boundaries Of Prediction To Address The Opioid Crisismentioning

confidence: 99%