Opioid overdose decedent characteristics during COVID-19

Garcia, Gian‐Gabriel P.; Stringfellow, Erin; DiGennaro, Catherine; Poellinger, Nicole; Wood, Jaden; Wakeman, Sarah E.; Jalali, Mohammad S.

doi:10.1080/07853890.2022.2067350

Cited by 40 publications

(34 citation statements)

References 30 publications

(28 reference statements)

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“…Overall, the highest plateau was observed in the West Census region, followed in descending order by South, Midwest and Northeast. Variability in these profiles is consistent with recent reports focusing on all opioid overdoses (i.e., not only those due to synthetic opioids), for selected states ( 25 , 26 , 40 ). Future studies could examine the relationship between different relative increases in mortality across regions and States, and diverse public health measures enacted after the onset of COVID-19.…”

Section: Discussionsupporting

confidence: 90%

“…Sigmoidal equations (including the sigmodal Boltzmann model) have been used for epidemiological and opioid clinical pharmacology studies ( 32 , 37 , 38 ). The sigmoidal Boltzmann model was used to fit minimum and maximum (i.e., bottom and top) plateaus for mortality due to synthetic opioids, and the midpoint of the rise in mortality ( 23 , 25 ). Data sets from the 29 authorities which had a detected maximum plateau in the last 4 months of the study period (as defined above; Table 1 ) were entered in an overall Boltzmann sigmoidal equation model, using GraphPad Prism (V.9) software.…”

Section: Methodsmentioning

confidence: 99%

“…The time-dependent increase in opioid-induced overdoses after the onset of COVID-19 was recently examined in 11 states (ending in August–December 2020) ( 25 ). This study reported heterogeneous profiles across these 11 states, for different kinds of opioids, including potential stabilizing trends in some states (i.e., tending toward a plateau).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Has the United States Reached a Plateau in Overdoses Caused by Synthetic Opioids After the Onset of the COVID-19 Pandemic? Examination of Centers for Disease Control and Prevention Data to November 2021

Brown

Chen²,

Dong³

et al. 2022

Front. Psychiatry

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BackgroundOverdoses caused by synthetic mu-opioid receptor (MOR) agonists such as fentanyl are causing increasing mortality in the United States. The COVID-19 pandemic continues to have complex effects on public health, including opioid use disorders (OUD). It is unclear whether recent increases in mortality caused by synthetic opioids have reached a plateau (i.e., a stable period), after the onset of the COVID-19 pandemic.MethodThis study examined provisional overdose mortality data from the Centers for Disease Control and Prevention, for synthetic opioids excluding methadone (code T40.4; monthly data available from 39 States, plus New York City and Washington DC), for June 2019–November 2021. Data were first examined as crude mortality rates. The presence of a maximum plateau was analyzed for the last 4 months of available data. For authorities in which a plateau in mortality was detected, sigmoidal Boltzmann equations were used to model parameters of this phenomenon (e.g., level of the plateau).ResultsAt the end of the study period, all but one authority (New Hampshire) reported increases in mortality rates for synthetic opioids, compared to the baseline month of June 2019 (range: 111–745% of baseline). A plateau was observed over the last 4 months of the study period (Aug 2021–Nov 2021) in 29 of the authorities. Ten other authorities had not reached a stable plateau at the end of the study period. For the authorities where a plateau was detected, a sigmoidal Boltzmann model revealed a fitted maximum of 262% rise in mortality over the study period, from the baseline month. The midpoint in the rise in mortality was fitted in September 2020. After separation of data into census regions, the highest plateau was observed in the West region, followed by South, Midwest, and Northeast (fitted plateau values were 409, 262, 204, and 149% of baseline, respectively).DiscussionThere were increases in overdose mortality due to synthetic opioids across most states, ranging considerably in magnitude. A plateau in overdose mortality was detected at the end of the study period in most of these authorities. The reasons for these plateaus should be explored, in order to develop optimized public health interventions.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Has the United States Reached a Plateau in Overdoses Caused by Synthetic Opioids After the Onset of the COVID-19 Pandemic? Examination of Centers for Disease Control and Prevention Data to November 2021

Brown

Chen²,

Dong³

et al. 2022

Front. Psychiatry

View full text Add to dashboard Cite

show abstract

“…Our research is consistent with other research on the impacts of COVID-19 on opioid overdose deaths. Significant increases in opioid-related mortality were seen across the United States [ 38 , 39 ], with increases occurring during social distancing and continuing during reopening [ 40 ]. Although substance use treatment was considered an essential service during the height of the pandemic, staff and counselors who had a positive COVID-19 test or were exposed to a confirmed case were required to stay home for up to two-weeks, leaving many treatment centers understaffed and individuals already at risk of an overdose without a back-up plan, potentially affecting mortality [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 on Opioid-Related Overdose Deaths in Texas

Lalani

Bakos-Block

Cardenas-Turanzas

et al. 2022

IJERPH

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Prior to the COVID-19 pandemic, the United States was facing an epidemic of opioid overdose deaths, clouding accurate inferences about the impact of the pandemic at the population level. We sought to determine the existence of increases in the trends of opioid-related overdose (ORO) deaths in the Greater Houston metropolitan area from January 2015 through December 2021, and to describe the social vulnerability present in the geographic location of these deaths. We merged records from the county medical examiner’s office with social vulnerability indexes (SVIs) for the region and present geospatial locations of the aggregated ORO deaths. Time series analyses were conducted to determine trends in the deaths, with a specific focus on the years 2019 to 2021. A total of 2660 deaths were included in the study and the mean (standard deviation, SD) age at death was 41.04 (13.60) years. Heroin and fentanyl were the most frequent opioids detected, present in 1153 (43.35%) and 1023 (38.46%) ORO deaths. We found that ORO deaths increased during the years 2019 to 2021 (p-value ≤ 0.001) when compared with 2015. Compared to the year 2019, ORO deaths increased for the years 2020 and 2021 (p-value ≤ 0.001). The geographic locations of ORO deaths were not associated with differences in the SVI. The COVID-19 pandemic had an impact on increasing ORO deaths in the metropolitan Houston area; however, identifying the determinants to guide targeted interventions in the areas of greatest need may require other factors, in addition to community-level social vulnerability parameters.

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“… [3] The COVID-19 pandemic, declared on March 11 2020, [4] and subsequent disruptions in treatment, combined with increased psychological distress and social and economic stressors including social isolation and unemployment, may have fueled the opioid epidemic and rise in drug overdose mortality. [5] , [6] , [7] , [8] During the pandemic, drug overdose [9] , [10] , [11] , [12] and opioid-related overdose deaths [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] have significantly increased. Median emergency department (ED) visits for all drug overdoses in the US increased from 13,371 (711.1 per 100,000 ED visits) in 2019 to 15,604 (940.2 per 100,000 ED visits) in 2020.…”

Section: Introductionmentioning

confidence: 99%