Opioid-related Emergency Department Visits During COVID-19 in a Large Health System

Abstract

Objective: Multiple states have reported increases in opioid overdose deaths during the coronavirus disease 2019 (COVID-19) pandemic, however little is known about opioid-related presentations to the emergency department (ED). Methods: This was a time series analysis of visits to 7 EDs in greater Chicago, Illinois from October 20, 2019 to July 25, 2020. We compared the number of ED visits for opioid-related diagnoses in the time period preceding the World Health Organization pandemic declaration (prepandemic period, October 20, 2019–July 3, 2020) to the time period following the World Health Organization declaration (pandemic period, March 8, 2020 to July 25, 2020) using a single-group interrupted time series analysis with Newey-West standard errors. We also present data on alcohol-related ED visits for comparison. Results: We evaluated a total of 177,405 visits across the 7 EDs during the study period. The mean number of weekly ED visits in the prepandemic and pandemic periods was 4841 and 4029 weekly visits, respectively. In the interrupted time series analysis, there was no significant immediate effect of the pandemic start on opioid-related ED visits (−0.44 visits per 1000 ED visits, 95% CI −2.47 to 1.58, P = 0.66), however, there was a significant immediate effect of the pandemic start on alcohol-related ED visits (−4.1, 95% CI: −8.25 to −0.01, P < 0.05). Conclusions: Despite reductions in overall ED visit volumes and alcohol-related visits during COVID-19, the number of opioid-related visits was not significantly reduced during the early pandemic. These data reinforce the need to provide comprehensive treatment services for opioid use disorder during the co-occurring COVID-19 and opioid crises.

Opioid Overdoses Increase at Home During the COVID-19 Stay-At-Home Order Period in Cook County, Illinois

“…Likewise, in a sample of Washington, District of Columbia/Baltimore area EDs, opioid overdoses did not increase (although other drug overdoses did). 16,17 Our findings could be consistent with those of these studies because if more people have fatal opioid overdoses at home, then transport to the ED is unnecessary. However, research from Kentucky showed that EMS transports for opioid overdoses increased by 17%, and national data also showed sharp weekly increases in opioid overdoses after the start of the pandemic.…”

The COVID‐19 impact and characterization on substance use‐related emergency department visits for adolescents and young adults in Canada: Practical implications

“…While cannabis‐ and multiple psychoactive substance‐related ED visits recovered to the prepandemic level in 2021, alarmingly, opioid‐related ED visits were still on the rise in 2021 (6.2%). Increased opioid overdose and subsequent ED visits are well documented in previous studies 21,22,48–51 . A larger increase would likely be reported had patients not had elevated rates of opiate‐related deaths in the community 23,51 .…”

“…Increased opioid overdose and subsequent ED visits are well documented in previous studies. 21,22,[48][49][50][51] A larger increase would likely be reported had patients not had elevated rates of opiate-related deaths in the community. 23,51 Our finding suggests that the existing opioid epidemic in Canada, in combination with the disruptions in addiction treatments/programs, precipitated withdrawals or relapses that would require ED visits.…”

Occurrence and correlated factors of physical and verbal violence among emergency physicians in China

“…Most of the patients admitted to the emergency department (ED) have acute onset, rapid change of illness conditions, and high probability of poor outcomes. They are more likely to be alcoholics [ 7 ], drug addicts [ 8 , 9 ], and suffer from mental illnesses [ 10 ]. Emergency physicians (EPs) may be at greater risk of WPV.…”