Overdose and risk factors for coronavirus disease 2019

Abstract

Background: There have been significant efforts to respond to the two public health emergencies of coronavirus disease 2019 and overdose in British Columbia (BC), Canada. The purpose of this study was to quantify the prevalence of known risk factors associated with mortality due to COVID-19 for persons who have had a non-fatal overdose during 2015-2017 in comparison to persons who have not had an overdose. Methods: Data were extracted from the BC Provincial Overdose Cohort which includes a 20 % random sample of BC residents and persons who have had a non-fatal overdose in BC from January 2015 to December 2017. Chisquare tests and logistic regression were used to compare risk factors by overdose history. Results: Persons who had a non-fatal overdose were significantly more likely to have three (chronic pulmonary disease, diabetes, coronary heart disease) of the four known chronic conditions associated with the development of severe illness due to COVID-19 compared to persons who did not have a previous non-fatal overdose event. Conclusion: Persons who had an overdose were more likely to have several chronic conditions associated with the development of severe illness due to COVID-19. The increased likelihood of having these risk factors is reflective of the social and health inequities experienced by persons who have a history of overdose.This study included 1,041,536 persons, 19,005 persons had one or more non-fatal overdose events from 2015 to 2017. The average age was 39 years and 50.0 % were male. Among persons who had an overdose, 56.0 % had a record of receiving social assistance (N = 10,649) from 2015 to 2017. Of these persons, 53.7 % had a record of no

Substance Use Disorders and COVID-19: Multi-Faceted Problems Which Require Multi-Pronged Solutions

“…Second, many individuals with SUD have limited financial resources, unstable housing and limited access to clean water and soap increasing their risk of infection (8,9). Third, co-morbidities prevalent among people with SUD are associated with more severe COVID-19 symptoms, complications and fatalities and increase vulnerability to COVID-19 (3)(4)(5)(6)(7). Fourth, COVID-19 public health mitigation measures (i.e., physical distancing, quarantine and isolation) may exacerbate loneliness, mental health symptoms, withdrawal symptoms and psychological trauma (10)(11)(12)(13).…”

“…Persistent use of psychoactive substances increases risk of substance use disorders (SUDs)biopsychosocial disorders with multiple risk factors interacting at individual and contextual levels resulting in co-morbid health conditions and affecting people from all social and economic backgrounds (1,2). The health consequences of SUDs (e.g., cardiovascular diseases, respiratory diseases, type-2 diabetes, immune and central nervous system depression, and psychiatric disorders) and the associated environmental challenges (e.g., housing instability, unemployment, and criminal justice involvement) increase risk for COVID-19 (3)(4)(5)(6)(7). COVID-19 adds to the complexity of SUD as it affects the lives of individuals with SUD.…”

Substance Use Disorder in the COVID-19 Pandemic: A Systematic Review of Vulnerabilities and Complications

“…According to a recent study in British Columbia, Canada, among 19,005 individuals who had one or more non-fatal overdose events between 2015 and 2017, 10,649 (56.0%) had a record of receiving social assistance, and 5716 (30.0%) had no fixed address record. These individuals with a history of overdose are more likely to have at least three known chronical conditions associated with COVID-19 severity, including chronical pulmonary disease, diabetes, and coronary heart disease, with adjusted odds ratios (ORs) to be 2.01, 1.24 and 2.08, respectively, with reference to people without an overdose [ 39 ]. During the COVID-19 pandemic, risks of abusing substances and addictive behaviors are also increasing.…”

Substance use and related harms in the context of COVID-19: a conceptual model

“…45 Many of the conditions that have been identified as risk factors also disproportionately affect people who use substances: chronic lung disease, cardiovascular disease and weakened immune system. 45,46 As mentioned in the section "Substance use as a means of coping," effects of the pandemic may contribute to increased substance use. In addition, use of certain substances may increase the risk of severe illness among people diagnosed with COVID-19: the use of certain substances may weaken the immune system and the use of long-acting and immunosuppressive opioids, such as methadone or fentanyl, has been associated with increased risks of respiratory infections.…”