The impact of the national stay-at-home order on emergency department visits for suspected opioid overdose during the first wave of the COVID-19 pandemic

Root, Elisabeth Dowling; Slavova, Svetla; Larochelle, Marc R.; Feaster, Daniel J.; Villani, Jennifer; DeFiore-Hyrmer, Jolene; El‐Bassel, Nabila; Ergas, Rosa; Gelberg, Kitty H.; Jackson, Rebecca D.; Manchester, Kara; Parikh, Megha; Rock, Peter; Walsh, Sharon

doi:10.1016/j.drugalcdep.2021.108977

Cited by 23 publications

(28 citation statements)

References 33 publications

(35 reference statements)

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“…Young people seem to be more affected by technological addiction, for instance, misuse of their smartphone [1] and social media [41] and excessive gaming [38]. Moreover, some results concerning the impact of the COVID-19 on addictive behaviors had some heterogeneity; for instance, COVID-19 had a differential impact on opioid overdoses in certain US states [64], implying that further and more thorough research is needed to have a whole picture.…”

Section: Discussionmentioning

confidence: 99%

The Increase in Addiction during COVID-19

Daglis

2021

Encyclopedia

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The increase in addiction during COVID-19 is a condition that emerged as an aftermath of COVID-19-related events, for instance, fear of the spread of COVID-19, self-abstention from many activities, and restrictions established by the lockdown measures. This condition includes substance addictions such as drugs and alcohol but also behavioral addictions such as gambling, gaming, pornography, and smartphone and internet misuse.

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Section: Discussionmentioning

confidence: 99%

The Increase in Addiction during COVID-19

Daglis

2021

Encyclopedia

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“…Early studies reported increases in opioid overdose admissions and deaths across emergency departments in San Francisco from January 1, 2020 to April 18, 2020 [ 3 ], Indianapolis from March 25, 2019 to July 24, 2020 [ 4 ], and Kentucky, Massachusetts, New York, and Ohio from January 1, 2020 to August 1, 2020 [ 5 , 6 ]. Official cause of death data from Los Angeles County from January 1, 2019 to July 2020 [ 7 ] and Massachusetts from March 24, 2020 to November 8, 2020 [ 8 ] supported findings from these hospital data.…”

Section: Introductionmentioning

confidence: 99%

Opioid overdose decedent characteristics during COVID-19

et al. 2022

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Introduction Alongside the emergence of COVID-19 in the United States, several reports highlighted increasing rates of opioid overdose from preliminary data. Yet, little is known about how state-level opioid overdose death trends and decedent characteristics have evolved using official death records. Methods We requested vital statistics data from 2018–2020 from all 50 states and the District of Columbia, receiving data from 14 states. Accounting for COVID-19, we excluded states without data past March 2020, leaving 11 states for analysis. We defined state-specific analysis periods from March 13 until the latest reliable date in each state’s data, then conducted retrospective year-over-year analyses comparing opioid-related overdose death rates, the presence of specific opioids and other psychoactive substances, and decedents’ sex, race, and age from 2020 to 2019 and 2019 to 2018 within each state’s analysis period. We assessed whether significant changes in 2020 vs. 2019 in opioid overdose deaths were new or continuing trends using joinpoint regression. Results We found significant increases in opioid-related overdose death rates in Alaska (55.3%), Colorado (80.2%), Indiana (40.1%), Nevada (50.0%), North Carolina (30.5%), Rhode Island (29.6%), and Virginia (66.4%) – all continuing previous trends. Increases in synthetic opioid-involved overdose deaths were new in Alaska (136.5%), Indiana (27.6%), and Virginia (16.5%), whilst continuing in Colorado (44.4%), Connecticut (3.6%), Nevada (75.0%), and North Carolina (14.6%). We found new increases in male decedents in Indiana (12.0%), and continuing increases in Colorado (15.2%). We also found continuing increases in Black non-Hispanic decedents in Massachusetts (43.9%) and Virginia (33.7%). Conclusion This research analyzes vital statistics data from 11 states, highlighting new trends in opioid overdose deaths and decedent characteristics across 10 of these states. These findings can inform state-specific public health interventions and highlight the need for timely and comprehensive fatal opioid overdose data, especially amidst concurrent crises such as COVID-19. Key messages: Our results highlight shifts in opioid overdose trends during the COVID-19 pandemic that cannot otherwise be extracted from aggregated or provisional opioid overdose death data such as those published by the Centres for Disease Control and Prevention. Fentanyl and other synthetic opioids continue to drive increases in fatal overdoses, making it difficult to separate these trends from any possible COVID-19-related factors. Black non-Hispanic people are making up an increasing proportion of opioid overdose deaths in some states. State-specific limitations and variations in data-reporting for vital statistics make it challenging to acquire and analyse up-to-date data on opioid-...

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“…Increased adulteration with fentanyl analogs in different types of illicit drug products (including both opioid and non-opioid compounds) is another potential cause of this trend ( 39 , 45 , 48 ). Behavioral changes in the early pandemic period, such as injecting alone, or refusal of transport to the ED may have also contributed to this rise in mortality ( 5 , 49 ).…”

Section: Discussionmentioning

confidence: 99%

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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The impact of the national stay-at-home order on emergency department visits for suspected opioid overdose during the first wave of the COVID-19 pandemic

Cited by 23 publications

References 33 publications

The Increase in Addiction during COVID-19

The Increase in Addiction during COVID-19

Opioid overdose decedent characteristics during COVID-19

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

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