Trends in Drug Overdose Mortality in Ohio During the First 7 Months of the COVID-19 Pandemic

Currie, Janet; Schnell, Molly; Schwandt, Hannes; Zhang, Jonathan

doi:10.1001/jamanetworkopen.2021.7112

Cited by 48 publications

(56 citation statements)

References 4 publications

(7 reference statements)

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“…Other host factors (eg, tolerance to opioids) may temporarily decrease due to pandemic-related barriers that limit acquiring and using opioids, only to be supplanted with an escalation of overdose risk when opioids become more available and used at prehiatus dosage [ 3 , 37 ]. Consistent with this notion, Currie et al [ 38 ] reported an initial fentanyl-fueled spike in opioid overdose deaths in Ohio approximately 6 weeks following the declaration of a national public health emergency on March 13, 2020. Notably, opioid overdose deaths returned to comparable historical levels within approximately 3 months.…”

Section: Discussionmentioning

confidence: 92%

Increases in Naloxone Administrations by Emergency Medical Services Providers During the COVID-19 Pandemic: Retrospective Time Series Study

Khoury¹,

Preiss²,

Geiger³

et al. 2021

JMIR Public Health Surveill

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Background The opioid crisis in the United States may be exacerbated by the COVID-19 pandemic. Increases in opioid use, emergency medical services (EMS) runs for opioid-related overdoses, and opioid overdose deaths have been reported. No study has examined changes in multiple naloxone administrations, an indicator of overdose severity, during the COVID-19 pandemic. Objective This study examines changes in the occurrence of naloxone administrations and multiple naloxone administrations during EMS runs for opioid-related overdoses during the COVID-19 pandemic in Guilford County, North Carolina (NC). Methods Using a period-over-period approach, we compared the occurrence of opioid-related EMS runs, naloxone administrations, and multiple naloxone administrations during the 29-week period before (September 1, 2019, to March 9, 2020) and after NC’s COVID-19 state of emergency declaration (ie, the COVID-19 period of March 10 to September 30, 2020). Furthermore, historical data were used to generate a quasi-control distribution of period-over-period changes to compare the occurrence of each outcome during the COVID-19 period to each 29-week period back to January 1, 2014. Results All outcomes increased during the COVID-19 period. Compared to the previous 29 weeks, the COVID-19 period experienced increases in the weekly mean number of opioid-related EMS runs (25.6, SD 5.6 vs 18.6, SD 6.6; P<.001), naloxone administrations (22.3, SD 6.2 vs 14.1, SD 6.0; P<.001), and multiple naloxone administrations (5.0, SD 1.9 vs 2.7, SD 1.9; P<.001), corresponding to proportional increases of 37.4%, 57.8%, and 84.8%, respectively. Additionally, the increases during the COVID-19 period were greater than 91% of all historical 29-week periods analyzed. Conclusions The occurrence of EMS runs for opioid-related overdoses, naloxone administrations, and multiple naloxone administrations during EMS runs increased during the COVID-19 pandemic in Guilford County, NC. For a host of reasons that need to be explored, the COVID-19 pandemic appears to have exacerbated the opioid crisis.

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Section: Discussionmentioning

confidence: 92%

Increases in Naloxone Administrations by Emergency Medical Services Providers During the COVID-19 Pandemic: Retrospective Time Series Study

Khoury¹,

Preiss²,

Geiger³

et al. 2021

JMIR Public Health Surveill

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“…Partygoers in New York City tended to reduce their use of cocaine, ecstasy, and LSD during COVID-related social distancing (Palamar et al, 2021). In contrast, in the state of Ohio, overdose deaths among people aged 24 years and younger in May 2020 were 2.06 times the May 2018-2019 mean (42 vs 20 deaths) (Currie et al, 2021). Most of these overdoses involved opioids, the use of which was not reported in the other publications.…”

Section: Youth Substance Use During Covid-19mentioning

confidence: 82%

Changes in youth mental health, psychological wellbeing, and substance use during the COVID-19 pandemic: A rapid review

Zolopa¹,

Burack²,

O’Connor³

et al. 2021

Preprint

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Background: The focus of this review was to assess changes in youth mental health, psychological wellbeing, or substance use, as well as changes or disruptions to the delivery of mental health or substance use services for young people during the COVID-19 pandemic. Method: We conducted a rapid review of the literature on our outcomes of interest among youth (age <=25) in the context of the COVID-19 pandemic. Primary studies and systematic reviews on change were eligible for inclusion. Searches were conducted in PubMed and Embase in May 2021, and two reviewers screened studies for inclusion. We report results using a narrative synthesis.Results: We included 156 primary publications. A variety of methods were used to assess change, including prospective assessment of longitudinal cohorts, retrospective recall by participants in cross-sectional and qualitative studies, and comparison of peri-pandemic data to pre-pandemic normative values. Publications regarding mental health (n = 121) and psychological wellbeing (n = 26) generally indicated poor outcomes during the pandemic period. Publications on substance use (n = 41) revealed overall declines or unchanged patterns of use, though certain groups reported increased or problematic use. Studies of service delivery (n = 11) indicated a generally positive reception for helplines and telehealth, although some youth experienced difficulties accessing mental health services. Conclusions: The evidence indicates negative impacts of the COVID-19 pandemic on young people’s mental health, although declines in alcohol and nicotine use were also found. Services will need to continue to adapt as the pandemic progresses, particularly to support disadvantaged youth who lack access to telehealth resources.

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“…Reassuringly, there does not appear to be any strong relationship. 16 Mortality and adverse health outcomes generally increase during periods of economic recession and distress (Ruhm 2000); deaths from drug overdoses have increased in the early COVID-19 months (CDC 2020b; Currie et al 2021); and incidence of mental health and suicide ideation are elevated during the pandemic (Czeisler et al 2020).…”

Section: Heterogeneity In Utilization and Mortality At The County And Patient Levelmentioning

confidence: 99%

Hospital Avoidance and Unintended Deaths during the COVID-19 Pandemic

Zhang¹

2021

American Journal of Health Economics

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The COVID-19 pandemic significantly altered individual behaviors, including the consumption of health care. I study utilization and mortality in the largest integrated healthcare system in the United States, the Veterans Health Administration, and find that between the middle of March and the beginning of May 2020, emergency department and inpatient hospital visits declined by 37 percent and 46 percent, and remained 10 percent and 17 percent below expected levels by the end of October. Declines were more pronounced for nonurgent and non-life-threatening conditions, although urgent and life-threatening conditions also dropped by a quarter during the early months. Conditional on arrival at the emergency department, conditions were more severe at presentation. In the first two months of the pandemic, veteran mortality increased by 19.5 percent, yet non-COVID-19 mortality in VA inpatient settings declined. I find suggestive evidence that hospital avoidance may have resulted in higher non-COVID-19 mortality. By focusing on counties with no official COVID-19 deaths by May 19, 2020, I estimate that an upper bound of 7.9 percent of excess veteran deaths in the first two months of the pandemic were due to hospital avoidance.

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Trends in Drug Overdose Mortality in Ohio During the First 7 Months of the COVID-19 Pandemic

Abstract: This cross-sectional study uses data from the Ohio Department of Health to evaluate trends in drug overdose mortality in that state by type of drug and user age during the first 7 months of the COVID-19 epidemic.

Cited by 48 publications

References 4 publications

Increases in Naloxone Administrations by Emergency Medical Services Providers During the COVID-19 Pandemic: Retrospective Time Series Study

Increases in Naloxone Administrations by Emergency Medical Services Providers During the COVID-19 Pandemic: Retrospective Time Series Study

Changes in youth mental health, psychological wellbeing, and substance use during the COVID-19 pandemic: A rapid review

Hospital Avoidance and Unintended Deaths during the COVID-19 Pandemic

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