Signal of increased opioid overdose during COVID-19 from emergency medical services data

Slavova, Svetla; Rock, Peter; Bush, Heather; Quesinberry, Dana; Walsh, Sharon

doi:10.1016/j.drugalcdep.2020.108176

Cited by 365 publications

(388 citation statements)

References 10 publications

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“…We used data from the EMS electronic medical records and the coroner's office to measure changes in the rates of overdose CFS and deaths after implementation of the COVID-19 stay-at-home order. The increases we observed-CFS in which naloxone was administered and overdose deaths-are consistent with recent studies [16,22]. Looking at several micro datasets in the same jurisdiction, our study additionally revealed that increases in overdoses were consistent across age and racial/ethnic groups, as well as spatially in high-volume zip codes.…”

Section: Discussionsupporting

confidence: 91%

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Impact of COVID-19 Pandemic on Drug Overdoses in Indianapolis

et al. 2020

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We described the change in drug overdoses during the COVID-19 pandemic in one urban emergency medical services (EMS) system. Data was collected from Marion County, Indiana (Indianapolis), including EMS calls for service (CFS) for suspected overdose, CFS in which naloxone was administered, and fatal overdose data from the County Coroner's Office. With two sample t tests and ARIMA time series forecasting, we showed changes in the daily rates of calls (all EMS CFS, overdose CFS, and CFS in which naloxone was administered) before and after the stay-at-home order in Indianapolis. We further showed differences in the weekly rate of overdose deaths. Overdose CFS and EMS naloxone administration showed an increase with the social isolation of the Indiana stay-at-home order, but a continued increase after the stay-at-home order was terminated. Despite a mild 4% increase in all EMS CFS, overdose CFS increased 43% and CFS with naloxone administration increased 61% after the stay-athome order. Deaths from drug overdoses increased by 47%. There was no change in distribution of age, race/ethnicity, or zip code of those who overdosed after the stay-at-home order was issued. We hope this data informs policy-makers preparing for future COVID-19 responses and other disaster responses.

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Section: Discussionsupporting

confidence: 91%

“…Some evidence suggests that spikes have occurred in opioid overdoses in several jurisdictions across the U.S. during the COVID-19 pandemic [9][10][11][12][13][14][15][16][17][18]. To date, no national data exist to assess the impact to overdose events of the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 Pandemic on Drug Overdoses in Indianapolis

et al. 2020

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“…The results of our study are interesting to compare with a study from Kentucky, a state which has also been greatly affected by substance use disorder, demonstrating a 17% increase in the number of EMS opioid-related calls after a statewide COVID-19 emergency declaration (16).…”

Section: Accepted Manuscriptmentioning

confidence: 61%

Ambulance Calls for Substance-Related Issues Before and After COVID-19

Weiner¹,

Cash²,

Hendricks³

et al. 2020

Prehospital Emergency Care

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A c c e p t e d M a n u s c r i p t Background: The United States is currently facing two epidemics: sustained morbidity and mortality from substance use and the more recent COVID-19 pandemic. We tested the hypothesis that the pandemic has disproportionately affected individuals with substance use disorder by evaluating average daily 911 ambulance calls for substance use-related issues compared with all other calls. Methods: This was a retrospective cross-sectional analysis of 911 ambulance calls before and after the start of COVID-19 in Massachusetts. We used consecutive samples of 911 ambulance calls, categorized into those which were substance-related or not. An interrupted time series analysis was performed to determine if there were changes in numbers of daily calls before a statewide declaration of emergency for COVID-19 (February 15-March 9, 2020), from the emergency declaration until a stay-at-home advisory (March 10-March 22, 2020) and following the stay-at-home advisory (March 23-May 15, 2020). Results: Compared with prior to the statewide emergency, the post-statewide emergency average of daily ambulance calls decreased from 2,453.2 to 1,969.6, a 19.7% decrease. Similarly, calls for substance-related reasons decreased by 16.4% compared with prior to the statewide emergency. However, despite an initial decrease in calls, after the stay-at-home advisory calls for substance use began increasing by 0.7 (95% confidence interval (CI) 0.4-1.1) calls/day, while calls for other reasons did not significantly change (+1.2 (95% CI-0.8 to 3.1) calls/day). Refusal of transport for substance-related calls increased from 5.0% before the statewide emergency to 7.5% after the declaration (p<0.001). Conclusions: After an initial decline in substance-related ambulance calls following a statewide declaration of emergency, calls for substance use increased to pre-COVID-19 levels while those A c c e p t e d M a n u s c r i p t for other reasons remained at a lower rate. The results suggest that COVID-19 is disproportionately affecting individuals with substance use disorder.

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“…The COVID-19 pandemic is likely to be considered a traumatic event, especially by those whose life circumstances have been affected. The pandemic has also presented particular challenges for individuals who struggle with substance use due to the fact that social isolation and despair are risk factors for the development and exacerbation of addiction (11,12). Professionals across multiple disciplines have raised alarms about the potential for increased family violence or intimate partner violence [e.g.…”

Section: Introductionmentioning

confidence: 99%