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Trends in proportions of specific drugs in the months ending in Oct. 2021: drug-overdose deaths over time by drug type
Source publication
Data from a single state indicated there was an increase in opioid overdose related emergency services during the COVID-19 pandemic. The current study examined the provisional rolling 12-month drug overdose deaths between January 2019 and October 2021 at the national, state, and specific-drug levels, to identify trends in drug-overdose deaths befor...
Contexts in source publication
Context 1
... confidence intervals [CI], 0.141 to 0.213, P < 0.001), which however, was attenuated after January 2021 (MPC=-0.424, 95% CI, -0.46 to -0.388, P < 0.001, Table 1). Strikingly, the proportions of synthetic opioid overdose deaths and psychostimulant deaths increased throughout the study period of January 2019 to October 2021, respectively ( Table 1). ...Context 2
... CI, -0.46 to -0.388, P < 0.001, Table 1). Strikingly, the proportions of synthetic opioid overdose deaths and psychostimulant deaths increased throughout the study period of January 2019 to October 2021, respectively ( Table 1). The proportions of synthetic opioid overdose deaths increased most during November 2019 to December/2020 (MPC=1.177, ...Context 3
... confidence intervals [CI], 0.141 to 0.213, P < 0.001), which however, was attenuated after January 2021 (MPC=-0.424, 95% CI, -0.46 to -0.388, P < 0.001, Table 1). Strikingly, the proportions of synthetic opioid overdose deaths and psychostimulant deaths increased throughout the study period of January 2019 to October 2021, respectively ( Table 1). ...Context 4
... CI, -0.46 to -0.388, P < 0.001, Table 1). Strikingly, the proportions of synthetic opioid overdose deaths and psychostimulant deaths increased throughout the study period of January 2019 to October 2021, respectively ( Table 1). The proportions of synthetic opioid overdose deaths increased most during November 2019 to December/2020 (MPC=1.177, ...Similar publications
Many law enforcement and other first responder agencies have adopted deflection as a front-line response to the increasing number of drug overdoses and deaths in the United States over the past two decades. Deflection programs aim to connect individuals with substance use disorder (not necessarily limited to opioids or one particular substance) who...
Citations
... However, these factors were augmented by the COVID-19 pandemic, exacerbating the risk for PWID. [31][32][33][34] Other risk factors that were more significant during the pandemic include solitary drug use, interruptions in SUD treatment, less/unstable social supports, lower employment, and interruptions in drug supply. 5,35,36 Nonetheless, some studies argued that the COVID-19 pandemic had a smaller impact on overdose deaths and that the higher overdose mortality just reflects a continuation of pre-pandemic overdose trends. ...
... 11 In contrast, a few studies suggested national and regional accelerations of drug overdose deaths during the COVID-19 pandemic compared to pre-COVID time, with an increase ranging from 30% to 49%. 1,31,32 Further, a study of vital statistics data from 11 states in the US revealed great heterogeneity in opioid-related overdose deaths by state. 3 Such geographic variations are potentially attributed to distinct data and populations investigated. ...
... This finding is in line with the nationwide escalating synthetic opioid crisis reported by a majority of previous studies. 1,3,10,32,38 The CDC provisional data displayed a 53.1% increase in synthetic opioid overdoses from 2019 to 2020, as a key driver of the increasing overall opioid overdose mortalities during that period. 48 The emergence of this synthetic opioid crisis is complex and attributable to an array of individual and structural factors on demand and supply side, including economic instability, mental health distress, health care inequity as well as increased lethality and variations of fentanyls and concomitant profit incentives, all of which have been magnified by the unanticipated lockdown owing to the COVID-19 pandemic. ...
Objective
The COVID-19 pandemic placed extreme burden on hospitals, while opioid overdose is another challenging public health issue. This study aimed to examine the trends and outcomes of opioid overdose hospitalizations in Pennsylvania during 2018 to 2021.
Design
We identified opioid overdose hospitalizations in the state of Pennsylvania using the state-wide hospital discharge database (PHC4) 2018 to 2021. We examined the number of opioid overdose hospitalizations, the corresponding mortality and discharges against medical advice comparing the pre-COVID period (2018-2019) and the COVID period (2020-2021). We also assessed what patient and hospital characteristics were associated with in-hospital death or leaving against medical advice.
Results
A total of 13 446 opioid-related hospitalizations were identified in 2018 to 2021. Compared to pre-pandemic, a higher percentage of cases involving synthetics (17.0%vs 10.3%, P < .0001) were observed during COVID. After controlling for covariates, there was no significant difference in opioid overdose in-hospital deaths in the years 2020 to 2021 compared to 2018 to 2019 (OR = 0.846, 95% CI: 0.71-1.01, P = .065). The COVID period was significantly associated with more leaving against medical advice compared to years 2018 to 2019 (OR = 1.265, 95% CI: 1.11-1.44, P = .0003). Compared to commercial insurance, Medicaid insurance was associated with higher odds of both in-hospital death (OR = 1.383, 95% CI: 1.06-1.81, P = .0176) and leaving against medical advice (OR = 1.903, 95% CI: 1.56-2.33, P < .0001).
Conclusion
There were no substantial changes in the number of overall opioid overdose cases and deaths at hospitals following the outbreak of COVID-19 in Pennsylvania. This observation suggests that an increased number of patients may have succumbed to overdoses outside of hospital settings, possibly due to a higher severity of overdoses. Further, we found that patients were more likely to leave against medical advice during the COVID-19 pandemic.
... Finally, the onset of the COVID-19 pandemic coincided with a sharp increase in the rates of opioid overdose deaths. While the monthly percentage changes in opioid overdoses have more recently shown some decline, the rate of opioid overdose deaths remains greater than rates prior to the COVID-19 pandemic onset (27). The COVID-19 pandemic occasioned improvements in treatment accessibility with BOX 1. DSM-5-TR criteria for opioid use disorder a A problematic pattern of opioid use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period: ...
Objectives. To assess heterogeneity in pandemic-period excess fatal overdoses in the United States, by location (state, county) and substance type.
Methods. We used seasonal autoregressive integrated moving average (SARIMA) models to estimate counterfactual death counts in the scenario that no pandemic had occurred. Such estimates were subtracted from actual death counts to assess the magnitude of pandemic-period excess mortality between March 2020 and August 2021.
Results. Nationwide, we estimated 25 668 (95% prediction interval [PI] = 2811, 48 524) excess overdose deaths. Specifically, 17 of 47 states and 197 of 592 counties analyzed had statistically significant excess overdose-related mortality. West Virginia, Louisiana, Tennessee, Kentucky, and New Mexico had the highest rates (20–37 per 100 000). Nationally, there were 5.7 (95% PI = 1.0, 10.4), 3.1 (95% PI = 2.1, 4.2), and 1.4 (95% PI = 0.5, 2.4) excess deaths per 100 000 involving synthetic opioids, psychostimulants, and alcohol, respectively.
Conclusions. The steep increase in overdose-related mortality affected primarily the southern and western United States. We identified synthetic opioids and psychostimulants as the main contributors.
Public Health Implications. Characterizing overdose-related excess mortality across locations and substance types is critical for optimal allocation of public health resources. ( Am J Public Health. 2024;114(6):599–609. https://doi.org/10.2105/AJPH.2024.307618 )
Background: Understanding the self-management practices of persistent symptoms of SARS-Cov-2 (COVID-19) is critical given the misinformation that has been presented about this disease in the U.S. The purpose of this descriptive study is to assess the self-management of persistent symptoms of COVID-19 with commonly used and misused substances (i.e., alcohol, marijuana and commonly prescribed medications) among adults in the U.S. Methods: The data for this study comes from a cross-sectional survey of U.S. adults that was designed to broadly assess symptom burden, persistent symptom patterns, self-efficacy for symptom management and self-management strategies among people who experienced persistent/Long COVID. Multiple logistic regression analyses were used to assess how symptom length of COVID-19 was associated with the use of several substances to manage these persistent symptoms. Results: The analysis found that adults who had COVID-19 symptoms that persisted for 13 weeks or longer had higher rates of using alcohol (27.3%), marijuana (30.9%) and prescription tranquilizers (21.4%) to manage these symptoms when compared to their adult peers who had COVID-19 symptoms persist for only 4 weeks or less. For instance, the odds of indicating the use of marijuana (AOR = 4.21 95% CI = 1.68,10.5) to manage COVID-19 related symptoms was roughly four times higher for respondents who had COVID-19 symptoms persist for 13 weeks or longer when compared to respondents whose COVID-19 symptoms persisted for only 4 weeks or less. Conclusion: The findings suggest that screening of substance use disorders should be considered among healthcare providers who are treating adults who have persistent symptoms of COVID-19.
