Tuesday, September 22, 2020

Nonfatal Opioid Overdoses Rose During COVID-19 Pandemic, Report Suggests

Data from an emergency department in Richmond suggests that the number of nonfatal opioid-related overdoses may have risen during the first few months of the COVID-19 pandemic, particularly among people who are Black. The findings were published in JAMA.

Taylor A. Ochalek, Ph.D., of Virginia Commonwealth University (VCU) and colleagues compared the number of nonfatal opioid overdoses recorded in electronic medical records from VCU’s Emergency Department from March to June 2019 with those that occurred from March to June 2020—the first few months of the COVID-19 pandemic. They found nonfatal opioid overdoses increased from 102 between March and June 2019 to 227 between March and June 2020. The increase in nonfatal opioid overdose visits occurred at the same time that the emergency department experienced a significant decline in the total number of emergency department visits, the authors reported.

“This data is from the Richmond area, but it confirms what we’re hearing anecdotally from across the U.S.,” F. Gerard Moeller, M.D., director of the Wright Center and director of the VCU Institute for Drug and Alcohol Studies, said in a press release. “The pandemic is more than a crisis of one disease. Its ripple effects will be felt for some time in the form of secondary health impacts like addiction.”

Further analysis of patient characteristics of those who experienced a nonfatal opioid overdose during the three-month period in 2019 versus the three-month period in 2020 revealed that while patients in both periods were about the same age (mean ages 42.2 years and 44.0 years, respectively) and predominantly male (70% and 73%, respectively), the percentage of Black patients rose from 63% in 2019 to 80% in 2020.

“While the use of records from March to June across two years serves as a control for underlying seasonal variation in overdose, the generalizability of these findings is limited by the small sample size and reporting of a single emergency department,” wrote Danielle F. Haley, M.P.H., Ph.D., of Boston University School of Public Health and Richard Saitz, M.D., M.P.H., of Boston University School of Medicine in an accompanying editorial. Nonetheless, they noted that the study by Ochalek and colleagues is “consistent with the hypothesis that the U.S. COVID-19 epidemic has been accompanied by an increase in substance use with important consequences (nonfatal overdose), with a signal of greater effect among people who are Black.”

They continued, “There has been a historic failure to deliver effective treatments for opioid use disorder, despite long-standing evidence of efficacy, in the absence of the additional burden COVID-19 has placed on U.S. health care infrastructure. Given this, combined with the racial/ethnic and socioeconomic disparities in opioid overdose and COVID-19–related morbidity and mortality, the introduction of policies alone will be insufficient to mitigate the effect of the COVID-19 pandemic on overdoses. It is critical to identify how best to translate these policies into clinical practice, expand infrastructure, and address the broader social and structural determinants of health that create disparities in access to health care.”

For related information, see the Psychiatric News article “Patient’s Race May Influence Access to MH Care Following Overdose.”

(Image: iStock/FangXiaNuo)


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