Dalia Khoury1, Alexander Preiss1, Paul Geiger1, Mohd Anwar2, Kevin Paul Conway3. 1. RTI International, 3040 East Cornwallis Road, Research Triangle Park, US. 2. NC Agricultural and Technical State University, Durham, US. 3. National Institute of Mental Health, Bethesda, US.
Abstract
BACKGROUND: The opioid crisis in the United States may be exacerbated by the COVID-19 pandemic. Increases in opioid use, Emergency Medical Service (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 examined changes in the occurrence of naloxone administrations (NAs) and multiple naloxone administrations (MNAs) 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, NAs, and MNAs during the 29-week period before (September 1, 2019 to March 9, 2020) and after NC's COVID-19 state-of-emergency declaration (i.e., the 'COVID-19 period' of 3/10/2020 to 9/30/2020). 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 versus 18.6, p<.001), NAs (22.3 versus 14.1, p<.001), and MNAs (5.0 versus 2.7, 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 as well as NAs and MNAs 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 exacerbate the opioid crisis.
BACKGROUND: The opioid crisis in the United States may be exacerbated by the COVID-19 pandemic. Increases in opioid use, Emergency Medical Service (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 examined changes in the occurrence of naloxone administrations (NAs) and multiple naloxone administrations (MNAs) 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, NAs, and MNAs during the 29-week period before (September 1, 2019 to March 9, 2020) and after NC's COVID-19 state-of-emergency declaration (i.e., the 'COVID-19 period' of 3/10/2020 to 9/30/2020). 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 versus 18.6, p<.001), NAs (22.3 versus 14.1, p<.001), and MNAs (5.0 versus 2.7, 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 as well as NAs and MNAs 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 exacerbate the opioid crisis.
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