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

• Published in: Drug and alcohol dependence Vol. 214; p. 108176
• Main Authors: Slavova, Svetla, Rock, Peter, Bush, Heather M., Quesinberry, Dana, Walsh, Sharon L.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.09.2020; Elsevier Science Ltd
• Subjects: Analgesics, Opioid - poisoning; Averages; Betacoronavirus; Coronavirus Infections; Coronaviruses; COVID-19; Data Collection; Drug addiction; Drug overdose; Drug Overdose - epidemiology; Emergency medical care; Emergency medical services; Emergency Medical Services - statistics & numerical data; Emergency Service, Hospital; Emergency services; Emergency vehicles; Empirical analysis; Full Length; Health services; Humans; Interrupted time series; Narcotics; Opioid overdose; Opioid-Related Disorders - epidemiology; Opioids; Overdose; Overdoses; Pandemics; Pneumonia, Viral; Psychological distress; SARS-CoV-2; Segmented regression; Social interactions; Social isolation; Statistical methods; Statistical significance; Substance use disorder; Surveillance systems; Transportation; United States > US; Kentucky; COVID-19; Opioid overdose; Segmented regression; Interrupted time series; Emergency medical services
• ISSN: 0376-8716; 1879-0046; 1879-0046
• DOI: 10.1016/j.drugalcdep.2020.108176

•COVID-19 pandemic disrupted treatment service delivery and harm reduction.•Individuals with opioid use disorder may be at heightened risk of opioid overdose.•Emergency medical services (EMS) data is a timely source for overdose surveillance.•Kentucky EMS opioid overdose runs increased significantly during COVID-19 period.•In contrast, average EMS daily runs for other conditions leveled or declined. Individuals with opioid use disorder may be at heightened risk of opioid overdose during the COVID-19 period of social isolation, economic distress, and disrupted treatment services delivery. This study evaluated changes in daily number of Kentucky emergency medical services (EMS) runs for opioid overdose between January 14, 2020 and April 26, 2020. We evaluated the statistical significance of the changes in the average daily EMS opioid overdose runs in the 52 days before and after the COVID-19 state of emergency declaration, March 6, 2020. Kentucky EMS opioid overdose daily runs increased after the COVID-19 state emergency declaration. In contrast, EMS daily runs for other conditions leveled or declined. There was a 17% increase in the number of EMS opioid overdose runs with transportation to an emergency department (ED), a 71% increase in runs with refused transportation, and a 50% increase in runs for suspected opioid overdoses with deaths at the scene. The average daily EMS opioid overdose runs with refused transportation increased significantly, doubled to an average of 8 opioid overdose patients refusing transportation every day during the COVID-19-related study period. This Kentucky-specific study provides empirical evidence for concerns that opioid overdoses are rising during the COVID-19 pandemic and calls for sharing of observations and analyses from different regions and surveillance systems with timely data collection (e.g., EMS data, syndromic surveillance data for ED visits) to improve our understanding of the situation, inform proactive response, and prevent another big wave of opioid overdoses in our communities.