Emergency department visits related to opioid overdoses up significantly during COVID-19 pandemic
Emergency department visit rates because of an opioid overdose increased by 28.5% across the U.S. in 2020, compared to 2018 and 2019, recent Mayo Clinic research finds. Emergency visits overall decreased by 14% last year, while visits because of an opioid overdose increased by 10.5%. The result: Opioid overdoses were responsible for 0.32 out of 100 visits, or 1 in every 313 visits, which is up from 0.25, or 1 in every 400 visits, the previous two years.
This trend is supported by preliminary data recently released by the Centers for Disease Control and Prevention (CDC), which recorded more than 93,000 opioid overdose deaths in 2020. That's a 29.4% increase from the year prior and the most opioid overdose deaths every recorded in the U.S.
The research was published in the Annals of Emergency Medicine and was presented in June at the AcademyHealth annual research meeting. The research also was presented at the Society for Academic Emergency Medicine's conference, where it was selected for a plenary session.
"COVID-19, and the disruptions in every part of our social and work lives, made this situation even harder by increasing the risk of opioid misuse and relapse because people were separated from their social support and normal routines," says Molly Jeffery, Ph.D., a researcher in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery and senior author. "While institutions across the U.S. are keenly aware that opioid misuse is a major health concern, this shows that there is more work to be done, and it provides an opportunity for institutions and policymakers to expand evidence-based treatments and resources."
Over 70% of drug overdose deaths in 2019 involved an opioid, according to the CDC, though trends were leveling off before the COVID-19 pandemic. Since then, that trend has reversed significantly, data are showing.
The research team studied visits to 25 emergency departments in six states―Alabama, Colorado, Connecticut, North Carolina, Massachusetts and Rhode Island―from January 2018 through December 2020. Opioid-related overdose visits increased to 3,486 in 2020 from 3,285 and 3,020 in 2019 and 2018, respectively. Previous research by this team found an immediate and significant decrease in emergency department visits during the first few months of the COVID-19 pandemic, a trend that continued throughout 2020.
Despite the increase in opioid-related visits, the researchers say evidence suggests the percentage of people who experience an overdose but choose not to visit the emergency department is likely increasing, suggesting overdose rates may be even higher.
"In the absence of comprehensive, real-time national surveillance data, our results offer evidence that the increases in nonfatal opioid overdose rates are not isolated to specific communities," the researchers wrote.
Dr. Jeffery says treatments for opioid misuse, such as buprenorphine and methadone, need to be more accessible, as does naloxone, an opioid overdose reversal drug. She says, however, it's a good sign that telemedicine access for psychiatric care increased during the pandemic and has remained high.
"We think this may be an important way to increase the accessibility of care for many people with opioid misuse disorder or addiction," Dr. Jeffery says.
The lead author is William Soares, M.D., University of Massachusetts Medical School-Baystate. Co-authors are from the Yale School of Medicine, The University of Alabama at Birmingham, the University of North Carolina School of Medicine, the Warren Alpert Medical School of Brown University, and the University of Colorado School of Medicine.
The research was supported by the National Institute on Drug Abuse, of the National Institutes of Health.
The research also was supported by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. The center seeks to discover new ways to improve health; translate those discoveries into evidence-based, actionable treatments, processes and procedures; and apply this new knowledge to improve care for patients everywhere.