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. 2020 Sep 1:214:108176.
doi: 10.1016/j.drugalcdep.2020.108176. Epub 2020 Jul 10.

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

Svetla Slavova  1 , Peter Rock  2 , Heather M Bush  3 , Dana Quesinberry  4 , Sharon L Walsh  5
Affiliations

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

Svetla Slavova et al. Drug Alcohol Depend. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: COVID-19; Emergency medical services; Interrupted time series; Opioid overdose; Segmented regression.

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Conflict of interest statement

Declaration of Competing Interest The authors have no competing interests to declare.

Figures

Fig. 1
Fig. 1
Daily Series of Number of Kentucky Emergency Medical Services Runs, by Type of Run, January 14, 2020 to April 26, 2020. Number of Emergency Medical Services (EMS) Daily Runs for All EMS Runs Excluding Opioid Overdose (left panel) and EMS Runs for Opioid Overdose (right panel), further stratified as EMS runs with transportation of the patient to an emergency department (ED) (top row) or with a refusal for transportation to an ED (bottom row), from January 14, 2020 to April 26, 2020. The daily counts are visualized by the gray line; the 7-day rolling averages are visualized by the black line.
Fig. 2
Fig. 2
Trends in Kentucky Emergency Medical Services Daily Runs for Opioid Overdose, January 14, 2020 to April 26, 2020. (2A) March 18, 2020 was identified as the point of the slope change (estimated change of 0.14 runs/day, 95% CI, 0.01 to 0.28; P = .04) from the pre−COVID-19 trend line of EMS daily opioid overdose runs with transportation to ED. (2B) March 20, 2020 was the change point associated with an immediate jump (3.58 runs; 95% CI, 1.76–5.41; P < .001) in the level of the average daily EMS opioid overdose runs with refused transportation to ED.
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