Abstract
Introduction: Stay-at-home orders during the COVID-19 pandemic decreased population mobility to reduce SARS-CoV-2 infection rates. We empirically tested the hypothesis that this public health measure was associated with a higher likelihood of opioid- and stimulant-involved deaths occurring in homes located in Cook County, Illinois. Methods: The stay-at-home period was from March 21, 2020 to May 30, 2020. We analyzed overdose data from the Cook County Medical Examiner's Office using a death location description from case investigations categorized as home, medical, motel, scene, and other. Two groups of decedents were defined as either having an opioid or stimulant listed in the primary cause of death field. We modeled a weekly time series to detect changes in deaths (number) and trends during segmented time periods. Chi-square or Fisher's exact and adjusted logistic regression was used for testing the differences between the stay-at-home and a 13-week preceding period. Results: There were 4,169 and 2,012 opioid- and stimulant-involved deaths, respectively, from 2018 to 2020. Both groups were demographically similar: 75% male, 52% White, and aged 45 years (mean). In the 13 weeks before stay-at-home orders, 51% of opioid-involved deaths occurred in homes, which increased to 59% (p<0.0001) during the 10 weeks of the order and decreased back to 51% in the 18 weeks after the order expired. For stimulant-involved deaths, 51% were residential immediately before the orders, with a nonsignificant increase to 52% during the stay-at-home period. Before the pandemic, there were 20 deaths/week, increasing to 37 deaths/week (p<0.0001) during stay-at-home enactment. Deaths involving fentanyl among the opioid-involved group increased from 76% to 89%, whereas those involving heroin decreased from 55% to 37%. The adjusted OR for opioid-involved fatal overdoses occurring at home during this period compared with that occurring the 13 weeks before was 1.37 (95% CI=1.05, 1.79). Conclusions: The likelihood of a death occurring at home, especially for people using opioids, increased during the stay-at-home order period. Findings have implications for mitigating overdose risks during social isolation.
| Original language | English |
|---|---|
| Article number | 100007 |
| Journal | AJPM Focus |
| Volume | 1 |
| Issue number | 1 |
| DOIs | |
| State | Published - Sep 2022 |
Bibliographical note
Publisher Copyright:© 2022 The Authors
Funding
This project is supported by the Centers for Disease Control and Prevention of HHS as part of Grant 1R01CE003360-01-00 . The authors wish to thank the Cook County Government of Illinois and the Office of the Medical Examiner for opening their data to the public and Jungjun Bae for data visualization. The contents are those of the author(s) and do not necessarily represent the official views of nor an endorsement by the Centers for Disease Control and Prevention/HHS or the U.S. Government. This project is supported by the Centers for Disease Control and Prevention of HHS as part of Grant 1R01CE003360-01-00. No financial disclosures were reported by the authors of this paper. Chris Delcher: Conceptualization, Formal analysis, Writing - original draft. Daniel R. Harris: Writing - review and editing. Nicholas Anthony: Data curation, Writing - review and editing. Mojde Mir: Data curation, Funding acquisition, Writing - review and editing.
| Funders | Funder number |
|---|---|
| Cook County Government of Illinois | |
| Centers for Disease Control and Prevention | 1R01CE003360-01-00 |
Keywords
- COVID-19
- Opioids
- fatal overdoses
- stimulants
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Health Informatics
- Epidemiology
