The impact of the national stay-at-home order on emergency department visits for suspected opioid overdose during the first wave of the COVID-19 pandemic

Elisabeth D. Root, Svetla Slavova, Marc LaRochelle, Daniel J. Feaster, Jennifer Villani, Jolene Defiore-Hyrmer, Nabila El-Bassel, Rosa Ergas, Kitty Gelberg, Rebecca Jackson, Kara Manchester, Megha Parikh, Peter Rock, Sharon L. Walsh

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background: Although national syndromic surveillance data reported declines in emergency department (ED) visits after the declaration of the national stay-at-home order for COVID-19, little is known whether these declines were observed for suspected opioid overdose. Methods: This interrupted time series study used syndromic surveillance data from four states participating in the HEALing Communities Study: Kentucky, Massachusetts, New York, and Ohio. All ED encounters for suspected opioid overdose (n = 48,301) occurring during the first 31 weeks of 2020 were included. We examined the impact of the national public health emergency for COVID-19 (declared on March 14, 2020) on trends in ED encounters for suspected opioid overdose. Results: Three of four states (Massachusetts, New York and Ohio) experienced a statistically significant immediate decline in the rate of ED encounters for suspected opioid overdose (per 100,000) after the nationwide public health emergency declaration (MA: -0.99; 95 % CI: -1.75, -0.24; NY: -0.10; 95 % CI, -0.20, 0.0; OH: -0.33, 95 % CI: -0.58, -0.07). After this date, Ohio and Kentucky experienced a sustained rate of increase for a 13-week period. New York experienced a decrease in the rate of ED encounters for a 10-week period, after which the rate began to increase. In Massachusetts after a significant immediate decline in the rate of ED encounters, there was no significant difference in the rate of change for a 6-week period, followed by an immediate increase in the ED rate to higher than pre-COVID levels. Conclusions: The heterogeneity in the trends in ED encounters between the four sites show that the national stay-at-home order had a differential impact on opioid overdose ED presentation in each state.

Original languageEnglish
Article number108977
JournalDrug and Alcohol Dependence
Volume228
DOIs
StatePublished - Nov 1 2021

Bibliographical note

Funding Information:
We would like to acknowledge support for this study from the following agencies: Kentucky Cabinet for Health and Family Services (Department for Public Health, Kentucky Health Information Exchange, Office of Health Data and Analytics) ; New York State (NYS) Department of Health, Bureau of Surveillance and Data Systems, Division of Epidemiology ; RecoveryOhio, the Ohio Department of Health, the Ohio Department of Administrative Services (InnovateOhio Platform) ; the Massachusetts Department of Public Health, Bureau of Infectious Disease and Laboratory Sciences , and the Biostatistics Epidemiology Data Analytics Center (BEDAC) at Boston University . We also would like to thank the following colleagues and collaborators for their support for the study and contribution to the HCS measures: Sharon Coleman, Megan Lindstrom, Austin Booth.

Funding Information:
This research was supported by the National Institutes of Health through the NIH HEAL Initiative under award numbers UM1DA049394 (RTI), UM1DA049406 (KY), UM1DA049412 (MA), UM1DA049415 (NY), and UM1DA049417 (OH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or its NIH HEAL Initiative.

Publisher Copyright:
© 2021

Keywords

  • COVID-19
  • Emergency department encounter
  • HEALing Communities Study
  • Opioid use disorder
  • Segmented regression
  • Syndromic surveillance

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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