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

doi:10.1016/j.drugalcdep.2021.108977

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 journal › Article › peer-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 language	English
Article number	108977
Journal	Drug and Alcohol Dependence
Volume	228
DOIs	https://doi.org/10.1016/j.drugalcdep.2021.108977
State	Published - 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)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.drugalcdep.2021.108977

Cite this

Root, E. D., Slavova, S., LaRochelle, M., Feaster, D. J., Villani, J., Defiore-Hyrmer, J., El-Bassel, N., Ergas, R., Gelberg, K., Jackson, R., Manchester, K., Parikh, M., Rock, P., & Walsh, S. L. (2021). 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. Drug and Alcohol Dependence, 228, [108977]. https://doi.org/10.1016/j.drugalcdep.2021.108977

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title = "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",

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.",

keywords = "COVID-19, Emergency department encounter, HEALing Communities Study, Opioid use disorder, Segmented regression, Syndromic surveillance",

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

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: {\textcopyright} 2021",

year = "2021",

month = nov,

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doi = "10.1016/j.drugalcdep.2021.108977",

language = "English",

volume = "228",

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Root, ED, Slavova, S, LaRochelle, M, Feaster, DJ, Villani, J, Defiore-Hyrmer, J, El-Bassel, N, Ergas, R, Gelberg, K, Jackson, R, Manchester, K, Parikh, M, Rock, P & Walsh, SL 2021, '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', Drug and Alcohol Dependence, vol. 228, 108977. https://doi.org/10.1016/j.drugalcdep.2021.108977

TY - JOUR

T1 - 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

AU - Root, Elisabeth D.

AU - Slavova, Svetla

AU - LaRochelle, Marc

AU - Feaster, Daniel J.

AU - Villani, Jennifer

AU - Defiore-Hyrmer, Jolene

AU - El-Bassel, Nabila

AU - Ergas, Rosa

AU - Gelberg, Kitty

AU - Jackson, Rebecca

AU - Manchester, Kara

AU - Parikh, Megha

AU - Rock, Peter

AU - Walsh, Sharon L.

N1 - 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

PY - 2021/11/1

Y1 - 2021/11/1

N2 - 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.

AB - 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.

KW - COVID-19

KW - Emergency department encounter

KW - HEALing Communities Study

KW - Opioid use disorder

KW - Segmented regression

KW - Syndromic surveillance

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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

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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Cite this