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Abstract
BackgroundThere are preliminary indications that the trajectory of drug overdose-related deaths in North America has been exacerbated due to the novel coronavirus disease pandemic (COVID-19). As such, the impact of COVID-19 on drug overdose-related deaths was examined through a systematic review of the literature and percentage change analyses of surveillance data.MethodsSystematic searches in electronic databases were conducted, a topical issue brief and bibliography were reviewed, reference lists of included studies were searched and expert consultations were held to identify studies (Registration # CRD42021230223). Observational studies from the United States and Canada were eligible for inclusion if drug overdose-related deaths were assessed in quantitative or qualitative analyses onwards from at least March 2020. In addition, percentage changes comparing drug overdose-related deaths in the second annual quarter (Q2 2020 [April to June]) with the first annual quarter (Q1 2020 [January to March]) were generated using national and subnational data from public health surveillance systems and reports from jurisdictions in the United States and Canada.ResultsNine studies were included in the systematic review, eight from the United States and one from Canada. The maximum outcome assessment period in the included studies extended until September 2020. Drug overdose-related deaths after the onset of COVID-19 were higher compared with the months leading up to the pandemic in 2020 and the comparative months in 2019. In additional percentage change analyses, drug overdose-related deaths increased by 2 to 60% in jurisdictions in the United States and by 58% in Canada when comparing Q2 2020 with Q1 2020.ConclusionsDrug overdose-related deaths increased after the onset of COVID-19. The current situation necessitates a multi-pronged approach, encompassing expanded access to substance use disorder treatment, undisrupted access to harm reduction services, emphasis on risk reduction strategies, provision of a safe drug supply and decriminalization of drug use.
Highlights
The severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a zoonotic coronavirus, the causative agent of the novel coronavirus disease (COVID-19) [1]
Drug overdose-related deaths increased after the onset of COVID-19
Four included studies focused exclusively on opioids. These studies underscored that drug overdose-related deaths after the onset of COVID-19 were higher compared with the months leading up to the pandemic in 2020 and comparative months in 2019 offices of the chief medical officer or coroner, vital records systems and other electronic surveillance systems
Summary
The severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a zoonotic coronavirus, the causative agent of the novel coronavirus disease (COVID-19) [1]. Given the severity of the outbreaks across the globe, the World Health Organization declared it a pandemic on March 11, 2020. Self-isolation after potential exposure or symptom development has been recommended or mandated depending on the local jurisdiction. Despite their utility in reducing the spread of the disease, these measures are associated with substantial social and economic consequences [3, 4], with disproportionate impacts on marginalized populations, including people who use drugs (PWUD). There are preliminary indications that the trajectory of drug overdose-related deaths in North America has been exacerbated due to the novel coronavirus disease pandemic (COVID-19). The impact of COVID-19 on drug overdose-related deaths was examined through a systematic review of the literature and percentage change analyses of surveillance data
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