Trends in non-fatal and fatal opioid overdoses during the first two years of the coronavirus disease–2019 pandemic

Abstract

PurposeThis study assessed opioid-involved overdose rates by age, sex, and race-ethnicity across strict pandemic mitigation phases and how this varied across data systems. MethodsWe examined opioid-involved overdoses using medical examiner and hospital data for Cook County, Illinois between 2016-2021. Multivariable segmented regression was used to assess weekly overdose rates across subgroups of age, sex and race/ethnicity and strict pandemic mitigation phases. ResultsThe overall rate of weekly opioid-involved overdoses increased when assessing the medical examiner (β = 0.01; 95% CI = 0.01,0.02; P ≤ .001) and emergency department visits data sources (β = 0.15; 95% CI = 0.09,0.20; P ≤ .001) but not for the hospital admissions data source. We found differences in overdose rates across subgroups and phases of pandemic mandates. Fatal overdoses increased during lockdown-1 while admissions and emergency department (ED) visits for opioid-involved overdoses generally decreased across all phases of pandemic mitigation mandates except for the period following lockdown-1. Across pandemic mitigation phases, Hispanics and individuals under 25 years did not demonstrate any change in admissions and ED visits for overdoses. ConclusionsWe underscore the importance of utilizing multiple sources of surveillance to better characterize opioid-involved overdoses and for public health planning.