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      Impact of the COVID-19 Pandemic on Opioid Overdose Deaths: a Spatiotemporal Analysis

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          Abstract

          The effects of the opioid crisis have varied across diverse and socioeconomically defined urban communities, due in part to widening health disparities. The onset of the COVID-19 pandemic has coincided with a spike in drug overdose deaths in the USA. However, the extent to which the impact of the pandemic on overdose deaths has varied across different demographics in urban neighborhoods is unclear. We examine the influence of COVID-19 pandemic on opioid overdose deaths through spatiotemporal analysis techniques. Using Milwaukee County, Wisconsin as a study site, we used georeferenced opioid overdose data to examine the locational and demographic differences in overdose deaths over time (2017–2020). We find that the pandemic significantly increased the monthly overdose deaths. The worst effects were seen in the poor, urban neighborhoods, affecting Black and Hispanic communities. However, more affluent, suburban White communities also experienced a rise in overdose deaths. A better understanding of contributing factors is needed to guide interventions at the local, regional, and national scales.

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          Most cited references36

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          Signal of Increased Opioid Overdose during COVID-19 from Emergency Medical Services Data

          Highlights • COVID-19 pandemic disrupted treatment service delivery and harm reduction. • Individuals with opioid use disorder may be at heightened risk of opioid overdose. • Emergency medical services (EMS) data is a timely source for overdose surveillance. • Kentucky EMS opioid overdose runs increased significantly during COVID-19 period. • In contrast, average EMS daily runs for other conditions leveled or declined.
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            Inferring causal impact using Bayesian structural time-series models

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              Is Open Access

              Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis

              Objective To evaluate the impact of state supported overdose education and nasal naloxone distribution (OEND) programs on rates of opioid related death from overdose and acute care utilization in Massachusetts. Design Interrupted time series analysis of opioid related overdose death and acute care utilization rates from 2002 to 2009 comparing community-year strata with high and low rates of OEND implementation to those with no implementation. Setting 19 Massachusetts communities (geographically distinct cities and towns) with at least five fatal opioid overdoses in each of the years 2004 to 2006. Participants OEND was implemented among opioid users at risk for overdose, social service agency staff, family, and friends of opioid users. Intervention OEND programs equipped people at risk for overdose and bystanders with nasal naloxone rescue kits and trained them how to prevent, recognize, and respond to an overdose by engaging emergency medical services, providing rescue breathing, and delivering naloxone. Main outcome measures Adjusted rate ratios for annual deaths related to opioid overdose and utilization of acute care hospitals. Results Among these communities, OEND programs trained 2912 potential bystanders who reported 327 rescues. Both community-year strata with 1-100 enrollments per 100 000 population (adjusted rate ratio 0.73, 95% confidence interval 0.57 to 0.91) and community-year strata with greater than 100 enrollments per 100 000 population (0.54, 0.39 to 0.76) had significantly reduced adjusted rate ratios compared with communities with no implementation. Differences in rates of acute care hospital utilization were not significant. Conclusions Opioid overdose death rates were reduced in communities where OEND was implemented. This study provides observational evidence that by training potential bystanders to prevent, recognize, and respond to opioid overdoses, OEND is an effective intervention.
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                Author and article information

                Contributors
                rghose@uwm.edu
                aforati@uwm.edu
                jomantsch@mcw.edu
                Journal
                J Urban Health
                J Urban Health
                Journal of Urban Health : Bulletin of the New York Academy of Medicine
                Springer US (New York )
                1099-3460
                1468-2869
                18 February 2022
                : 1-12
                Affiliations
                [1 ]GRID grid.267468.9, ISNI 0000 0001 0695 7223, Department of Geography, , University Wisconsin-Milwaukee, ; Milwaukee, WI 53211 USA
                [2 ]GRID grid.30760.32, ISNI 0000 0001 2111 8460, Department of Pharmacology and Therapeutics and Institute for Health and Equity, , Medical College of Wisconsin, ; Milwaukee, WI 53206 USA
                Article
                610
                10.1007/s11524-022-00610-0
                8856931
                35181834
                43255e3c-1e06-4270-8dd6-0cb37786d8d0
                © The New York Academy of Medicine 2022

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 18 January 2022
                Categories
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                Public health
                Public health

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