Opioid Overdose Crises During the COVID-19 Pandemic: Implication of Health Disparity

Background. Given increased opioid overdose death and the racial disparities in COVID-19 morbidity and mortality, this study aims to describe ED visits pertaining to opioid overdose and any related health disparities in a tertiary medical center.
Methods. Patients presenting to the ED at the University of Alabama at Birmingham hospital with opioid overdoses from January 1 to October 31, 2019, and from January 1 to October 31, 2020, were identified from electronic medical records.
Results. The total number of opioid overdose visits increased 10.0% (557 to 611) between January through October of 2019 and 2020. Among patients who presented with opioid overdose, the mean ages were 50.3 years and 48.3 years, in 2019 and 2020, respectively. Although 28 patients did not record their sex and race in 2020, more females presented with opioid overdose (274 vs. 241) and more Blacks than Whites (306 vs. 284). An increase was noted in patients who did not have health insurance (70 vs. 61) and were enrolled in Medicaid or Medicare programs (387 vs. 345). Based on ICD-10 codes, fewer heroin-related overdose in 2020 was observed than in 2019, however, total opioid overdose was increased.
Conclusions. The study reported a greater number of visits for opioid overdoses from January to October of 2020 in an ED. Our findings highlight the importance of substance use treatment, harm reduction, and overdose prevention efforts that should be immediately present to reduce opioid overdose especially for vulnerable populations, including the Black community and individuals with low socioeconomic status.

References: 1. https://www.cdc.gov/media/releases/2020/p1218-overdose-deaths-covid-19.html
2. https://www.al.com/news/2020/09/opioid-crisis-roars-back-in-alabama-as-overdoses-rise-during-pandemic.html
3. https://www.acep.org/corona/covid-19-field-guide/special-populations/patients-with-substance-use-disorders
4. Slavova S, Rock P, Bush HM, Quesinberry D, Walsh SL. Signal of increased opioid overdose during COVID-19 from emergency medical services data. Drug Alcohol Depend. 2020 Sep 1;214:108176

Learning Objective: The objective of this paper is to highlight any health disparities that may result more clearly due to COVID-19 and its unintended impact on patients living with opioid use disorder. The paper also aims to demonstrate how individuals from certain backgrounds with opioid use disorder are influenced more negatively due to the pandemic and the limitations imposed by the pandemic as well as the society.