TY - JOUR
T1 - How emergency department visits for substance use disorders have evolved during the early COVID-19 pandemic
AU - Pines, Jesse M.
AU - Zocchi, Mark S.
AU - Black, Bernard S.
AU - Carlson, Jestin N.
AU - Celedon, Pablo
AU - Moghtaderi, Ali
AU - Venkat, Arvind
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/10
Y1 - 2021/10
N2 - Objective: Higher opioid overdoses and drug use have reportedly occurred during the COVID-19 pandemic. We provide evidence on how emergency department (ED) visits for substance use disorders (SUD) changed in the early pandemic period. Methods: Using retrospective data from January–July 2020 compared to January–July 2019, we calculated weekly 2020/2019 visit ratios for opioid-related, alcohol-related, other drug–related disorders, and all non-COVID-19 visits. We assess how this ratio as well as overall visit numbers changed after the mid-March 2020 onset of general pandemic restrictions. Results: In 4.5 million ED visits in 2020 and 2019 to 108 EDs in 18 U.S. states, SUD visits were higher in early 2020 compared to 2019. During the peak-pandemic restriction period (March 13–July 31), non-COVID-19, non-SUD visits fell by approximately 45% early on, and then partly recovered with an average decline of 33% relative to 2019 levels. Visits for opioid-related, alcohol-related, and other drug–related disorders also declined, although less sharply, with an average drop of 17%, which was similar across SUD types. The visit ratios for 2020/2019 partially or fully recovered later in our sample period, depending on SUD type, but did not exceed early-2020 levels. However, substantial variation occurred across SUD types and across states. SUD visit declines were most prominent in the 65+ age group, except for alcohol-related visits where trends were similar across ages. SUD visits arriving by ambulance declined less or increased relative to self-transport visits, and ED deaths were rare. Conclusions: The 2020/2019 ratios of SUD ED visits fell substantially early in the COVID-19 pandemic, yet less than non-SUD, non-COVID ED visits. SUD ED visit ratios partly or fully recovered to 2019 levels by early June 2020, but did not exceed early 2020 ratios.
AB - Objective: Higher opioid overdoses and drug use have reportedly occurred during the COVID-19 pandemic. We provide evidence on how emergency department (ED) visits for substance use disorders (SUD) changed in the early pandemic period. Methods: Using retrospective data from January–July 2020 compared to January–July 2019, we calculated weekly 2020/2019 visit ratios for opioid-related, alcohol-related, other drug–related disorders, and all non-COVID-19 visits. We assess how this ratio as well as overall visit numbers changed after the mid-March 2020 onset of general pandemic restrictions. Results: In 4.5 million ED visits in 2020 and 2019 to 108 EDs in 18 U.S. states, SUD visits were higher in early 2020 compared to 2019. During the peak-pandemic restriction period (March 13–July 31), non-COVID-19, non-SUD visits fell by approximately 45% early on, and then partly recovered with an average decline of 33% relative to 2019 levels. Visits for opioid-related, alcohol-related, and other drug–related disorders also declined, although less sharply, with an average drop of 17%, which was similar across SUD types. The visit ratios for 2020/2019 partially or fully recovered later in our sample period, depending on SUD type, but did not exceed early-2020 levels. However, substantial variation occurred across SUD types and across states. SUD visit declines were most prominent in the 65+ age group, except for alcohol-related visits where trends were similar across ages. SUD visits arriving by ambulance declined less or increased relative to self-transport visits, and ED deaths were rare. Conclusions: The 2020/2019 ratios of SUD ED visits fell substantially early in the COVID-19 pandemic, yet less than non-SUD, non-COVID ED visits. SUD ED visit ratios partly or fully recovered to 2019 levels by early June 2020, but did not exceed early 2020 ratios.
KW - Alcohol
KW - COVID-19
KW - Drug use
KW - Emergency department
KW - Opioids
KW - Overdose
KW - Substance use
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U2 - 10.1016/j.jsat.2021.108391
DO - 10.1016/j.jsat.2021.108391
M3 - Review article
C2 - 33994360
AN - SCOPUS:85103095776
SN - 0740-5472
VL - 129
JO - Journal of Substance Abuse Treatment
JF - Journal of Substance Abuse Treatment
M1 - 108391
ER -