Impact of COVID-19 Pandemic on Drug Overdoses in Indianapolis
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Impact of COVID-19 Pandemic on Drug Overdoses in Indianapolis Nancy Glober & George Mohler & Philip Huynh & Tom Arkins & Dan O’Donnell & Jeremy Carter & Brad Ray
Accepted: 4 September 2020 # The New York Academy of Medicine 2020
Abstract We described the change in drug overdoses during the COVID-19 pandemic in one urban emergency medical services (EMS) system. Data was collected from Marion County, Indiana (Indianapolis), including EMS calls for service (CFS) for suspected overdose, CFS in which naloxone was administered, and fatal overdose data from the County Coroner’s Office. With two sample t tests and ARIMA time series forecasting, we showed changes in the daily rates of calls (all EMS CFS, overdose CFS, and CFS in which naloxone was administered) before and after the stay-at-home order in Indianapolis. We further showed differences in the weekly rate of overdose deaths. Overdose CFS and EMS naloxone administration showed an increase with the social isolation of the Indiana stay-at-home order, but a continued increase after the stay-at-home order was terminated. Despite a mild 4% increase in all EMS CFS, overdose CFS increased 43% and CFS with naloxone administration increased 61% after the stay-athome order. Deaths from drug overdoses increased by 47%. There was no change in distribution of age, race/ethnicity, or zip code of those who overdosed after the stay-at-home order was issued. We hope this data informs policy-makers preparing for future COVID-19 responses and other disaster responses. N. Glober (*) : G. Mohler : T. Arkins : D. O’Donnell J. Carter Indiana University, Indianapolis, IN, USA e-mail: [email protected] P. Huynh : B. Ray Wayne State University, Detroit, MI, USA
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Keywords Overdose . Opioid . COVID-19 . Pandemic . EMS
Introduction The overdose epidemic persists as one of the most pressing public health issues in the United States (U.S.). The majority of deaths from overdoses are opioid-related, though the specific type of opioid varies [1–3]. Over time, increases in overdoses were initially linked to opioid pain analgesics but shifted to illicit opioids, such as heroin and fentanyl [2, 4–7]. More recently, public health officials and healthcare providers have noted a sharp increase in overdose deaths associated with illicit synthetic substances, specifically cocaine and methamphetamines, in urban areas [6–8]. Some evidence suggests that spikes have occurred in opioid overdoses in several jurisdictions across the U.S. during the COVID-19 pandemic [9–18]. To date, no national data exist to assess the impact to overdose events of the COVID-19 pandemic. Different theories exist to explain the observed increase in overdose deaths during the COVID-19 pandemic. Drug trafficking patterns likely changed secondary to disrupted travel and international social distancing guidelines. With the changes in drug trafficking, it is possible that illicit drugs differing in purity and potency are being manufactured locally and by individuals. In light of widespread social distancing, individual patterns of dr
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