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Impact of the COVID-19 pandemic on opioid overdose and other adverse events in the USA and Canada: a systematic review.
Simha, Siddartha; Ahmed, Yusuf; Brummett, Chad M; Waljee, Jennifer F; Englesbe, Michael J; Bicket, Mark C.
  • Simha S; Anesthesiology, Michigan Medicine, Ann Arbor, Michigan, USA.
  • Ahmed Y; University of Michigan Medical School, Ann Arbor, Michigan, USA.
  • Brummett CM; Anesthesiology, Michigan Medicine, Ann Arbor, Michigan, USA.
  • Waljee JF; Michigan Opioid Prescribing Engagement Network, Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan, USA.
  • Englesbe MJ; Michigan Opioid Prescribing Engagement Network, Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan, USA.
  • Bicket MC; Surgery, Michigan Medicine, Ann Arbor, Michigan, USA.
Reg Anesth Pain Med ; 48(1): 37-43, 2023 01.
Article in English | MEDLINE | ID: covidwho-2053292
ABSTRACT
IMPORTANCE The COVID-19 pandemic impacted healthcare beyond COVID-19 infections. A better understanding of how COVID-19 worsened the opioid crisis has potential to inform future response efforts.

OBJECTIVE:

To summarize changes from the COVID-19 pandemic on outcomes regarding opioid use and misuse in the USA and Canada. EVIDENCE REVIEW We searched MEDLINE via PubMed, EMBASE, and CENTRAL for peer-reviewed articles published between March 2020 and December 2021 that examined outcomes relevant to patients with opioid use, misuse, and opioid use disorder by comparing the period before vs after COVID-19 onset in the USA and Canada. Two reviewers independently screened studies, extracted data, assessed methodological quality and bias via Newcastle-Ottawa Scale, and synthesized results.

FINDINGS:

Among 20 included studies, 13 (65%) analyzed service utilization, 6 (30%) analyzed urine drug testing results, and 2 (10%) analyzed naloxone dispensation. Opioid-related emergency medicine utilization increased in most studies (85%, 11/13) for both service calls (17% to 61%) and emergency department visits (42% to 122%). Urine drug testing positivity results increased in all studies (100%, 6/6) for fentanyl (34% to 138%), most (80%, 4/5) studies for heroin (-12% to 62%), and most (75%, 3/4) studies for oxycodone (0% to 44%). Naloxone dispensation was unchanged and decreased in one study each.

INTERPRETATION:

Significant increases in surrogate measures of the opioid crisis coincided with the onset of COVID-19. These findings serve as a call to action to redouble prevention, treatment, and harm reduction efforts for the opioid crisis as the pandemic evolves. PROSPERO REGISTRATION NUMBER CRD42021236464.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Drug Overdose / Opiate Overdose / COVID-19 / Opioid-Related Disorders Type of study: Diagnostic study / Experimental Studies / Observational study / Reviews / Systematic review/Meta Analysis Limits: Humans Country/Region as subject: North America Language: English Journal: Reg Anesth Pain Med Journal subject: Anesthesiology / Neurology / Psychophysiology Year: 2023 Document Type: Article Affiliation country: Rapm-2022-103591

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Drug Overdose / Opiate Overdose / COVID-19 / Opioid-Related Disorders Type of study: Diagnostic study / Experimental Studies / Observational study / Reviews / Systematic review/Meta Analysis Limits: Humans Country/Region as subject: North America Language: English Journal: Reg Anesth Pain Med Journal subject: Anesthesiology / Neurology / Psychophysiology Year: 2023 Document Type: Article Affiliation country: Rapm-2022-103591