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Opioids

Nonfatal Opioid Overdoses at an Urban Emergency Department During the COVID-19 Pandemic

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA

Published Online: September 18, 2020

Research Letter

Article Information and Disclosures

Taylor A. Ochalek, PhD¹;

Kirk L. Cumpston, DO²;

Brandon K. Wills, DO²;

Tamas S. Gal, PhD³;

F. Gerard Moeller, MD⁴

Author Affiliations

¹Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond
²Department of Emergency Medicine, Virginia Commonwealth University, Richmond
³Department of Biostatistics, Virginia Commonwealth University, Richmond
⁴Department of Psychiatry, Virginia Commonwealth University, Richmond

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Risks of Mortality Following Nonfatal Intentional and Unintentional Opioid Overdoses

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Psychosocial consequences related to coronavirus disease 2019 (COVID-19) may place individuals at a heightened likelihood of opioid overdose or relapse.¹^,2 In 1 study,² emergency medical services responses to opioid overdoses in Kentucky were increased in the early weeks following the COVID-19 state emergency declaration compared with the 52 previous days. This increased risk of opioid overdose may be particularly concerning among Black patients, who have been overrepresented in COVID-19–related infections, hospitalizations, and deaths, as well as associated socioeconomic consequences.³^- 5 Given that emergency departments offer an opportune setting to initiate treatment, this study compared numbers of nonfatal, unintentional opioid-related opioid overdoses presenting to an urban emergency department during the early months of the pandemic relative to the previous year.

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Article Information

Corresponding Author: Taylor A. Ochalek, PhD, Virginia Commonwealth University C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Richmond Academy of Medicine Bldg, 1200 E Clay St, Richmond, VA 23298 (taylor.ochalek@vcuhealth.org).

Accepted for Publication: August 25, 2020.

Published Online: September 18, 2020. doi:10.1001/jama.2020.17477

Author Contributions: Drs Ochalek and Gal had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Ochalek, Wills, Moeller.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Ochalek.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Ochalek, Gal.

Administrative, technical, or material support: Wills, Moeller.

Supervision: Ochalek, Cumpston, Moeller.

Conflict of Interest Disclosures: Dr Moeller reported consulting for Indivior PLC, Boehringer Ingelheim, and Astellas and receiving grant support from Indivior PLC and Nektar. No other disclosures were reported.

Funding/Support: This study was supported in part by National Institutes of Health research training grant NIDA T32 DA7027-44; National Institutes of Health grants UL1TR002649, U54DA038999, and NCI P30 CA016059/36; and funding from Indivior PLC and Virginia Catalyst.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References

Wakeman SE , Green TC , Rich J . An overdose surge will compound the COVID-19 pandemic if urgent action is not taken. Nat Med. 2020;26(6):819-820. doi:10.1038/s41591-020-0898-0 PubMed Google Scholar

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;214:108176. doi:10.1016/j.drugalcdep.2020.108176 PubMed Google Scholar

Yancy CW . COVID-19 and African Americans. JAMA. 2020;323(19):1891. doi:10.1001/jama.2020.6548 PubMed Google Scholar

Dowling MK , Kelly RL . Policy solutions for reversing the color-blind public health response to COVID-19 in the US. JAMA. 2020;324(3):229. doi:10.1001/jama.2020.10531 PubMed Google Scholar

Galea S , Abdalla SM . COVID-19 pandemic, unemployment, and civil unrest: underlying deep racial and socioeconomic divides. JAMA. 2020;324(3):227. doi:10.1001/jama.2020.11132 PubMed Google Scholar

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.