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During the COVID-19 pandemic, emergency department (ED) visits plummeted. Yet studies have shown the proportion of visits for substance use has increased (Am J Emerg Med 2020 Jun 1; [e-pub]).
Using data from a single ED in Richmond, Virginia, researchers compared unintentional nonfatal opioid overdoses between March 1 and June 30, 2020, with the same time period in 2019. There were more than twice as many visits for nonfatal opioid overdoses in 2020 (n=227) compared with 2019 (n=102), despite roughly 10,000 fewer ED visits in 2020. Black patients accounted for the highest number of overdoses in both years, and the proportion was 17% higher in 2020 than in 2019 (80% vs. 63%). Only 55% of patients received a naloxone prescription at discharge; however, there is a standing order at pharmacies for outpatient naloxone in Virginia. More patients in 2020 than in 2019 received treatment resources or referrals (the minimum for which was a list of phone numbers; 68% vs. 44%) and attended outpatient opioid treatment (10% vs. 3%).
Ochalek TA et al. Nonfatal opioid overdoses at an urban emergency department during the COVID-19 pandemic. JAMA 2020 Sep 18; [e-pub]. (https://doi.org/10.1001/jama.2020.17477)
Comment
These findings suggest that during the COVID-19 pandemic, patients with opioid use disorder (OUD), particularly Black patients, may be at higher risk for nonfatal overdose. Although it is encouraging that the proportion of patients receiving referrals or attending outpatient opioid treatment increased from 2019 to 2020, the numbers are still dismal. This study highlights the need for emergency clinicians, communities, and healthcare systems to aggressively promote harm-reduction strategies and help appropriate patients begin treatment with medication for OUD.