Theme: Epidemiology and Public Health Research Year: 2021
Background: The syndemic of COVID-19 and drug overdose deaths continues to evolve in the United States (US) and elsewhere. We sought to identify emerging characteristics of drug overdose decedents during the COVID-19 pandemic. Methods: In this retrospective cohort studies of overdose decedents in Rhode Island, US, we compared 470 adult whose deaths occurred during the periods of January to August 2019 and January to August, 2020. This population-based study leverages 4 statewide databases that are linked at the personlevel via the Rhode Island Data Ecosystem. We compared sociodemographic characteristics, drugs contributing to the cause of death, location of death, and sociostructural factors (i.e., housing insecurity, job loss, and wages). Among overdose decedents who were Medicaid beneficiaries (N=271), we also examined behavioral health treatment and diagnosis claims in the year prior to death. Results: The rate of accidental drug overdose deaths increased by 28.1% (P=0.009), during the two observation periods. In the 2020 observation period, overdose decedents were primarily male (204, 77%) and white (223, 84%). Relative to the prior year, we documented increases in the rate of overdose deaths among males (P=0.003), people who are single (P=0.039), in deaths involving synthetic opioids (P=0.005), and in deaths occurring in one’s personal residence (P=0.003). We also documented a decline in the proportion of overdose deaths involving heroin (P=0.016) and an increase among persons experiencing job loss (P=0.014). Among overdose decedents who were Medicaid beneficiaries, we documented substantial increases in the proportion of persons age 50-59 with anxiety (113%), persons age 50-59 with depression (75%), and males with depression (70%). Conclusion: We identified several emerging characteristics of drug overdose decedents during the COVID-19 pandemic. The results from this study may be used to inform policy and service delivery interventions that are responsive to sociostructural and environmental changes precipitated by the pandemic. Disclosure of Interest Statement: Ms. Macmadu was supported by a grant from the National Institute on Drug Abuse (F31-DA052971- 01). Dr. Marshall and Ms. Yedinak were supported by grants from the National Institute on Drug Abuse (R01-DA046620-02S1) and the Center for Biomedical Research Excellence (COBRE) on Opioids and Overdose, funded by the National Institute of General Medical Sciences (P20-GM125507). The funding sources 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. The views and opinions outlined herein are those of the authors and do not necessarily reflect those of the state of Rhode Island, the Rhode Island Executive Office of Health and Human Services, or any organizations contributing data.
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