Impact of the COVID-19 pandemic on opioid overdose and other adverse events in the USA and Canada: a systematic review.
Reg Anesth Pain Med
; 48(1): 37-43, 2023 01.
Article
in En
| MEDLINE
| ID: mdl-36202619
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.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Drug Overdose
/
Opiate Overdose
/
COVID-19
/
Opioid-Related Disorders
Type of study:
Diagnostic_studies
/
Systematic_reviews
Limits:
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
Reg Anesth Pain Med
Journal subject:
ANESTESIOLOGIA
/
NEUROLOGIA
/
PSICOFISIOLOGIA
Year:
2023
Document type:
Article
Affiliation country:
United States
Country of publication:
United kingdom