Opioid Overdoses Increase at Home During the COVID-19 Stay-At-Home Order Period in Cook County, Illinois
Introduction: Stay-at-home orders during the COVID-19 pandemic decreased population mobility to reduce SARS-CoV-2 infection rates. We empirically tested the hypothesis that this public health measure was associated with a higher likelihood of opioid- and stimulant-involved deaths occurring in homes...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | AJPM Focus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2773065422000062 |
| _version_ | 1828158657897955328 |
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| author | Chris Delcher, PhD Daniel R. Harris, PhD Nicholas Anthony, MS Mojde Mir, MPH |
| author_facet | Chris Delcher, PhD Daniel R. Harris, PhD Nicholas Anthony, MS Mojde Mir, MPH |
| author_sort | Chris Delcher, PhD |
| collection | DOAJ |
| description | Introduction: Stay-at-home orders during the COVID-19 pandemic decreased population mobility to reduce SARS-CoV-2 infection rates. We empirically tested the hypothesis that this public health measure was associated with a higher likelihood of opioid- and stimulant-involved deaths occurring in homes located in Cook County, Illinois. Methods: The stay-at-home period was from March 21, 2020 to May 30, 2020. We analyzed overdose data from the Cook County Medical Examiner's Office using a death location description from case investigations categorized as home, medical, motel, scene, and other. Two groups of decedents were defined as either having an opioid or stimulant listed in the primary cause of death field. We modeled a weekly time series to detect changes in deaths (number) and trends during segmented time periods. Chi-square or Fisher's exact and adjusted logistic regression was used for testing the differences between the stay-at-home and a 13-week preceding period. Results: There were 4,169 and 2,012 opioid- and stimulant-involved deaths, respectively, from 2018 to 2020. Both groups were demographically similar: 75% male, 52% White, and aged 45 years (mean). In the 13 weeks before stay-at-home orders, 51% of opioid-involved deaths occurred in homes, which increased to 59% (p<0.0001) during the 10 weeks of the order and decreased back to 51% in the 18 weeks after the order expired. For stimulant-involved deaths, 51% were residential immediately before the orders, with a nonsignificant increase to 52% during the stay-at-home period. Before the pandemic, there were 20 deaths/week, increasing to 37 deaths/week (p<0.0001) during stay-at-home enactment. Deaths involving fentanyl among the opioid-involved group increased from 76% to 89%, whereas those involving heroin decreased from 55% to 37%. The adjusted OR for opioid-involved fatal overdoses occurring at home during this period compared with that occurring the 13 weeks before was 1.37 (95% CI=1.05, 1.79). Conclusions: The likelihood of a death occurring at home, especially for people using opioids, increased during the stay-at-home order period. Findings have implications for mitigating overdose risks during social isolation. |
| first_indexed | 2024-04-11T23:47:26Z |
| format | Article |
| id | doaj.art-36cf0d71d03a48eaa145653c0cd8e7d7 |
| institution | Directory Open Access Journal |
| issn | 2773-0654 |
| language | English |
| last_indexed | 2024-04-11T23:47:26Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | AJPM Focus |
| spelling | doaj.art-36cf0d71d03a48eaa145653c0cd8e7d72022-12-22T03:56:35ZengElsevierAJPM Focus2773-06542022-09-0111100007Opioid Overdoses Increase at Home During the COVID-19 Stay-At-Home Order Period in Cook County, IllinoisChris Delcher, PhD0Daniel R. Harris, PhD1Nicholas Anthony, MS2Mojde Mir, MPH3Institute for Pharmaceutical Outcomes and Policy, UK College of Pharmacy, University of Kentucky, Lexington, Kentucky; Department of Pharmacy Practice and Science, UK College of Pharmacy, University of Kentucky, Lexington, Kentucky; Address correspondence to: Chris Delcher, PhD, Institute for Pharmaceutical Outcomes and Policy, University of Kentucky, 760 Press Avenue, Research Building 2, Suite 260, Lexington KY 40536-0679.Institute for Pharmaceutical Outcomes and Policy, UK College of Pharmacy, University of Kentucky, Lexington, Kentucky; Department of Pharmacy Practice and Science, UK College of Pharmacy, University of Kentucky, Lexington, KentuckyInstitute for Pharmaceutical Outcomes and Policy, UK College of Pharmacy, University of Kentucky, Lexington, Kentucky; Department of Pharmacy Practice and Science, UK College of Pharmacy, University of Kentucky, Lexington, KentuckyCook County Medical Examiner's Office, Chicago, IllinoisIntroduction: Stay-at-home orders during the COVID-19 pandemic decreased population mobility to reduce SARS-CoV-2 infection rates. We empirically tested the hypothesis that this public health measure was associated with a higher likelihood of opioid- and stimulant-involved deaths occurring in homes located in Cook County, Illinois. Methods: The stay-at-home period was from March 21, 2020 to May 30, 2020. We analyzed overdose data from the Cook County Medical Examiner's Office using a death location description from case investigations categorized as home, medical, motel, scene, and other. Two groups of decedents were defined as either having an opioid or stimulant listed in the primary cause of death field. We modeled a weekly time series to detect changes in deaths (number) and trends during segmented time periods. Chi-square or Fisher's exact and adjusted logistic regression was used for testing the differences between the stay-at-home and a 13-week preceding period. Results: There were 4,169 and 2,012 opioid- and stimulant-involved deaths, respectively, from 2018 to 2020. Both groups were demographically similar: 75% male, 52% White, and aged 45 years (mean). In the 13 weeks before stay-at-home orders, 51% of opioid-involved deaths occurred in homes, which increased to 59% (p<0.0001) during the 10 weeks of the order and decreased back to 51% in the 18 weeks after the order expired. For stimulant-involved deaths, 51% were residential immediately before the orders, with a nonsignificant increase to 52% during the stay-at-home period. Before the pandemic, there were 20 deaths/week, increasing to 37 deaths/week (p<0.0001) during stay-at-home enactment. Deaths involving fentanyl among the opioid-involved group increased from 76% to 89%, whereas those involving heroin decreased from 55% to 37%. The adjusted OR for opioid-involved fatal overdoses occurring at home during this period compared with that occurring the 13 weeks before was 1.37 (95% CI=1.05, 1.79). Conclusions: The likelihood of a death occurring at home, especially for people using opioids, increased during the stay-at-home order period. Findings have implications for mitigating overdose risks during social isolation.http://www.sciencedirect.com/science/article/pii/S2773065422000062Opioidsstimulantsfatal overdosesCOVID-19 |
| spellingShingle | Chris Delcher, PhD Daniel R. Harris, PhD Nicholas Anthony, MS Mojde Mir, MPH Opioid Overdoses Increase at Home During the COVID-19 Stay-At-Home Order Period in Cook County, Illinois AJPM Focus Opioids stimulants fatal overdoses COVID-19 |
| title | Opioid Overdoses Increase at Home During the COVID-19 Stay-At-Home Order Period in Cook County, Illinois |
| title_full | Opioid Overdoses Increase at Home During the COVID-19 Stay-At-Home Order Period in Cook County, Illinois |
| title_fullStr | Opioid Overdoses Increase at Home During the COVID-19 Stay-At-Home Order Period in Cook County, Illinois |
| title_full_unstemmed | Opioid Overdoses Increase at Home During the COVID-19 Stay-At-Home Order Period in Cook County, Illinois |
| title_short | Opioid Overdoses Increase at Home During the COVID-19 Stay-At-Home Order Period in Cook County, Illinois |
| title_sort | opioid overdoses increase at home during the covid 19 stay at home order period in cook county illinois |
| topic | Opioids stimulants fatal overdoses COVID-19 |
| url | http://www.sciencedirect.com/science/article/pii/S2773065422000062 |
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