REFILE-Rates of fatal drug overdose rise during COVID-19 pandemic among men, at-home deaths


(Refiling October 26 story to correct formatting problem experienced by some clients.)

By Lisa Rapaport

(Reuters Health) - Rates of drug overdose fatalities climbed overall in Rhode Island over the first eight months of 2020 when compared to the same period the previous year, with notable increases in fatalities at home, among men and from synthetic opioids, a small study suggests.

Researchers examined data on unintentional deaths from drug overdoses from January through August in 2019 and 2020. The records came from four sources: the Rhode Island Department of Health, Medicaid claims and enrollment, the Department of Labor and Training, and the Homeless Management Information System.

The analysis included a total of 470 people who died of overdoses at a mean age of 43.5 years, most of whom (75%) were male.

Overdose death rates climbed 28.1%, from 29.2 fatalities per 100,000 person years during the 2019 study period to 37.4 fatalities per 100,000 person years during the observation period in 2020.

During the pandemic, more than half of these deaths (53%) occurred at home, far more than happened in hospitals (6%) or outpatient clinics (27%).

"We already knew that stay-at-home orders left many people socially and physically isolated, especially during initial months of the pandemic," said lead study author Alexandria Macmadu and senior study author Brandon D.L. Marshall of the Department of Epidemiology at the Brown University School of Public Health in Providence, Rhode Island.

"Our finding suggests that more people used drugs alone during the pandemic, which led to more overdose deaths happening at home rather than in a hospital or elsewhere," the authors said by email.

The surge in overdose deaths in 2020 was driven in large part by certain groups of drug users, according to the results published in JAMA Network Open.

In particular, overdose death rates climbed from 2019 to 2020 among men (from 43.2 to 59.2 per 100,000 person-years); white people (from 31.0 to 42.0 per 100,000 person-years); and individuals who were single (54.8 vs 70.4 per 100,000 person-years).

Death rates among synthetic opioid users also climbed during the pandemic (from 20.8 to 28.3 per 100,000 person-years), as did deaths occurring in personal residences (from 13.2 to 19.7 per 100,000 person-years).

When researchers looked specifically at Medicaid beneficiaries who died of overdoses during the study periods in 2019 and 2020, they also found increased fatality rates among certain groups.

In particular, death rates climbed among Medicaid beneficiaries aged 50 to 59 years old with anxiety (from 9% to 19%), men with depression (from 22% to 38%), and men with anxiety (from 23% to 37%).

The proportion of deaths tied to heroin declined (from 5% to less than 2%) during the pandemic.

At the same time, the proportion of overdose deaths among people who were unemployed or who lost a job climbed during the pandemic (from 8% to 16%).

Beyond the limited number of fatalities in the analysis, the results from Rhode Island may not be generalizable to other parts of the U.S., the authors note.

SOURCE: JAMA Network Open, online September 17, 2021.

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