Opioid Overdose-Related Emergency Department Visits Pre- and Post-COVID-19.
Opioid overdose and medication for OUD treatment emergency department visit trends both fell 27% below projected rates.
Opioid Overdose-Related Emergency Department Visits Pre- and Post-COVID-19.
Understanding changes in opioid overdose-related emergency department (emergency department) visits and emergency department-based opioid use disorder (opioid use disorder) treatment post-coronavirus disease 2019 (COVID-19) pandemic can inform ongoing efforts to address the opioid crisis.
We aimed to examine trends in opioid overdose-related emergency department visits, emergency department-based medication for opioid use disorder (medication for OUD) treatment, and appendicitis-related emergency department visits (as a control) before and after the initial COVID-19 peak in April 2020.
We conducted an interrupted time series analysis of monthly emergency department visits from January 2017-December 2022 at three hospitals in California.
Of the 781,488 emergency department visits across the entire study period, there were 2,536 (0.32%) opioid overdose-related visits, 9,755 (1.25%) medication for OUD treatment visits, and 1,123 (0.14%) appendicitis-related visits.
Pre-pandemic, monthly increases were observed in opioid overdose-related visits (6.7 visits/10,000 per month, 95% confidence interval [CI] 2.6-10.8, P = .001), medication for OUD-positive visits (34.9 visits/10,000 per month, 95% CI, 26.0-43.7, P < .001), and appendicitis visits (2.5 visits/10,000 per month, 95% CI, 1.2-3.9, P < .001).
From pre- to post-initial COVID-19 peak, absolute emergency department-based medication for OUD treatment trends declined over three times faster than those of opioid overdose-related emergency department visits (although percentage changes relative to expected April 2020 rates were both -27%).
These findings may reflect reduced perceived urgency as overdose presentations decreased and a shift away from crisis-driven implementation, underscoring the need for intentional integration of medication for OUD into routine emergency department practice to sustain treatment capacity.