Statement of purpose To use data from a state-wide opioid overdose surveillance system in Michigan to evaluate changes in opioid overdose frequency during the COVID-19 pandemic.
Methods/Approach The System for Opioid Overdose Surveillance (SOS) is a near real-time overdose surveillance system in the state of Michigan run out of the University of Michigan Injury Prevention Center, in collaboration with the Michigan HIDTA. SOS receives daily data feeds containing all EMS encounters involving naloxone administration, and daily data on suspected fatal overdoses from medical examiners covering ∼80% of the state’s population. We used SOS data to compare spatial and temporal changes in suspected opioid overdoses after 3/1/20, the approximate timing of the intensification of the COVID-19 pandemic, and compared those changes to those seen at the same time in 2019.
Results From 3/1/20–9/16/20, suspected fatal overdoses were 15.0% higher than during the same time in 2019, and naloxone administrations by EMS were 28.8% higher; a majority of counties and cities saw analogous changes, though the magnitude varied. Rates of both suspected fatal overdoses and EMS naloxone administrations were higher in 2020 prior to March, but the difference increased following the start of the pandemic. By late August, rates of suspected fatal overdoses returned to 2019 levels, but EMS naloxone administration rates remained nearly 40% higher than the same time in 2019.
Conclusions Evidence suggests that overdose and the COVID-19 pandemic are interwoven crises, and resources are required to address both the isolation and stress of the pandemic, and the medical system excess burdens, which all may intensify substance use, and reduce the likelihood of seeking treatment.
Significance Overdose remains a leading cause of death, and that burden has increased during the pandemic in Michigan. Approaches are needed to address secondary effects of the COVID-19 pandemic.
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