Investigating the pandemic's effect on overdoses

While preliminary data shows no significant change in overdose numbers, one agency describes how stay-at-home orders have impacted overdose locations and outreach efforts


As COVID-19 quickly materialized from a mysterious pneumonia to a global pandemic, federal, state, local and tribal governments and communities were faced with the challenge of balancing two national public health emergencies: opioids and COVID-19.

As restrictions progressed from social distancing to stay-at-home orders, those on the front lines of the opioid epidemic began to deliberate the possible implications of COVID-19 on substance use disorder (SUD) populations. Concurrently, the Overdose Detection Mapping Application Program (ODMAP) Program Office received multiple requests from media, communities, ODMAP users and quick response teams, inquiring about the data and impact on this population.

As a result, beginning on March 23, 2020, we have analyzed the data weekly. Preliminary analysis presented a potential decline, however, as the pandemic has progressed, no statistically significant change has been observed. Here are a few reminders regarding ODMAP data:

  • Many state and local governments have never captured non-fatal suspected overdose data, so a control does not exist;
  • Drug trends are continually evolving due to the rapid introduction of synthetic analogs, which makes it difficult to use historical data as a predictor of future data
  • ODMAP defers to state and local agencies to define "suspected overdose," so there are concerns with data quality and consistency across jurisdictional boundaries;
  • There are areas that are not reporting suspected overdoses into ODMAP and/or not doing so consistently; and
  • Analysis to date has been conducted on a small sample size of the highest level of data integrity.

The Cheektowaga Police Department (CPD) and the Erie County Department of Public Health have been utilizing ODMAP since August 2017. The integrative public health and public safety model has been led by Assistant Chief Brian Gould, (CPD) and Cheryll Moore, Medical Care Administrator.

The partnership we have established with Gould and Moore has been incredibly productive, giving us an opportunity to co-present on this issue at numerous national meetings. Given the data integrity, consistency and historical nature of their data, it was a natural starting point to evaluate trends/patterns.

As the pandemic progressed ODMAP Analyst Chris Yeager found that suspected overdoses reported in ODMAP for Erie were increasing. Prior to this observation, suspected overdoses within Erie County had been on a significant decline for nearly two years. We reached out to Gould and Moore to review and validate the data and trends and were informed, regrettably, that the data was accurate.

Moore and Gould reported the pandemic appears to be affecting a population that they have not engaged with previously. Overdose victims are being found in their residences or motels, no longer in public places as they had previously witnessed. There does not appear to be a dominant drug as they are ranging from cocaine, prescription pills, heroin and more. Arguably, the most detrimental component of the epidemic are the stay-at-home orders, which are not only producing a change in overdose locations, but also the method in which harm reduction services occur. Moore and Gould report community-level outreach has been reduced, peer recovery coaches are conducting virtual outreach and community naloxone training has been halted.

Gould and Moore have always been progressive and determined, and as a result, are continuing to respond with innovative methods to keep people alive. They are now working with partners such as food pantries, soup kitchens and first responders to distribute naloxone to residents during their daily routines. They are also targeting messaging and access to hotels, homeless shelters and gas stations.

Did I mention that Gould and Moore are so committed that Moore’s personal number is utilized for people to contact about access to naloxone? Of course, this is all anecdotal, but we can’t wait for the data to be perfect to develop strategies. We have to act now, so our communities will be around to thank us later.

Agencies using ODMAP can use COVID-19 data layers to compare virus and overdose datasets and see any potential correlations. The video below demonstrates how to use the feature.

 

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