Large Increase Seen in Overdose-Related Cardiac Arrests in COVID-19

FRIDAY, Dec. 4, 2020 — There was a large national increase in overdose-related cardiac arrests during the initial months of the COVID-19 pandemic, according to a research letter published online Dec. 3 in JAMA Psychiatry.

Joseph Friedman, M.P.H., from the University of California in Los Angeles, and colleagues conducted a retrospective observational analysis using the National Emergency Medical Service (EMS) Information System to characterize trends in overdose mortality during the COVID-19 pandemic. Weekly overdose-related cardiac arrests and overdose-related EMS activations were calculated; values for 2020 were compared to the average of 2018 and 2019 values.

The researchers observed a sharp increase in overdose-related cardiac arrests during April 2020, reaching 74.1 per 100,000 EMS activations by May 4 (123.4 percent above baseline). A subsequent decrease was seen in overdose-related cardiac arrests, but the number remained elevated at 48.7 per 100,000 EMS activations by July 27 (53.7 percent above baseline). Through Aug. 1, overdose-related cardiac arrests totaled 49.5 per 100,000 EMS activations, at 48.5 percent above baseline. These trends corresponded temporally with a decrease in mobility starting March 16, reaching −51.8 percent by April 13 and −24.3 percent by July 27. In 2020, weekly rates of overdose-related EMS activations were elevated, but values were similar before and during reductions in mobility.

“Shifts observed here suggest that measures to address the pandemic have largely failed to mitigate overdose risk,” the authors write. “These trends implicate investments in substance use treatment, harm reduction, and structural drivers of overdose as core elements of COVID-19 response.”

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