@Article{info:doi/10.2196/29298,
author="Khoury, Dalia
and Preiss, Alexander
and Geiger, Paul
and Anwar, Mohd
and Conway, Kevin Paul",
title="Increases in Naloxone Administrations by Emergency Medical Services Providers During the COVID-19 Pandemic: Retrospective Time Series Study",
journal="JMIR Public Health Surveill",
year="2021",
month="May",
day="27",
volume="7",
number="5",
pages="e29298",
keywords="opioids; naloxone; EMS; emergency medical services; COVID-19; pandemic; medical services; overdose; outcomes; opioid crisis; public health",
abstract="Background: The opioid crisis in the United States may be exacerbated by the COVID-19 pandemic. Increases in opioid use, emergency medical services (EMS) runs for opioid-related overdoses, and opioid overdose deaths have been reported. No study has examined changes in multiple naloxone administrations, an indicator of overdose severity, during the COVID-19 pandemic. Objective: This study examines changes in the occurrence of naloxone administrations and multiple naloxone administrations during EMS runs for opioid-related overdoses during the COVID-19 pandemic in Guilford County, North Carolina (NC). Methods: Using a period-over-period approach, we compared the occurrence of opioid-related EMS runs, naloxone administrations, and multiple naloxone administrations during the 29-week period before (September 1, 2019, to March 9, 2020) and after NC's COVID-19 state of emergency declaration (ie, the COVID-19 period of March 10 to September 30, 2020). Furthermore, historical data were used to generate a quasi-control distribution of period-over-period changes to compare the occurrence of each outcome during the COVID-19 period to each 29-week period back to January 1, 2014. Results: All outcomes increased during the COVID-19 period. Compared to the previous 29 weeks, the COVID-19 period experienced increases in the weekly mean number of opioid-related EMS runs (25.6, SD 5.6 vs 18.6, SD 6.6; P<.001), naloxone administrations (22.3, SD 6.2 vs 14.1, SD 6.0; P<.001), and multiple naloxone administrations (5.0, SD 1.9 vs 2.7, SD 1.9; P<.001), corresponding to proportional increases of 37.4{\%}, 57.8{\%}, and 84.8{\%}, respectively. Additionally, the increases during the COVID-19 period were greater than 91{\%} of all historical 29-week periods analyzed. Conclusions: The occurrence of EMS runs for opioid-related overdoses, naloxone administrations, and multiple naloxone administrations during EMS runs increased during the COVID-19 pandemic in Guilford County, NC. For a host of reasons that need to be explored, the COVID-19 pandemic appears to have exacerbated the opioid crisis. ",
issn="2369-2960",
doi="10.2196/29298",
url="https://publichealth.jmir.org/2021/5/e29298",
url="https://doi.org/10.2196/29298",
url="http://www.ncbi.nlm.nih.gov/pubmed/33999828"
}