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Cited by 101Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesHIV, Drug Use, Sexual Risk

The impact of the novel coronavirus disease (COVID-19) pandemic on drug overdose-related deaths in the United States and Canada: a systematic review of observational studies and analysis of public health surveillance data

Open access
Imtiaz, Sameer, Nafeh, Frishta, Russell, Cayley, Ali, Farihah, Elton-Marshall, Tara, Rehm, Jürgen·2021·Substance Abuse Treatment, Prevention, and Policy
DOI 10.1186/s13011-021-00423-5PMC PMC8628272
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Abstract

Background: There are preliminary indications that the trajectory of drug overdose-related deaths in North America has been exacerbated due to the novel coronavirus disease pandemic (COVID-19). As such, the impact of COVID-19 on drug overdose-related deaths was examined through a systematic review of the literature and percentage change analyses of surveillance data. Methods: Systematic searches in electronic databases were conducted, a topical issue brief and bibliography were reviewed, reference lists of included studies were searched and expert consultations were held to identify studies (Registration # CRD42021230223). Observational studies from the United States and Canada were eligible for inclusion if drug overdose-related deaths were assessed in quantitative or qualitative analyses onwards from at least March 2020. In addition, percentage changes comparing drug overdose-related deaths in the second annual quarter (Q2 2020 [April to June]) with the first annual quarter (Q1 2020 [January to March]) were generated using national and subnational data from public health surveillance systems and reports from jurisdictions in the United States and Canada. Results: Nine studies were included in the systematic review, eight from the United States and one from Canada. The maximum outcome assessment period in the included studies extended until September 2020. Drug overdose-related deaths after the onset of COVID-19 were higher compared with the months leading up to the pandemic in 2020 and the comparative months in 2019. In additional percentage change analyses, drug overdose-related deaths increased by 2 to 60% in jurisdictions in the United States and by 58% in Canada when comparing Q2 2020 with Q1 2020. Conclusions: Drug overdose-related deaths increased after the onset of COVID-19. The current situation necessitates a multi-pronged approach, encompassing expanded access to substance use disorder treatment, undisrupted access to harm reduction services, emphasis on risk reduction strategies, provision of a safe drug supply and decriminalization of drug use.

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  • Drug-related overdose deaths in the US have skyrocketed over the past decade and further accelerated during the COVID pandemic.

    “Most notable are the increases in drug- related overdose deaths in the US, which have skyrocketed over the past decade and further accelerated during the COVID pan demic 7,8 .”

    From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [7]

    The Results (Systematic review; page unavailable) report that the average monthly increase in US overdose deaths rose from 680 before COVID-19 to 2,348 after its onset. The Discussion (Interpretation and implications; page unavailable) likewise says deaths increased before the pandemic and accelerated afterward. The passages do not establish that deaths had skyrocketed over the preceding decade; the reported comparisons cover a much shorter period. (LLM, conf=0.87)

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Research works printed but not linked: 1

  1. [13]Ontario Agency for Health Protection and Promotion (Public Health Ontario). Rapid review: Substance use-related harms and risk factors during periods of disruption. Toronto, Ontario: Queen's Printer for Ontario; 2020.

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Related

Authors
Imtiaz, S., Nafeh, F., Russell, C., Ali, F., Elton-Marshall, T., & Rehm, J.
Affiliations
Centre for Addiction and Mental Health (CA)
Corresponding author
Imtiaz, Sameer
ORCID
Venue
Substance Abuse Treatment, Prevention, and Policy
Publisher
Springer Science and Business Media LLC
Published
2021-11-29
Volume
16
Issue
1
Pages
87-87
ISSN
1747-597X (ISSN-L)
DOI
10.1186/s13011-021-00423-5
PMC
PMC8628272
OpenAlex
W3217757484
Cited by
101
References
43
Citations by year
2026: 13 · 2025: 16 · 2024: 21 · 2023: 27 · 2022: 24
FWCI
3.21
Type
journal article
Language
en
Open access
Licence
Locations
  • Substance Abuse Treatment Prevention and Policy (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • uO Research (University of Ottawa) (submittedVersion, public-domain)
  • TSpace (University of Toronto) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
CIHR Institute of Neurosciences, Mental Health and Addiction (CUG-171602)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
COVID-19 pandemic, drug overdose deaths, opioid overdose, substance use disorders, harm reduction, drug decriminalization, risk mitigation strategies, substance use disorder treatment access, disease surveillance, United States, Canada
MeSH terms
COVID-19, SARS-CoV-2, Canada, Humans, United States, Pandemics, Public Health Surveillance, Drug Overdose

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