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

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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

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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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Fig. 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Flow Diagram of Study Selection. The electronic database searches yielded 413 unique records. Based on title and abstract screening, 398 records were excluded and 15 records underwent full-text assessments. The additional searches yielded another six studies. After the application of the selection criteria, nine studies were included in the systematic reviewCC BY · PubMed Central

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Additional file 4 of BeHERE’s effective virtual training to build capacity to support people who use drugs in non-substance use disorder settings
Kenefick, H. W., & Wing, A. (2024) · Figshare · doi:10.6084/m9.figshare.26680343
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Self-citation
Socially Yours
Erdem, O. (2026) · Springer eBooks · doi:10.1007/978-3-032-24189-4_10

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: Imtiaz, Sameer
Nafeh, Frishta
Russell, Cayley
Ali, Farihah
Rehm, Jürgen
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: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
creativecommons.org/licenses/by/4.0 (vor)
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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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

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