Changes to opioid overdose deaths and community naloxone access among Black, Hispanic and White people from 2016 to 2021 with the onset of the COVID-19 pandemic: An interrupted time-series analysis in Massachusetts, USA

IF 5.2 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2023-08-28 DOI:10.1111/add.16324

Xiao Zang, Alexander Y. Walley, Avik Chatterjee, Simeon D. Kimmel, Jake R. Morgan, Sean M. Murphy, Benjamin P. Linas, Shayla Nolen, Brittni Reilly, Catherine Urquhart, Bruce R. Schackman, Brandon D. L. Marshall

{"title":"Changes to opioid overdose deaths and community naloxone access among Black, Hispanic and White people from 2016 to 2021 with the onset of the COVID-19 pandemic: An interrupted time-series analysis in Massachusetts, USA","authors":"Xiao Zang, Alexander Y. Walley, Avik Chatterjee, Simeon D. Kimmel, Jake R. Morgan, Sean M. Murphy, Benjamin P. Linas, Shayla Nolen, Brittni Reilly, Catherine Urquhart, Bruce R. Schackman, Brandon D. L. Marshall","doi":"10.1111/add.16324","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and Aims</h3>\n \n <p>The onset of the coronavirus disease 2019 (COVID-19) pandemic was associated with a surge in opioid overdose deaths in Massachusetts, particularly affecting racial and ethnic minority communities. We aimed to compare the impact of the pandemic on opioid overdose fatalities and naloxone distribution from community-based programs across racial and ethnic groups in Massachusetts.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Interrupted time-series.</p>\n </section>\n \n <section>\n \n <h3> Setting and Cases</h3>\n \n <p>Opioid overdose deaths (OODs) among non-Hispanic White, non-Hispanic Black, Hispanic and non-Hispanic other race people in Massachusetts, USA (January 2016 to June 2021).</p>\n </section>\n \n <section>\n \n <h3> Measurements</h3>\n \n <p>Rate of OODs per 100 000 people, rate of naloxone kits distributed per 100 000 people and ratio of naloxone kits per opioid overdose death as a measure of naloxone availability. We applied five imputation strategies using complete data in different periods to account for missingness of race and ethnicity for naloxone data.</p>\n </section>\n \n <section>\n \n <h3> Findings</h3>\n \n <p>Before COVID-19 (January 2016 to February 2020), the rate of OODs declined among non-Hispanic White people [0.2% monthly reduction (95% confidence interval = 0.0–0.4%)], yet was relatively constant among all other population groups. The rate of naloxone kits increased across all groups (0.8–1.2% monthly increase) and the ratio of naloxone kits per OOD death among non-Hispanic White was 1.1% (0.8–1.4%) and among Hispanic people was 1.0% (0.2–1.8%). After the onset of the pandemic (March 2020+), non-Hispanic Black people experienced an immediate increase in the rate of OODs [63.6% (16.4–130%)], whereas rates among other groups remained similar. Trends in naloxone rescue kit distribution did not substantively change among any groups, and the ratio of naloxone kits per OOD death for non-Hispanic Black people did not compensate for the surge in OODs deaths in this group.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>With the onset of the COVID-19 pandemic, there was a surge in opioid overdose deaths among non-Hispanic Black people in Massachusetts, USA with no compensatory increase in naloxone rescue kit distribution. For non-Hispanic White and Hispanic people, opioid overdose deaths remained stable and naloxone kit distribution continued to increase.</p>\n </section>\n </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"118 12","pages":"2413-2423"},"PeriodicalIF":5.2000,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Addiction","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/add.16324","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and Aims

The onset of the coronavirus disease 2019 (COVID-19) pandemic was associated with a surge in opioid overdose deaths in Massachusetts, particularly affecting racial and ethnic minority communities. We aimed to compare the impact of the pandemic on opioid overdose fatalities and naloxone distribution from community-based programs across racial and ethnic groups in Massachusetts.

Design

Interrupted time-series.

Setting and Cases

Opioid overdose deaths (OODs) among non-Hispanic White, non-Hispanic Black, Hispanic and non-Hispanic other race people in Massachusetts, USA (January 2016 to June 2021).

Measurements

Rate of OODs per 100 000 people, rate of naloxone kits distributed per 100 000 people and ratio of naloxone kits per opioid overdose death as a measure of naloxone availability. We applied five imputation strategies using complete data in different periods to account for missingness of race and ethnicity for naloxone data.

Findings

Before COVID-19 (January 2016 to February 2020), the rate of OODs declined among non-Hispanic White people [0.2% monthly reduction (95% confidence interval = 0.0–0.4%)], yet was relatively constant among all other population groups. The rate of naloxone kits increased across all groups (0.8–1.2% monthly increase) and the ratio of naloxone kits per OOD death among non-Hispanic White was 1.1% (0.8–1.4%) and among Hispanic people was 1.0% (0.2–1.8%). After the onset of the pandemic (March 2020+), non-Hispanic Black people experienced an immediate increase in the rate of OODs [63.6% (16.4–130%)], whereas rates among other groups remained similar. Trends in naloxone rescue kit distribution did not substantively change among any groups, and the ratio of naloxone kits per OOD death for non-Hispanic Black people did not compensate for the surge in OODs deaths in this group.

Conclusions

With the onset of the COVID-19 pandemic, there was a surge in opioid overdose deaths among non-Hispanic Black people in Massachusetts, USA with no compensatory increase in naloxone rescue kit distribution. For non-Hispanic White and Hispanic people, opioid overdose deaths remained stable and naloxone kit distribution continued to increase.

查看原文本刊更多论文

随着新冠肺炎大流行的爆发，2016年至2021年黑人、西班牙裔和白人阿片类药物过量死亡和社区纳洛酮使用情况的变化：美国马萨诸塞州的中断时间序列分析。

背景和目的：2019冠状病毒病（新冠肺炎）大流行的爆发与马萨诸塞州阿片类药物过量死亡人数激增有关，尤其影响到种族和少数民族社区。我们旨在比较疫情对马萨诸塞州种族和族裔社区项目阿片类药物过量死亡人数和纳洛酮分布的影响，美国（2016年1月至2021年6月）。测量：每100人中OOD的比率 000人，每100人分发纳洛酮试剂盒的比率 000人，以及每阿片类药物过量死亡纳洛酮试剂盒的比率作为纳洛酮可用性的衡量标准。我们使用不同时期的完整数据应用了五种插补策略，以解释纳洛酮数据中种族和民族的缺失。研究结果：在新冠肺炎之前（2016年1月至2020年2月），非西班牙裔白人的OOD发病率下降【每月下降0.2%（95%置信区间 = 0.0-0.4%）]，但在所有其他人群中相对恒定。纳洛酮试剂盒在所有组中的使用率都有所增加（每月增加0.8-1.2%），非西班牙裔白人每OOD死亡纳洛酮试剂盒的比例为1.1%（0.8-1.4%），西班牙牙裔为1.0%（0.2-1.8%）。疫情爆发后（2020年3月+），非西班牙裔黑人OOD的使用率立即增加[63.6%（16.4-130%）]，而其他组的发病率保持相似。纳洛酮抢救试剂盒的分布趋势在任何一组中都没有实质性变化，非西班牙裔黑人每OOD死亡纳洛酮试剂盒的比例并不能弥补该组OOD死亡人数的激增。结论：随着新冠肺炎大流行的爆发，美国马萨诸塞州非西班牙裔黑人阿片类药物过量死亡人数激增，纳洛酮救援试剂盒的分发没有补偿性增加。对于非西班牙裔白人和西班牙牙裔，阿片类药物过量死亡人数保持稳定，纳洛酮试剂盒的分发继续增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.