Assessing the Relationships Between COVID-19 Stay-at-Home Orders and Opioid Overdoses in the State of Pennsylvania

• DOI: 10.1177/00220426211006362
• Published date: 01 October 2021
• Author: Andrea Rishworth,Brian King,Ruchi Patel
• Date: 01 October 2021
• Subject Matter: Articles

2021, Vol. 51(4) 648 –660

https://doi.org/10.1177/00220426211006362

Journal of Drug Issues

© The Author(s) 2021

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DOI: 10.1177/00220426211006362

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Article

Assessing the Relationships

Between COVID-19 Stay-at-Home

Orders and Opioid Overdoses in

the State of Pennsylvania

Brian King1, Ruchi Patel1, and Andrea Rishworth2

Abstract

COVID-19 is compounding opioid use disorder throughout the United States. While recent

commentaries provide useful policy recommendations, few studies examine the intersection of

COVID-19 policy responses and patterns of opioid overdose. We examine opioid overdoses

prior to and following the Pennsylvania stay-at-home order implemented on April 1, 2020.

Using data from the Pennsylvania Overdose Information Network, we measure change in

monthly incidents of opioid-related overdose pre- versus post-April 1, and the significance of

change by gender, age, race, drug class, and naloxone doses administered. Findings demonstrate

statistically significant increases in overdose incidents among both men and women, White and

Black groups, and several age groups, most notably the 30–39 and 40–49 ranges, following April

1. Significant increases were observed for overdoses involving heroin, fentanyl, fentanyl analogs

or other synthetic opioids, pharmaceutical opioids, and carfentanil. The study emphasizes

the need for opioid use to be addressed alongside efforts to mitigate and manage COVID-19

infection.

Keywords

opioid, opioid overdose, COVID-19, COVID-19 responses, Pennsylvania

Introduction

The U.S. opioid epidemic and COVID-19 pandemic are two of the most pressing societal chal-

lenges of the 21st century. The overprescription, use, and misuse of opioids span several decades

with varied and significant impacts that have expanded into a national health crisis (Dasgupta et al.,

2018; Katz, 2017; National Academies of Sciences, Engineering, and Medicine, 2017). Opioids

are responsible for more than half of all drug overdoses (Ruhm, 2017), and overdoses are the

leading cause of injury death in the United States with over one and a half times more fatalities

than motor vehicle crashes (Rudd et al., 2016). Between 2001 and 2015, more than 530,000

Americans died from drug overdoses (National Institute on Drug Abuse [NIDA], 2017), which is

more than those who died during the height of the HIV/AIDS epidemic in the 1990s (Dowell

1The Pennsylvania State University, University Park, USA

2Department of Geography, McMaster University, ON, Canada

Corresponding Author:

Andrea Rishworth, Department of Geography, McMaster University, 1280 Main Street W. Hamilton ON, Canada.

Email: rishwora@mcmaster.ca

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JODXXX10.1177/00220426211006362Journal of Drug IssuesKing et al.

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