TY  - BOOK
AU  - Desale, Sameer
AU  - Mazer-Amirshahi, Maryann
AU  - Mete, Mihriye
TI  - Impact of COVID-19 pandemic on emergency department substance use screens and overdose presentations
SN  - 0735-6757
PY  - 2021///
KW  - *COVID-19/ep [Epidemiology]
KW  - *Drug Overdose/ep [Epidemiology]
KW  - *Emergency Service, Hospital
KW  - *Substance Abuse Detection
KW  - *Substance-Related Disorders/di [Diagnosis]
KW  - *Substance-Related Disorders/ep [Epidemiology]
KW  - Adult
KW  - Aged
KW  - Drug Overdose/di [Diagnosis]
KW  - Drug Overdose/th [Therapy]
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Retrospective Studies
KW  - Substance-Related Disorders/th [Therapy]
KW  - MedStar Health Research Institute
KW  - MedStar Washington Hospital Center
KW  - Emergency Medicine
KW  - Journal Article
N2  - BACKGROUND: The COVID-19 pandemic can exacerbate underlying substance use disorder and has impacted this vulnerable population in a variety of ways. There are limited data regarding how this pandemic has impacted emergency department (ED) patient presentations; DISCUSSION: There was an increase in the proportion of positive SBIRT screens and visits for acute overdoses and intoxication during the first wave of the COVID-19 pandemic. Additional research should focus on mitigation strategies to address substance use during this vulnerable time. Copyright (c) 2021 Elsevier Inc. All rights reserved; METHODS: We extracted data on ED visits from the electronic health record (EHR) of a large healthcare system in the Washington, DC/Baltimore, MD metropolitan area. The dataset includes data from 7 hospitals on ED visits between 11/1/2019-6/30/2020. The health system utilizes a validated screening program for substance use, Screening, Brief Intervention, and Referral to Treatment (SBIRT), for ED patients who are clinically stable and willing to complete screening. We evaluated trends in patients with a positive SBIRT screen and those presenting with a clinical diagnosis of acute alcohol or substance intoxication/overdose before (11/1/19-2/29/2020-pre) and during the first wave of the COVID pandemic (3/1/2020-6/30/2020-post). Data were described using descriptive statistics. Bivariate analyses were conducted using chi-square test and two-sample t-tests. Interrupted time series analysis was used to evaluate the changes in the weekly trends with the start of the pandemic; RESULTS: There were 107,930 screens performed in the EDs during the study period (61,961 pre, 45,969 post). The population was primarily African American (64.7%) and female (57.1%). Positive SBIRT screens increased from 12.5% to 15.8% during COVID (p < 0.001). Alcohol intoxication presentations increased as a proportion of positive screens from 12.6% to 14.4% (p = 0.001). A higher percentage of screened patients reported problem drinking (AUDIT score >= 7) during the pandemic (2.4% pre vs 3.2% post, p < 0.001). Substance intoxication/overdoses among all screened increased from 2.1% to 3.1% (p < 0.001) and as a percentage of positive screens during the pandemic (16.8% to 20%, p < 0.001). The proportion of opioid vs. non-opioid overdoses remained unchanged before (67%) and during the pandemic (64%, p = 0.33)
UR  - https://dx.doi.org/10.1016/j.ajem.2021.08.058
ER  -