Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Addiction. 2023 Dec;118(12):2413-2423. doi: 10.1111/add.16324. Epub 2023 Aug 28.
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.
Interrupted time-series.
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).
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.
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.
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.
2019 年冠状病毒病（COVID-19）大流行的爆发与马萨诸塞州阿片类药物过量死亡人数的激增有关，特别是影响到少数族裔社区。我们旨在比较大流行对马萨诸塞州不同种族和族裔群体的社区为基础的项目中的阿片类药物过量死亡人数和纳洛酮分布的影响。
中断时间序列。
美国马萨诸塞州非西班牙裔白人、非西班牙裔黑人、西班牙裔和非西班牙裔其他种族人群中的阿片类药物过量死亡（OOD）（2016 年 1 月至 2021 年 6 月）。
每 100000 人中有多少人发生 OOD、每 100000 人中有多少人分发纳洛酮试剂盒以及纳洛酮试剂盒与阿片类药物过量死亡的比例作为纳洛酮可用性的衡量标准。我们使用不同时期完整数据中的五种插补策略来解释纳洛酮数据中种族和民族缺失的情况。
在 COVID-19 之前（2016 年 1 月至 2020 年 2 月），非西班牙裔白人的 OOD 发生率下降（每月减少 0.2%（95%置信区间为 0.0-0.4%）），而所有其他人群的发生率则相对稳定。纳洛酮试剂盒的发放率在所有人群中均有所增加（每月增加 0.8-1.2%），非西班牙裔白人的 OOD 死亡率与纳洛酮试剂盒的比例为 1.1%（0.8-1.4%），西班牙裔人的比例为 1.0%（0.2-1.8%）。大流行开始后（2020 年 3 月及以后），非西班牙裔黑人的 OOD 发生率立即增加（63.6%（16.4-130%）），而其他人群的发生率则保持相似。任何群体的纳洛酮救援套件分发趋势都没有实质性变化，非西班牙裔黑人的纳洛酮套件与 OOD 死亡的比例也没有弥补该群体中 OOD 死亡人数的激增。
随着 COVID-19 大流行的爆发，美国马萨诸塞州的非西班牙裔黑人阿片类药物过量死亡人数激增，而纳洛酮救援套件的分发并没有相应增加。对于非西班牙裔白人和西班牙裔人来说，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。
