COVID-19: MedStar Health Investigators Evaluate Substance Use Trends During the COVID-19 Pandemic

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Collaborative research from MedStar Health Research Institute, MedStar Washington Hospital Center, Georgetown University School of Medicine and the Rutgers New Jersey Medical School evaluated trends in the number of patients with positive substance use screens and those presenting with a clinical diagnosis of acute alcohol or substance intoxication/overdose in the Emergency Departments (EDs) of the MedStar Health system before and after the first wave of the COVID-19 pandemic (March 2019-2020, April 2020-June 2020). “Impact of COVID-19 pandemic on emergency department substance use screens and overdose presentations” was published in The American Journal of Emergency Medicine.

The health system utilizes a validated screening program for substance use, Screening, Brief Intervention, and Referral to Treatment (SBIRT), for emergency department patients who are clinically stable and willing to complete screenings. SBIRT is a comprehensive public health approach to deliver intervention and treatment for individuals who are at risk for or who currently use alcohol or other substances.

The retrospective chart review included all emergency visits data from seven EDs. The results showed that out of 107,930 screens performed in the EDs, positive SBIRT screens increased from 12.5% to 15.8% during COVID. Alcohol intoxication presentations increased as a proportion of positive screens from 12.6% to 14.4%. A higher percentage of screened patients reported problem drinking during the pandemic (2.4% pre vs 3.2% post). Substance intoxication/overdoses among all screened increased from 2.1% to 3.1% and as a percentage of positive screens during the pandemic (16.8% to 20%). The proportion of opioid vs. non-opioid overdoses remained unchanged before (67%) and during the pandemic (64%).

The study team concluded that there was a significant increase in positive substance use screens and visits for acute overdose and intoxication during the first wave of COVID-19 in the EDs. With the increase in substance abuse associated with the COVID-19 pandemic, there is a need to expand the already limited availability of resources for substance use disorders, early intervention, and treatment. Additional focus is needed to increase access to these resources for patients with substance use disorders.

The research team included Maryann Mazer-Amirshahi, PharmD, MD, MPH, PhD, from MedStar Washington Hospital Center; Mihriye Mete, PhD and Sameer Desale, MS from MedStar Health Research Institute; Kira Chandran and Nikash Shankar from Georgetown University School of Medicine and Lewis Nelson, MD from Rutgers New Jersey Medical School.

The American Journal of Emergency Medicine, DOI: 10.1016/j.ajem.2021.08.058

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