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Grunvald W, Herrington R, King R, et al. COVID-19: A new barrier to treatment for opioid use disorder in the emergency department. J Am Coll Emerg Physicians Open. 2021;2(2):e12403doi: 10.1002/emp2.12403.
Grunvald, W., Herrington, R., King, R., Lamberson, M., Mackey, S., Maruti, S., Rawson, R., & Wolfson, D. (2021). COVID-19: A new barrier to treatment for opioid use disorder in the emergency department. Journal of the American College of Emergency Physicians open, 2(2), e12403. https://doi.org/10.1002/emp2.12403
Grunvald, Warren, et al. "COVID-19: A new barrier to treatment for opioid use disorder in the emergency department." Journal of the American College of Emergency Physicians open vol. 2,2 (2021): e12403. doi: https://doi.org/10.1002/emp2.12403
Grunvald W, Herrington R, King R, Lamberson M, Mackey S, Maruti S, Rawson R, Wolfson D. COVID-19: A new barrier to treatment for opioid use disorder in the emergency department. J Am Coll Emerg Physicians Open. 2021 Mar 17;2(2):e12403. doi: 10.1002/emp2.12403. eCollection 2021 Apr. PMID: 33748808; PMCID: PMC7967916.
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J Am Coll Emerg Physicians Open. 2021 Mar 17;2(2):e12403. doi: 10.1002/emp2.12403. eCollection 2021 Apr.

COVID-19: A new barrier to treatment for opioid use disorder in the emergency department.

Journal of the American College of Emergency Physicians open

Warren Grunvald, Ramsey Herrington, Roz King, Miles Lamberson, Scott Mackey, Sanchit Maruti, Richard Rawson, Daniel Wolfson

Affiliations

  1. University of Vermont Larner College of Medicine Burlington Vermont USA.
  2. Division of Emergency Medicine, University of Vermont Larner College of Medicine Burlington Vermont USA.
  3. Division of Psychiatry, University of Vermont Larner College of Medicine Burlington Vermont USA.

PMID: 33748808 PMCID: PMC7967916 DOI: 10.1002/emp2.12403

Abstract

OBJECTIVE: Start Treatment and Recover (STAR) is an emergency department (ED) program that expands access to medication for opioid use disorder by identifying patients with opioid use disorder and offering ED-initiated buprenorphine/naloxone and rapid access to outpatient treatment. We sought to determine the impacts of the coronavirus disease 2019 pandemic on STAR and the patients with opioid use disorder it serves.

METHODS: We conducted a retrospective review of records comparing 2 periods: pre-pandemic (February 1, 2019-February 29, 2020) and pandemic (March 1, 2020-May 31, 2020). Variables evaluated included the number of STAR enrollments, ED census, percentage of census screening positive for opioid use disorder, number and percentage of ED overdose visits, and overdose fatalities by month. All analyses were conducted using 2-sample

RESULTS: Comparing the pre-pandemic to the pandemic period, the mean monthly ED visits decreased from 5126.9 to 3306.7 (difference = -1820.3; 95% CI, -3406.3 to -234.2), STAR mean monthly enrollments decreased from 9.7 to 1.3 (difference = -8.4; 95% CI, -12.8 to -4.0), and statewide monthly opioid-related fatalities increased from 9.4 to 15.3 (difference = 5.9; 95% CI, 0.8 to 11.1). However, the percentage of individuals who presented to the ED with opioid use disorder or overdose remained unchanged.

CONCLUSION: Although overall ED visits declined during the pandemic period, the percentage of patients presenting with opioid use disorder or overdose remained constant, yet there was a dramatic decline in enrollment in ED-initiated medication for opioid use disorder and an increase in statewide monthly opioid-related fatalities. Strategies to maintain medication for opioid use disorder treatment options must be implemented for this vulnerable population during the ongoing pandemic.

© 2021 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.

Keywords: COVID‐19; buprenorphine naloxone drug combination; emergency departments; opioid medication assisted treatment; opioid use disorder; opioid‐related disorders; vulnerable populations

Conflict of interest statement

The authors declare no conflict of interest.

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