Episode 17: Impact of COVID-19 on Opioid Overdose and Other Adverse Events in the USA and Canada

RAPM Focus

The impact of the COVID-19 pandemic was especially challenging for vulnerable populations, such as
those with chronic long-term health conditions, mental health conditions, and substance use disorders.
Lockdowns and fear of spread led to barriers for patients whether they were accessing methadone
through opioid treatment programs or being prescribed buprenorphine.

A systematic review first published online in October 2022 sought to identify whether there was a
change in opioid use and misuse outcomes during the COVID-19 pandemic. Authors Siddartha Simha,
MD, and Mark C. Bicket, MD, PhD, joined RAPM Editor-in-Chief Brian Sites, MD, to discuss their article,
“Impact of the COVID-19 pandemic on opioid overdose and other adverse events in the USA and
Canada: a systematic review,” published October 2022 (https://rapm.bmj.com/content/48/1/37). The
authors found that opioid-related emergency medicine use increased in most studies for both service
calls and emergency department visits. Urine drug testing positivity results increased in all studies for
fentanyl, and in most studies for heroin and oxycodone. Naloxone dispensation was unchanged and
decreased in one study. The authors concluded that efforts to curb the spread of COVID-19 aligned with
an increase in the opioid crisis severity, which has implications for future pandemic responses.

Dr. Siddartha Simha is a third-year anesthesiology resident at Michigan Medicine in Ann Arbor. Originally
from Troy, MI, he obtained his medical degree from Oakland University William Beaumont School of
Medicine in Auburn Hills, MI. Dr. Simha has a strong interest in acute and chronic pain management and
research with plans to pursue a clinical fellowship in pain medicine.

Dr. Mark C. Bicket is the co-director of the Opioid Prescribing Engagement Network and an assistant
professor at the University of Michigan Medical School with a joint appointment in the School of Public
Health. A clinician scientist and practicing physician, his work has been supported by the National
Institutes of Health, the Substance Abuse and Mental Health Services Administration, the Foundation for
Anesthesia Education and Research, and the Patient-Centered Outcomes Research Institute.

*The purpose of this podcast is to educate and to inform. The content of this podcast does not
constitute medical advice, and it is not intended to function as a substitute for a healthcare
practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of
the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this
podcast. Listeners should also be aware that professionals in the field may have different opinions. By
listening to this podcast, listeners agree not to use its content as the basis for their own medical
treatment or for the medical treatment of others.

Podcast and music produced by Dan Langa. Find us on Twitter @RAPMOnline.