Table 3.
Opioid-related diagnosesa (2016–2019 and 2020–2021) overall and for subtypes involving opioid categories of adverse event or poisoning in the nationwide emergency department sample.b
| Characteristics | Between 2016 and 2019 |
During the COVID-19 pandemic in 2020 and 2021 |
||||
|---|---|---|---|---|---|---|
| 2019 Rate, per 10,000 | Absolute difference from 2016 to 2019c | Percentage change from 2016 to 2019, % | 2021 Rate, per 10,000 | Absolute difference from 2019 to 2021d | Percentage change from 2019 to 2021, % | |
| Overall | 119.8 (112.2–127.4) | −5.0 (−15.3 to 5.2) | −4.0 (−12.2 to 4.2) | 130.2 (120.1–140.4) | 10.4 (−2.3 to 23.1) | 8.7 (−1.9 to 19.2) |
| Abuse or dependence | 88.4 (82.0–94.9) | −4.0 (−12.7 to 4.8) | −4.3 (−13.8 to 5.2) | 95.5 (86.1–104.8) | 7.0 (−4.3 to 18.4) | 8.0 (−4.9 to 20.8) |
| Adverse event or poisoning | 37.8 (35.6–40.1) | −2.7 (−6.1 to 0.7) | −6.6 (−15.0 to 1.8) | 41.7 (39.5–43.9) | 3.9 (0.7–7.0) | 10.2 (1.8–18.6) |
| Synthetic opioids as a proxy for fentanyl | 3.2 (3.0–3.5) | 0.5 (0.2–0.8) | 17.9 (7.3–28.4) | 5.4 (4.9–5.8) | 2.1 (1.6–2.7) | 65.9 (49.4–82.5) |
| Prescription natural/semisynthetic opioids as a proxy for opioid pain medications | 15.6 (14.7–16.5) | 0.4 (−0.7 to 1.6) | 2.8 (−4.6 to 10.3) | 17.5 (16.6–18.4) | 1.9 (0.6–3.2) | 12.2 (3.9–20.4) |
| Heroin | 10.7 (9.5–11.8) | −2.1 (−4.3 to 0.2) | −16.1 (−33.6 to 1.3) | 9.8 (8.5–11.1) | −0.8 (−2.6 to 0.9) | −7.8 (−24.2 to 8.6) |
| Opium | 0.3 (0.2–0.3) | −0.2 (−0.3 to −0.2) | −48.0 (−62.1 to −33.9) | 0.2 (0.2–0.3) | −0.04 (−0.1 to 0.03) | −15.4 (−42.6 to 11.8) |
| Methadone | 0.8 (0.7–0.9) | −0.2 (−0.3 to −0.1) | −20.8 (−33.2 to −8.4) | 0.7 (0.7–0.8) | −0.08 (−0.2 to 0.05) | −10.0 (−25.7 to 5.7) |
| Other opioids | 8.0 (7.3–8.7) | −1.0 (−1.9 to −0.2) | −11.5 (−21.0 to −2.0) | 9.0 (8.4–9.5) | 0.9 (0.05–1.8) | 11.7 (0.6–22.9) |
Cases of opioid-related diagnoses were identified following the definition proposed by the Healthcare Cost and Utilization Project, including two subtypes: abuse or dependence, and adverse event or poisoning (classified by opioid category, including: synthetic opioids as a proxy for fentanyl, prescription natural/semisynthetic opioids as a proxy for opioid pain medications, heroin, opium, methadone, and other opioids).
Weights provided by the Healthcare Cost and Utilization Project, Nationwide Emergency Department Sample were used to ensure that the estimates were nationally representative, and weights and design variables were included to obtain unbiased estimates and standard errors.
Reflects the overall or total difference between 2016 and 2019: absolute difference (2019–2016) and percentage change [(2019–2016)/2016 × 100].
Reflects the overall or total difference during the COVID-19 pandemic in 2020 and 2021: absolute difference (2021–2019) and percentage change [(2021–2019)/2019 × 100].