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Impact of the COVID-19 pandemic on opioid overdose and other adverse events in the USA and Canada: a systematic review
  1. Siddartha Simha1,
  2. Yusuf Ahmed2,
  3. Chad M Brummett1,3,
  4. Jennifer F Waljee3,4,
  5. Michael J Englesbe3,4 and
  6. Mark C Bicket1,3
  1. 1 Anesthesiology, University of Michigan Michigan Medicine, Ann Arbor, Michigan, USA
  2. 2 University of Michigan Medical School, Ann Arbor, Michigan, USA
  3. 3 Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan, USA
  4. 4 Surgery, University of Michigan Michigan Medicine, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Siddartha Simha, Anesthesiology, University of Michigan Michigan Medicine, Ann Arbor, MI 48109, USA; sidds{at}

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COVID-19 has profoundly impacted many facets of health and healthcare, but the impact of the COVID-19 pandemic on opioid-related adverse events in the USA and Canada is not fully known. In this systematic review of 20 studies investigating the effect of COVID-19 on the opioid crisis, notable impacts included more frequent emergency medicine service utilization, higher opioid urine drug testing positivity results for patients undergoing regular urine drug screening, but no clear increase in documented use of naloxone rescue medication.1–20 These findings suggest that the opioid crisis worsened in a significant way across several different outcomes due in part to initial measures taken to mitigate the spread of the COVID-19 pandemic. This is consistent with the findings of increased recent opioid-related overdose deaths in the USA and Canada, and provides a common set of outcomes to examine in the event of future stressors on the health system.21

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  • X @drchadb, @MarkBicket

  • Contributors Contributorship statement: (1) Conception and design: SS, MCB; (2) Administrative support: MCB, CMB, MJE, JFW; (3) Provision of study materials or patients: SS, YA, MCB; (4) Collection and assembly of data: SS, YA, MCB; (5) Data analysis and interpretation: SS, YA, MCB; (6) Manuscript writing: All authors and (7) Final approval of manuscript: all authors(VIII) Overall guarantor: SS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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