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Examination of methadone involved overdoses during the COVID-19 pandemic

Daniel E Kaufman1, Amy L Kennalley2, Kenneth L McCall3

  • 1Touro College of Osteopathic Medicine, Middletown, NY, USA.

Forensic Science International
|February 5, 2023
PubMed
Abstract

Insights

Methadone overdose deaths surged by 48.1% in 2020, reversing a downward trend. This highlights the need for careful review of policy changes, like methadone take-home doses, amidst the ongoing opioid crisis.

Area of Science:

  • Public Health
  • Epidemiology
  • Pharmacology

Background:

  • The US opioid overdose epidemic remains a critical public health concern.
  • Methadone availability, including take-home dosing, was altered during the COVID-19 pandemic.
  • Concerns exist regarding the diversion and street value of methadone.

Purpose of the Study:

  • To analyze trends in fatal methadone-related overdoses over two decades, including the pandemic period.
  • To investigate the relationship between methadone usage patterns and overdose rates.

Main Methods:

  • Utilized CDC WONDER data (1999-2020) for unintentional methadone overdose death rates (ICD X40-44, T40.3).
  • Incorporated DEA ARCOS data on methadone use (overall, OTP, pain management) for 2020, population-corrected.
  • Employed correlation analyses to assess associations between methadone use and overdose deaths.

Main Results:

  • Methadone overdose deaths increased from 0.9/million in 1999 to a peak of 15.9 in 2007, then declined to 6.5 in 2019.
  • A significant 48.1% increase in methadone overdose deaths occurred in 2020 compared to 2019.
  • Strong positive correlations were found between overall methadone use and opioid treatment program use with overdose rates, but not with pain management use.

Conclusions:

  • Fatal methadone overdoses saw a substantial rise in 2020, underscoring the evolving nature of the opioid crisis.
  • The study suggests that policy modifications, particularly those concerning methadone take-home policies implemented during the pandemic, require thorough evaluation.
  • Further research is recommended to inform future policy decisions regarding methadone access and safety.
Keywords:
AddictionCoronavirus-19OpiateOpioidOverdosePain

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