Changes in Drug-Induced Hospitalisations and Deaths During the First Year of the COVID-19 Pandemic in Australia

We aimed to determine whether the trend in the rate of drug-induced hospitalisations and deaths changed during the first year of the COVID-19 pandemic in Australia.

Data comprised crude monthly rates (per 1,000,000 persons) of hospitalisations and deaths directly attributable to illicit drugs, prescription medicines, or medicines available without a prescription, nationally from 2011 to 2021. Observed rates during the COVID-19 pandemic (2020-2021) were compared with their counterfactual forecast in an ARIMA model, overall and disaggregated by sex, age and drug involved.

Observed rates of drug-induced hospitalisation and death, overall and by sex, were not significantly different from the forecasted rates. The rates of drug-induced death among people aged 35-54 and 55+ years were lower than forecasted by 2.1 [95% prediction interval = -3.8, -0.4] and 0.7 [-1.3, -0.1] deaths per 1,000,000 persons per month, respectively. The rates of drug-induced hospitalisation and death involving heroin were lower than forecasted by 1.5 [-2.4, -0.7] and 1.0 [-1.3, -0.6] per 1,000,000 persons per month, respectively, as were those involving amphetamine-type stimulants by 12.4 [-21.4, -0.8] and 0.5 [-0.7, -0.2] per 1,000,000 persons per month, respectively. The rate of cannabinoid-induced hospitalisations was higher than forecasted by 3.8 [0.8, 6.8] hospitalisations per 1,000,000 persons per month.

We found no evidence of an overall difference in the rate of drug-induced harms during the COVID-19 pandemic relative to the forecasted trend. However, there were differences by drug involved, which may be explained by drug market disruptions and changes in drug use during the pandemic.