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Opioid Overdose-Related Emergency Department Visits Pre- and Post-COVID-19
Melanie F Molina1,2, Samuel D Pimentel3, Maria C Raven1,2
1University of California, San Francisco, Department of Emergency Medicine, San Francisco, California.
The Western Journal of Emergency Medicine
|August 4, 2026
Summary
Opioid overdose emergency department visits declined post-COVID-19, while medication for opioid use disorder (MOUD) treatment saw an initial increase then a decline. Intentional integration of MOUD into routine emergency department (ED) care is needed to sustain treatment capacity.
Area of Science:
- Emergency Medicine
- Public Health
- Addiction Medicine
Background:
- The COVID-19 pandemic impacted healthcare delivery, including services for opioid use disorder (OUD).
- Understanding shifts in emergency department (ED) visits for opioid overdose and OUD treatment is crucial for public health strategies.
- Appendicitis-related ED visits were used as a control to assess general trends.
Purpose of the Study:
- To analyze trends in opioid overdose-related ED visits and ED-based medication for OUD (MOUD) treatment before and after the initial COVID-19 peak in April 2020.
- To compare these trends with appendicitis-related ED visits as a control.
Main Methods:
- An interrupted time series analysis was performed on monthly ED visit data from January 2017 to December 2022 across three California hospitals.
- Linear regression models were used to assess pre- and post-COVID-19 trends and changes in trends.
- Outcomes included opioid overdose-related ED visits and MOUD treatment visits, with appendicitis visits as a control.
Main Results:
- Pre-pandemic, all visit types showed increasing monthly trends.
- Following April 2020, MOUD-positive visits immediately increased, while opioid overdose visits began to decline.
- Significant decreases in overall visit trends were observed post-COVID-19 for all visit types, most notably for MOUD-positive and opioid overdose visits.
Conclusions:
- Despite initial increases, ED-based MOUD treatment trends declined significantly post-COVID-19, faster than opioid overdose visits.
- Findings suggest a potential shift from crisis-driven OUD treatment implementation.
- There is a critical need for sustained, integrated MOUD services within routine ED care to maintain treatment accessibility.
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