ArticlePloS one2024
Evolution of an epidemic: Understanding the opioid epidemic in the United States and the impact of the COVID-19 pandemic on opioid-related mortality.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Local level of social inequity moderates implementation of evidence-based practices tailored to minoritized populations to reduce opioid overdose deaths.Journal of substance use and addiction treatment · 2026Trial
- Customizing and fine-tuning opioid overdose machine learning models for community-specific dashboards.Journal of big data · 2026Article
- Call to Action: The Hidden Role of Anesthesiologists in the Opioid Epidemic.Anesthesia and analgesia · 2026Article
- Mapping needles, reducing harm: Findings from a geospatial, community-based needle collection and naloxone training initiative in Saskatchewan, Canada.Harm reduction journal · 2026Article
- Applying the Consolidated Framework for Implementation Research (CFIR) to understand college health administrator perceptions on adopting and implementing opioid overdose education and naloxone distribution (OEND) programs among universities nationally.Harm reduction journal · 2026Article
- ACMT and AACT Position Statement: Preventing Occupational Opioid Exposure to Emergency Responders.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026Article
- The impact of COVID-19 on longevity trends and disparities among Native Americans and Whites in the Four Corners States.PloS one · 2026Article
- Methadone and morphine have equivalent analgesic but not reward potency in female mice.Addiction neuroscience · 2025Article
- Article
- Cancer Pain Is Not One-Size-Fits-All: Evolving from Tradition to Precision.Clinics and practice · 2025Review
- Identifying and responding to policy-related barriers, facilitators, and misunderstandings in the HEALing communities study: A community-driven approach.The International journal on drug policy · 2025Article
- Changes in Drug-Induced Hospitalisations and Deaths During the First Year of the COVID-19 Pandemic in Australia.Drug and alcohol review · 2025Article
- Paternal morphine alters offspring circulating beta-endorphin and corticosterone responses to oxycodone and cocaine.Neuropharmacology · 2025Article
- A lesson for post-COVID healthcare: assessment of physical and psychosocial risk factors on perceived pain intensity among urban individuals.Frontiers in psychology · 2024Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We conduct this research with a two-fold aim: providing a quantitative analysis of the opioid epidemic in the United States (U.S.), and exploring the impact of the COVID-19 pandemic on opioid-related mortality. The duration and persistence of the opioid epidemic lends itself to the need for an overarching analysis with extensive scope. Additionally, studying the ramifications of these concurrent severe public health crises is vital for informing policies to avoid preventable mortality. Using data from CDC WONDER, we consider opioid-related deaths grouped by Census Region spanning January 1999 to October 2022 inclusive, and later add on a demographic component with gender-stratification. Through the lens of key events in the opioid epidemic, we build an interrupted time series model to reveal statistically significant drivers of opioid-related mortality. We then employ a counterfactual to approximate trends in the absence of COVID-19, and estimate excess opioid-related deaths (defined as observed opioid-related deaths minus projected opioid-related deaths) associated with the pandemic. According to our model, the proliferation of fentanyl contributed to sustained increases in opioid-related death rates across three of the four U.S. census regions, corroborating existing knowledge in the field. Critically, each region has an immediate increase to its opioid-related monthly death rate of at least 0.31 deaths per 100,000 persons at the start of the pandemic, highlighting the nationwide knock-on effects of COVID-19. There are consistent positive deviations from the expected monthly opioid-related death rate and a sizable burden from cumulative excess opioid-related deaths, surpassing 60,000 additional deaths nationally from March 2020 to October 2022, ∼70% of which were male. These results suggest that robust, multi-faceted measures are even more important in light of the COVID-19 pandemic to prevent overdoses and educate users on the risks associated with potent synthetic opioids such as fentanyl.
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