Estimating the impact of the COVID-19 pandemic on rising trends in drug overdose mortality in the United States, 2018-2021

Purpose: During the COVID-19 pandemic, social and economic disruption such as social isolation, job and income losses, and increased psychological distress, may have contributed to the increase in drug -overdose mortality. This study aims to measure the impact of the pandemic on monthly trends in drug -overdose mortality in the United States.Methods: We used the 2018-2020 final and 2021 provisional monthly deaths from the National Vital Statistics System and monthly population estimates from the Census Bureau to compute monthly mortal-ity rates by age, sex, and race/ethnicity. We use log-linear regression models to estimate monthly percent increases in mortality rates from January 2018 through November 2021.Results: The age-adjusted drug-overdose mortality rate among individuals aged older than or equal to 15 years increased by 30% between 2019 (70,459 deaths) and 2020 (91,536 deaths). During January 2018- November 2021, the monthly drug-overdose mortality rate increased by 2.05% per month for Blacks, 2.25% for American Indians/Alaska Natives, 1.96% for Hispanics, 1.33% for Asian/Pacific Islanders, and 0.96% for non-Hispanic Whites. Average monthly increases in mortality were most marked among those aged 15- 24 and 35-44 years. Conclusions: The COVID-19 pandemic had a substantial impact on the rising trends in drug-overdose mortality during the peak months in 2020 and 2021.(c) 2022 Elsevier Inc. All rights reserved.