Effects of the COVID-19 Pandemic on the Opioid Epidemic in Allegheny County, PA: A Death Narrative Analysis

Introduction: In Allegheny County, long-lasting effects of the pandemic on overdose- related deaths for residents is still not fully known. Methods: ACHD’s overdose surveillance group received overdose-related death records from the Allegheny County Office of the Medical Examiner (ACOME). Each narrative in the cumulative set was read for frequencies of key themes of interest relating to overdoses and the pandemic. Trends were observed to determine when the highest amount of fatal overdose deaths occurred and identify topics that appeared to play significant roles in the lives of those who use substances. Results: ACHD received 465 death narratives. The preliminary number of overdose deaths in 2020 was higher than that of 2019 by approximately 64 deaths. The red restriction phase that marked the beginning of the stay-at-home order experienced significantly more deaths per day than other restriction phases. Case themes of housing insecurity significantly increased after the stay-at-home order took place. There was a decreasing trend in cases discussing naloxone distribution after the stay-at-home order was declared. Conclusion: Effects of the COVID-19 Pandemic and accompanying policies impacted those who use opioids. Policy changes need put in place to provide safety-net resources that will prevent marginalized populations from being harmed from necessary public health precautions. This work can inform knowledgeable disaster-prevention methods and for education on stigmatized health disparities that can be exacerbated in system-stressing events