Reducing Drug-Related Mortality Using Predictive Analytics: A Randomized, Statewide, Community Intervention Trial

COVID-19大流行与持续的药物过量流行相冲突，这是一场公共卫生危机， 在过去的二十年里，在美国夺走了超过75万人的生命。大流行病和相关的 政策应对措施将对有吸毒过量风险的人的生活产生持久影响。此外，立即 大流行病对获得过量预防和治疗资源的影响，以及致命和 非致命的过量率，需要紧急研究。这项研究将确定如何制定政策， COVID-19大流行应对的结果影响了过量预防和治疗的获得 资源，以及致命和非致命过量的比率在社区。急性变化对 2019冠状病毒病相关诊断、住院和死亡人数随后出现致命和非致命高峰 还将审查药物过量问题，特别是种族/族裔和经济困难社区的药物过量问题。 记录这些影响将为了解卫生服务措施的类型提供重要的见解， 在今后的灾难中，需要采取适当措施，以避免药物过量风险的升级。这次研究会 位于罗得岛，该州的COVID-10诊断率排名第四，COVID相关性排名第七 全国死亡率（截至2020年5月18日）。在目标1中，我们将确定政策如何 作为该州COVID-19大流行应对措施的一部分， 减少危害资源（例如，纳洛酮）和物质使用治疗的参与，以及 致命和非致命的过量。在目标2中，我们假设COVID-19疾病负担的各种指标 (e.g.,诊断率，住院治疗）将预测随后致命和非致命过量的峰值， 这些峰值在经济困难和种族/民族少数群体中尤其明显 社区.这项工作将有助于建立一个迫切需要的证据基础，以确定如何最有效地 管理COVID-19对过量流行病的不利影响，并支持与成瘾相关的健康 和社会服务体系在未来突发公共卫生危机中的作用。

The COVID-19 pandemic is colliding with the ongoing drug overdose epidemic, a public health crisis that has taken over 750,000 lives in the United States over the past two decades. The pandemic and associated policy responses will have lasting impacts of the lives of people at risk for overdose. Moreover, the immediate effects of the pandemic on access to overdose prevention and treatment resources, as well as fatal and nonfatal overdose rates, are in need of urgent study. This research will determine how policies enacted as a result of the COVID-19 pandemic response have affected both access to overdose prevention and treatment resources, as well as rates of fatal and non-fatal overdoses in the community. The effect of acute changes on COVID-19 related diagnoses, hospitalizations, and deaths on subsequent spikes in fatal and nonfatal overdose, particularly in racial/ethnic and economically distressed communities, will also be examined. Documenting these impacts will provide important insights into the types of health service measures that need to be put in place during future disasters to avoid escalation of drug overdose risk. The study will take place in Rhode Island, a state with the 4th highest COVID-10 diagnosis rate and the 7th highest COVIDassociated mortality rates in the nation (as of May 18th, 2020). In Aim 1, we will determine how policies enacted as part of the state’s COVID-19 pandemic response have influenced both access to and utilization of harm reduction resources (e.g., naloxone) and engagement in substance use treatment, as well as rates of fatal and non-fatal overdoses. In Aim 2, we hypothesize that various measures of COVID-19 disease burden (e.g., diagnosis rates, hospitalizations) will predict subsequent spikes in fatal and non-fatal overdose, and that these spikes will be particularly pronounced in economically distressed and racial/ethnic minority communities. This work will help build an urgently needed evidence base to determine how best to effectively manage the adverse effects of COVID-19 on the overdose epidemic, and to support addiction-related health and social service systems during unanticipated public health crises in the future.