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

新冠肺炎大流行正与正在进行的药物过量流行相撞，这是一场公共卫生危机，已经 在过去的二十年里在美国夺走了超过75万人的生命。大流行和相关的 政策回应将对服药过量风险人群的生活产生持久影响。此外，眼下的 这一大流行对获得过量预防和治疗资源的影响，以及致命和 非致命性过量用药率，亟待研究。这项研究将决定政策如何作为 新冠肺炎大流行应对措施的结果影响了预防和治疗服药过量的机会 资源以及社区致命性和非致命性过量的比率。急性变化对人的影响 与新冠肺炎相关的诊断、住院和死亡，随后致命和非致命的 还将审查吸毒过量，特别是在种族/民族和经济困难社区。 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 需要在未来的灾难期间到位，以避免药物过量风险的升级。这项研究将需要 位于罗德岛州，该州的COVID-10诊断率排名第四，与COVID相关的发病率排名第七 全国的死亡率(截至2020年5月18日)。在目标1中，我们将确定政策如何 作为该州新冠肺炎大流行应对措施的一部分制定的法律影响了对 减少危害资源(例如，纳洛酮)和参与药物使用治疗，以及 致命和非致命的过量用药。在目标2中，我们假设新冠肺炎疾病负担的各种衡量标准 (例如，诊断率、住院率)将预测随后致命和非致命过量服药的高峰，并且 这些激增将在经济困难和种族/少数民族中尤为明显。 社区。这项工作将有助于建立一个迫切需要的证据基础，以确定如何最好地有效地 管理新冠肺炎对吸毒过量流行的不良影响，并支持与成瘾相关的健康 和社会服务系统，以应对未来不可预见的公共卫生危机。

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.