COVID-19 Stay-At-Home Orders Increased EMS Utilization in United States


Emergency medical services runs increased in all 4 US Census regions.

Drug overdoses have increased more than 500% in the last 30 years, requiring widespread public health efforts to address the opioid crisis. The COVID-19 pandemic contributed to this increase in overdoses; according to CDC data, an increase in deaths of 28.5% was noted during the 12-month period ending April 2021 compared with the same period in 2020.1

According to research2 presented at the American Pharmacists Association (APhA) 2023 Annual Meeting, COVID-19 lockdown orders were associated with a significant increase in Emergency Medical Services (EMS) runs after initiation of these orders.

Investigators conducted an interrupted time series study using data from the National EMS System collected between July 2019 and December 2020. These data were analyzed to evaluate how the COVID-19 lockdowns impacted EMS runs associated with nonfatal opioid overdose rates in 4 United States Census regions (Midwest, South, Northeast, West).

Overall, 402,502 adult, nonfatal opioid-related overdose EMS runs took place between July 2019 and December 2020. Following the implementation of stay at home orders, the number of EMS runs increased in all 4 regions, with regional variation in the magnitude of increase. The biggest increase was seen in the South, where EMS runs increased an average of 2281 per week, then decreased by 21.71 per week; the smallest increase was in the Northeast, where EMS runs increased by 719.46 and decreased by 10.71 runs per week.

After adjustments, increases were “most dramatic in the Southern region of the United States, an under-resourced region of the country that has arguably been most affected by the opioid crisis,” the researchers wrote.

“Future research aimed at understanding why some regions were more successful than others in returning excess opioid morbidity to baseline could be useful in guiding the development of future prevention programs,” the researchers concluded.

  1. Drug overdose deaths in the US top 100,000 annually. News release. CDC. Novebmer 17, 2021. Accessed March 23, 2023.
  2. Yazdanfard S, Thornton D, Fatima B, Khalid J, Bhatt P, Varisco T. Evaluating the effects of the COVID-19 disaster shutdown on the opioid crisis in United States Census Regions: A National Emergency Medical Services study. Presented at: American Pharmacists Association 2023 Annual Meeting and Exposition; March 24-27, 2023; Phoenix, AZ. Poster 1314.
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