Nonfatal opioid-related overdoses treated by emergency medical services in Florida, before and during the COVID-19 pandemic

Previous studies have found increases in nonfatal opioid overdoses during the COVID-19 pandemic, which created difficult conditions for people with substance use disorders. We assessed changes in nonfatal opioid-related overdoses in Florida during the onset of the COVID-19 pandemic. Emergency medical service data was obtained from the Florida Department of Health. Naloxone administration with documented improvement was used as a proxy for nonfatal opioid-related overdoses. Age-adjusted rates were estimated per 100,000 population for April-September 2020 (n = 9,377) and compared to the same time period during 2019 (n = 6,765) using rate ratios. Age-adjusted rates were estimated by sex, race/ethnicity, and metro/nonmetro county classification, as well as county-level measures of medications for opioid use disorder (MOUD) availability, rates of COVID-19 deaths, and unemployment during 2020. The age-adjusted rate of nonfatal opioid-related overdoses increased from 32.41 (95 % CL: 31.64–33.19) during 2019 to 45.35 (95 % CL: 44.42–46.27) during 2020 (RR = 1.40; 95 % CL: 1.36–1.44). The rate for males increased most in metro counties (RR = 1.47, 95 % CL: 1.41–1.53); the rate for females increased most in nonmetro counties (RR = 1.51, 95 % CL: 1.10–2.06). The largest increases were observed among Hispanics (males: RR = 1.56, 95 % CL: 1.37–1.78; females: RR = 1.44, 95 % CL: 1.14–1.81), counties with no MOUD treatment options (RR = 1.66, 95 % CL: 1.14–2.44) and counties with the lowest rates of buprenorphine prescribers (RR = 1.70, 95 % CL: 1.29–2.22). Nonfatal opioid-related overdoses increased in Florida during the first six months of the COVID-19 pandemic. Expanding access to services that support treatment and recovery is critical to addressing the ongoing opioid crisis in Florida.