Adolescents and opioid-related outcomes amidst the COVID-19 pandemic

An interrupted time series analysis of trends in opioid-related emergency department visits from pre-COVID-19 pandemic to pandemic, from the Canadian Hospitals Injury Reporting and Prevention Program

BACKGROUND

Opioid-related emergency department (ED) visits in Canada increased during the COVID-19 pandemic, but how trends in volume and case severity changed from pre-pandemic times through the pandemic is not known. Trends in ED visits related to specific types of opioids also remain unclear. Our objective was to describe pre-pandemic trends and how they changed with the onset of COVID-19 and thereafter.

METHODS

Based on data from the Canadian Hospitals Injury Reporting and Prevention Program, we identified opioid-related ED visits and constructed a time series from March 12, 2018 through March 7, 2021-two pre-COVID periods and one COVID period. We used an interrupted time series (ITS) analysis to examine trends in volume and case severity. We compared medians and means of monthly counts and percentages of severe cases between the periods, by sex, age, and opioid type.

RESULTS

Before the pandemic, there was an increasing trend in fentanyl-related visits for males, females and 25- to 64-year-olds, and a decreasing trend in heroin-related visits for males and 18- to 64-year-olds. Fentanyl-related visits for 18- to 24-year-olds showed an immediate increase at the start of the pandemic and a decreasing trend during the pandemic. Heroin-related visits for 12- to 17-year-olds had an immediate increase at the start of the pandemic; for 18- to 24-year-olds and 45- to 64-year-olds, the prior decreasing pre-pandemic trend ceased. For pooled opioid-related visits, no significant trend in the percentage of severe cases was observed throughout the entire study period.

CONCLUSION

This study shows that an ITS approach in trend analysis is a valuable supplement to comparisons of before and after measures (with or without controlling seasonal effects). The findings provide evidence on how ED presentations for opioid use evolved in Canada from 2018 to 2021. The results can inform policies designed to reduce opioid-related harm in the context of a public health emergency.

Psychosocial Correlates of Opioid Use Profiles among Young Adults in a Longitudinal Study across 6 US Metropolitan Areas

Background: Examining opioid use profiles over time and related factors among young adults is crucial to informing prevention efforts. Objectives: This study analyzed baseline data (Fall 2018) and one-year follow-up data from a cohort of 2,975 US young adults (Mage=24.55, 42.1% male; 71.7% White; 11.4% Hispanic). Multinomial logistic regression was used to examine: 1) psychosocial correlates (i.e. adverse childhood experiences [ACEs], depressive symptoms, parental substance use) of lifetime opioid use (i.e. prescription use vs. nonuse, nonmedical prescription [NMPO] use, and heroin use, respectively); and 2) psychosocial correlates and baseline lifetime use in relation to past 6-month use at one-year follow-up (i.e. prescription use vs. nonuse and NMPO/heroin use, respectively). Results: At baseline, lifetime use prevalence was: 30.2% prescription, 9.7% NMPO, and 3.1% heroin; past 6-month use prevalence was: 7.6% prescription, 2.5% NMPO, and 0.9% heroin. Compared to prescription users, nonusers reported fewer ACEs and having parents more likely to use tobacco, but less likely alcohol; NMPO users did not differ; and heroin users reported more ACEs and having parents more likely to use cannabis but less likely alcohol. At one-year follow-up, past 6-month use prevalence was: 4.3% prescription, 1.3% NMPO, and 1.4% heroin; relative to prescription users, nonusers were less likely to report baseline lifetime opioid use and reported fewer ACEs, and NMPO/heroin users were less likely to report baseline prescription opioid use but more likely heroin use. Conclusions: Psychosocial factors differentially correlate with young adult opioid use profiles, and thus may inform targeted interventions addressing different use patterns and psychosocial risk factors.

Wearable Pressure Sensors Based on MXene/Tissue Papers for Wireless Human Health Monitoring

Though the widely available, low-cost, and disposable papers have been explored in flexible paper-based pressure sensors, it is still difficult for them to simultaneously achieve ultrahigh sensitivity, low limit and broad range of detection, and high-pressure resolution. Herein, we demonstrate a novel flexible paper-based pressure sensing platform that features the MXene-coated tissue paper (MTP) sandwiched between a polyimide encapsulation layer and a printing paper with interdigital electrodes. After replacing the polyimide with weighing paper in the MTP pressure sensor, the silver interdigital electrodes can be recycled through incineration. The resulting pressure sensor with polyimide or paper encapsulation exhibits a high sensitivity of 509.5 or 344.0 kPa^-1, a low limit (∼1 Pa) and a broad range (100 kPa) of detection, and outstanding stability over 10 000 loading/unloading cycles. With ultrahigh sensitivity over a wide pressure range, the flexible pressure sensor can monitor various physiological signals and human movements. Configuring the pressure sensors into an array layout results in a smart artificial electronic skin to recognize the spatial pressure distribution. The flexible pressure sensor can also be integrated with signal processing and wireless communication modules on a face mask as a remote respiration monitoring system to wirelessly detect various respiration conditions and respiratory abnormalities for early self-identification of opioid overdose, pulmonary fibrosis, and other cardiopulmonary diseases.