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Disability-Adjusted Life Years for Drug Overdose Crisis and COVID-19 Are Comparable During the Two Years of Pandemic in the United States

  • Qiushi Chen
    Correspondence
    Contact information for corresponding author: Qiushi Chen, PhD, Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, 302 Leonhard Building, University Park, PA 16802 Phone: 814-863-4562 [email protected]
    Affiliations
    The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, PA

    Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
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  • Paul M. Griffin
    Affiliations
    The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, PA

    Consortium for Substance Use and Addiction, Pennsylvania State University, University Park, PA
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  • Sarah S. Kawasaki
    Affiliations
    Psychiatry and Medicine, Penn State College of Medicine, Hershey, PA

    Psychiatry and Internal Medicine, Penn State Health, Hershey, PA
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Published:November 24, 2022DOI:https://doi.org/10.1016/j.jval.2022.11.010
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      HIGHLIGHTS

      • The COVID-19 pandemic and drug overdoses (from both opioids and stimulants) are two concurrent public health crises in the United States (US). To help inform public health policy, it is important to understand the relative scales of the disease burden that each has placed on society.
      • This study evaluated the disease burden of the drug overdose crisis (substance use disorder and the associated overdose deaths) and COVID-19 in the US during the two-year period since the COVID-19 pandemic. No prior study has compared the disease burden for these two major public health crises in the US under the same measure, and no systematic review exists on this topic.
      • Despite the smaller size of the affected population, substance use disorder and drug overdoses resulted in a comparable disease burden to the COVID-19 infections in the US during the two years of the pandemic, which may warrant substantial resources and continued endeavors to ameliorate the ongoing drug overdose crisis.

      ABSTRACT

      Objectives

      The drug overdose crisis with shifting patterns from primarily opioid to polysubstance uses and COVID-19 infections are two concurrent public health crises in the United States, affecting the population of sizes in different magnitudes (approximately <10 million for substance use disorder (SUD) and drug overdoses vs. 80 million for COVID-19 within two years of the pandemic). Our objective is to compare the relative scale of disease burden for the two crises within a common framework, which could help inform policymakers with resource allocation and prioritization strategies.

      Methods

      We calculated disability-adjusted life years (DALYs) for SUD (including opioids and stimulants) and COVID-19 infections, respectively. We collected estimates for SUD prevalence, overdose deaths, COVID-19 cases and deaths, disability weights, and life expectancy from multiple publicly available sources. We then compared age distributions of estimated DALYs.

      Results

      We estimated a total burden of 13.83 million DALYs for SUD and drug overdoses and 15.03 million DALYs for COVID-19 in two years since March 2020. COVID-19 burden was dominated by the fatal burden (>95% of total DALYs), whereas SUD burden was attributed to both fatal (53%) and non-fatal burdens (47%). The highest disease burden was among individuals aged 30-39 for SUD (27%) and 50-64 for COVID-19 (31%).

      Conclusions

      Despite the smaller size of the affected population, SUD and drug overdoses resulted in comparable disease burden to the COVID-19 pandemic. Additional resources supporting evidence-based interventions in prevention and treatment may be warranted to ameliorate SUD and drug overdoses during both the pandemic and post-pandemic recovery.