Researchers from EMBED, an NIH Pragmatic Trials Collaboratory Trials, found a sharp rise in out-of-hospital overdose deaths in the early years of the COVID-19 pandemic, attributable largely to increasing involvement of fentanyl.
The findings were published online ahead of print this week in the New England Journal of Medicine.
EMBED was a cluster randomized trial across 21 emergency departments in 5 healthcare systems in the United States. The trial evaluated a clinical decision support system for initiating buprenorphine in emergency department settings. Since completing the trial, the research team has pursued multiple health services research studies to describe the environment in which the EMBED clinical decision support tools are being implemented.
Using data from the National Center for Health Statistics from 2016 through 2021, the research team compared overdose deaths outside the hospital in the years before the COVID-19 pandemic to those in the early years of the pandemic. Out-of-hospital overdose deaths increased significantly during the early pandemic period and were driven primarily by deaths associated with fentanyl.
EMBED was supported within the NIH Collaboratory by a cooperative agreement from the National Institute on Drug Abuse and received logistical and technical support from the NIH Collaboratory Coordinating Center. Read more about EMBED in the Living Textbook, and learn about the other NIH Collaboratory Trials.