Fatal Drug Overdoses in Ohio in 2020 Spiked Weeks After National Emergency Declaration, Early Lockdowns

Upticks in fatal overdoses in Ohio followed initial major events in governmental response to the COVID-19 pandemic, researchers found in a cross-sectional study published in JAMA Network Open.

The researchers studied fatal overdoses (n=12,195, 8140 males (66.7%)) that occurred from January 2018 through October 10, 2020, according to data from the Ohio Department of Health. They grouped the overdoses by drug type (fentanyl and analogues; heroin, other opioids, all other drugs) and noted which week they occurred. They compared the deaths for 4 age groups (18 to 24 years, 25 to 44 years, 45 to 64 years, and 65 years and older) in each 4-week period with the average number of deaths that occurred in each group in 2018 through 2019.

They found that of the 12,195 overdose deaths that occurred in that period, fatal overdoses increased 70.6% from around March 15, the week after the declaration of a national emergency (n=85), to the week of May 31. In the same week (May 26) of the previous year, fatal overdoses had been 82.

Fatal overdoses had fallen back to 80 the week of August 16 to 22, and then risen to 105 for the week of October 4 to 11. State unemployment rate in October was 8.9%, the study researchers noted.

Most fatal overdoses were fentanyl-related (8981, 73.6%), which was the sole category that spiked over the sample period.

The largest relative spike occurred among the group aged 18 to 24 years. That group’s 4-week overdoses at the peak were twice as high (42 deaths) as the 2018-2019 4-week mean (20.42 deaths). In comparison, the peak for the group aged 25 to 44 years had 1.67 times the 2018-2019 4-week mean while the peak for the group aged 45 to 64 years had a peak that was 1.72 times the prior year’s 4-week mean. The oldest group’s peak was 1.89 times the 2018-2019 count.

Limitations of the study included that the cause of death is unknown for 121 (0.034%) of the 351,834 total deaths of the sample period and that the findings may not be generalizable outside of Ohio.

“Still unknown is whether and how the pandemic caused this spike in fatal overdoses, and why overdose deaths returned to baseline levels after rising sharply at the start of the pandemic,” the study authors said.

Disclosures: Dr Zhang reported affiliation with the US Department of Veteran Affairs Mental Health and Suicide Prevention.


Currie JM, Schnell MK, Schwandt H, Zhang J. Trends in drug overdose mortality in Ohio during the first 7 months of the COVID-19 pandemic. JAMA Network Open. Published online April 14, 202. doi:10.1001/jamanetworkopen.2021.7112