Michigan system tracks opioid overdoses in real time, shows rise after COVID-19 arrival

A Michigan system that tracks suspected opioid deaths and naloxone use by first responders gives a better picture of how opioid overdoses rose after the start of the COVID-19 pandemic.

The real-time tracking system developed by the University of Michigan Injury Prevention Center (IPC), in partnership with the Michigan High Intensity Drug Traffic Area program from the federal government, shows a 15 percent rise in suspected opioid overdose deaths across Michigan since March, and a 29 percent increase in the use of opioid overdose reversal drug Naloxone.

Called the System for Opioid Overdose Surveillance, or SOS for short, the system gathers data from EMS agencies and medical examiners across most of Michigan and generates daily updates. The data shows the two epidemics – COVID-19 and the opioid crisis – may be linked.

“While we don’t have a cause-and-effect explanation for what we’re seeing, we know that in the first few months after the pandemic arrived in Michigan, many people were avoiding emergency departments unless they had severe symptoms of COVID-19,” says IPC director Patrick Carter, M.D., an emergency medicine physician at Michigan Medicine, U-M’s academic medical center.

Carter said the increase in opioid-related fatalities during the initial months of the pandemic fit the pattern of people slipping back into opioid use. The isolation and stress of the pandemic, coupled with the loss of jobs and insurance, as well as social distancing, all added to the changing ways people were using opioids, he said.

The data shows that each week in the first two months of 2020, between 30 and 40 Michigan residents died of suspected opioid overdoses. But as the coronavirus took hold of the state in mid-March, that number rose to over 40 a week and kept rising through early June. Levels didn’t fall until late August.

Additionally, the use of Naloxone by emergency medical responders was around 250 a week at the beginning of the year but began to rise steadily in mid-March, peaking at nearly 400 a week in early August.

County-level data also shows that counties hit hardest by COVID-19 had the largest relative increases in overdose deaths.

The SOS system offers a public dashboard showing county- and state-level data. First responders and public health agencies are provided password-protected access that gives more detailed information.

Plans for the SOS system encompass enhancing the dashboard by adding spike alerts, data overlays, and customizable geographic windows.