A New Wave of the Overdose Epidemic arises during the COVID-19 Pandemic

Abstract Objective: The goal of this manuscript is to highlight the notoriety of the overdose epidemic which has been masked by the Coronavirus pandemic. Methods: A thorough literature review of PubMed and the latest statistics from the Centers for Disease Control and Prevention (CDC) was performed for the most relevant and updated data regarding overdose deaths. Conclusion: The global health crisis known as the Coronavirus Disease 2019 (COVID-19) pandemic collided with the opioid epidemic in March of 2020, with devastating consequences for the United States. By overwhelming the healthcare system, the pandemic impacted patients who require continued mental health services, treatment of chronic pain, and management of ongoing substance use disorder (SUD). Elective surgeries and in-person visits came to a halt, while society-wide priorities were diverted to the mitigation of the spread of COVID-19. Limitations in resources, increased social isolation, decreased access to care, and changes in the distribution of illicit fentanyl contributed to a “new wave” of the overdose opioid crisis. While the addiction crisis may have worsened the pandemic in some ways, undoubtedly, the COVID pandemic has fueled the overdose crisis. In 2020 and 2021, respectively, 91,799 and 106,699 people died from drug overdose deaths, substantial increases over the previous years Keywords COVID-19 Pandemic, opioid epidemic, chronic pain, substance use disorde

Mental Health Problems and Onset of Tobacco Use Among 12- to 24-Year-Olds in the PATH Study

Objective: To examine whether mental health problems predict incident use of 12 different tobacco products in a nationally representative sample of youth and young adults. Method: This study analyzed Wave (W) 1 and W2 data from 10,533 12- to 24-year-old W1 never tobacco users in the Population Assessment of Tobacco and Health (PATH) Study. Self-reported lifetime internalizing and externalizing symptoms were assessed at W1. Past 12-month use of cigarettes, electronic nicotine delivery systems (ENDS), traditional cigars, cigarillos, filtered cigars, pipe, hookah, snus pouches, other smokeless tobacco, bidis and kreteks (youth only), and dissolvable tobacco was assessed at W2. Results:In multivariable regression analyses, high-severity W1 interalizing (adjusted odds ratio [AOR] = 1.5, 95% CI = 1.3 - 1.8) and externalizing (AOR=1.3, 95% CI=1.1-1.5) problems predicted W2 onset of any tobacco use compared to no/low/moderate severity. High-severity W1 internalizing problems predicted W2 use onset across most tobacco products. High-severity W1 externalizing problems predicted onset of any tabacco (AOR=1.6, 95% C1=1.3-1.8), cigarettes (AOR=1.4, 95% CI=1.0-2.0), ENDS (AOR=1.8, 95& CI=1.5-2.1), and cigarillos (AOR=1.5, 95% CI=1.0-2.1) among youth only. Conclusion: Internalizing and externalizing problems predicted onset of any tobacco use. However, findings differed for internalizing and exter- nalizing problems across tobacco products, and by age, gender, and race/ethnicity. In addition to screening for tobacco product use, health care providers should screen for a range of mental health problems as a predictor of tobacco use. Interventions addressing mental health problems may prevent youth from initiating tobacco use