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Prevalence of Alcohol in Unintentional Opioid Overdose Deaths, 2017-2020

Although there is substantial literature on opioid overdose deaths (OODs) and polysubstance use, involvement of alcohol in these deaths is less clear. 

We investigated the prevalence of alcohol in OODs from July 1, 2017, to December 31, 2020, in Illinois, including temporal associations between Illinois’ COVID-19 stay-at-home order (March 21 to June 5, 2020) and the prevalence of alcohol in OODs. We also assessed differences by sex, race, ethnicity, and age.

Data on unintentional OODs were culled from the Illinois State Unintentional Drug Overdose Reporting System (SUDORS).

Alcohol involvement was assessed using toxicology reports, which describe positive findings of ethanol in peripheral blood, urine, or liver tissue (a less-common but suitable specimen for detection). Deaths were classified as involving alcohol if any level of ethanol was detected.

We used a modified Poisson interrupted time series model to assess the role of alcohol in OODs and any changes that occurred during and after the stay-at-home order.

Of 6774 total OODs (5033 males and 1741 females; 5233 aged <55 years and 1541 aged ≥55 years), alcohol was involved in 2073 OODs (30.6%).

Over 30% of unintentional OODs in Illinois from July 2017 to December 2020 involved alcohol. There was no evidence of changes in the prevalence of alcohol in unintentional OODs during or after the COVID-19 stay-at-home order.


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