What impact did the COVID-19 pandemic have on the variability of fentanyl concentrations in the Vancouver, Canada illicit drug supply? An interrupted time-series analysis

Background Increases in fatal overdoses were observed coinciding with the COVID-19 pandemic across the USA and Canada. Hypothesised explanations include pandemic-attributable healthcare service disruption, social isolation and illicit drug market disruption. Using data from a community drug checking...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:BMJ Public Health 2023-12, Vol.1 (1), p.e000197
Hauptverfasser: Tobias, Samuel, Grant, Cameron J, Laing, Richard, Lysyshyn, Mark, Buxton, Jane A, Tupper, Kenneth W, Wood, Evan, Ti, Lianping
Format: Artikel
Sprache:eng
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue 1
container_start_page e000197
container_title BMJ Public Health
container_volume 1
creator Tobias, Samuel
Grant, Cameron J
Laing, Richard
Lysyshyn, Mark
Buxton, Jane A
Tupper, Kenneth W
Wood, Evan
Ti, Lianping
description Background Increases in fatal overdoses were observed coinciding with the COVID-19 pandemic across the USA and Canada. Hypothesised explanations include pandemic-attributable healthcare service disruption, social isolation and illicit drug market disruption. Using data from a community drug checking service, this study sought to evaluate how COVID-19 pandemic measures affected the variability in fentanyl concentrations within the local illicit drug market.Methods Using a validated quantification model for fentanyl, Fourier-transform infrared spectra from fentanyl-positive drug checking samples in Vancouver, Canada were analysed to determine fentanyl concentration. An interrupted time-series analysis using an ordinary least squares model with autoregressive adjusted SEs was conducted to measure how the variance in monthly fentanyl concentrations changed following the declaration of the COVID-19 public health emergency in March 2020.Results Over the study period, 4713 fentanyl-positive samples were available for analysis. Monthly variance of fentanyl concentrations ranged from 7.9% in December 2017 to 159.2% in September 2020. An interrupted time-series analysis of variance in fentanyl concentrations increased significantly following the declaration of the COVID-19 public health emergency, with an immediate level change of 26.1 (95% CI 7.2 to 45.0, p=0.011) and a slope change of 15.8 (95% CI 10.2 to 21.4, p
doi_str_mv 10.1136/bmjph-2023-000197
format Article
fullrecord <record><control><sourceid>doaj_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1136_bmjph_2023_000197</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_eeeed572863641598e554c796706b00e</doaj_id><sourcerecordid>oai_doaj_org_article_eeeed572863641598e554c796706b00e</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1997-cf80463716f06781c7bdf38e879b5932868db9515ee508e76e25a1ea348118d43</originalsourceid><addsrcrecordid>eNpNkcFq3DAQhk1ooSHJA_SmB4hbybIs6VTCtk0WArmk6dGMpXFWiy0ZSbvgV-pTVtkNpXOZYeafbwb-qvrM6BfGePd1mPfLrm5ow2tKKdPyorpspOB12-j2w3_1p-ompX3RcE6los1l9ef3DjJx8wImE-ssyTskm6eX7feaabKAtzg7Q3ZwRBL8aXqE6GBwk8srCSMZ0Wfw60RM8KbUEbILPhF3Vr-AN-FwxHhLNuDBAnHT5Iwr1-LhlaTDskzrN3Lny0LGGA9LxvKFm7FOGB0mUramNbl0XX0cYUp4856vql8_fzxvHurHp_vt5u6xNkxrWZtR0bbjknUj7aRiRg525AqV1IPQvFGdsoMWTCAKqlB22AhgCLxVjCnb8qtqe-baAPt-iW6GuPYBXH9qhPjaQ8zOTNhjCStkYfKuZUIrFKI1UneSdgOlWFjszDIxpBRx_MdjtH_zrj95179515-9438BcKWOwg</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>What impact did the COVID-19 pandemic have on the variability of fentanyl concentrations in the Vancouver, Canada illicit drug supply? An interrupted time-series analysis</title><source>BMJ Open Access Journals</source><source>DOAJ Directory of Open Access Journals</source><creator>Tobias, Samuel ; Grant, Cameron J ; Laing, Richard ; Lysyshyn, Mark ; Buxton, Jane A ; Tupper, Kenneth W ; Wood, Evan ; Ti, Lianping</creator><creatorcontrib>Tobias, Samuel ; Grant, Cameron J ; Laing, Richard ; Lysyshyn, Mark ; Buxton, Jane A ; Tupper, Kenneth W ; Wood, Evan ; Ti, Lianping</creatorcontrib><description>Background Increases in fatal overdoses were observed coinciding with the COVID-19 pandemic across the USA and Canada. Hypothesised explanations include pandemic-attributable healthcare service disruption, social isolation and illicit drug market disruption. Using data from a community drug checking service, this study sought to evaluate how COVID-19 pandemic measures affected the variability in fentanyl concentrations within the local illicit drug market.Methods Using a validated quantification model for fentanyl, Fourier-transform infrared spectra from fentanyl-positive drug checking samples in Vancouver, Canada were analysed to determine fentanyl concentration. An interrupted time-series analysis using an ordinary least squares model with autoregressive adjusted SEs was conducted to measure how the variance in monthly fentanyl concentrations changed following the declaration of the COVID-19 public health emergency in March 2020.Results Over the study period, 4713 fentanyl-positive samples were available for analysis. Monthly variance of fentanyl concentrations ranged from 7.9% in December 2017 to 159.2% in September 2020. An interrupted time-series analysis of variance in fentanyl concentrations increased significantly following the declaration of the COVID-19 public health emergency, with an immediate level change of 26.1 (95% CI 7.2 to 45.0, p=0.011) and a slope change of 15.8 (95% CI 10.2 to 21.4, p&lt;0.001).Conclusion Though community drug checking samples may not be generalisable to the wider illicit drug market, our study found that variance in fentanyl concentrations increased significantly following the declaration of the COVID-19 public health emergency. While it remains unclear whether the observed increase in the variability of fentanyl concentration in illicit opioids was a direct result of COVID-19 and related measures, the volatility of fentanyl concentrations is likely to have posed significant risk to people who used drugs in this setting.</description><identifier>ISSN: 2753-4294</identifier><identifier>EISSN: 2753-4294</identifier><identifier>DOI: 10.1136/bmjph-2023-000197</identifier><language>eng</language><publisher>BMJ Publishing Group</publisher><ispartof>BMJ Public Health, 2023-12, Vol.1 (1), p.e000197</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1997-cf80463716f06781c7bdf38e879b5932868db9515ee508e76e25a1ea348118d43</citedby><cites>FETCH-LOGICAL-c1997-cf80463716f06781c7bdf38e879b5932868db9515ee508e76e25a1ea348118d43</cites><orcidid>0000-0001-6051-8950 ; 0000-0003-3281-073X ; 0000-0003-2470-438X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,27924,27925</link.rule.ids></links><search><creatorcontrib>Tobias, Samuel</creatorcontrib><creatorcontrib>Grant, Cameron J</creatorcontrib><creatorcontrib>Laing, Richard</creatorcontrib><creatorcontrib>Lysyshyn, Mark</creatorcontrib><creatorcontrib>Buxton, Jane A</creatorcontrib><creatorcontrib>Tupper, Kenneth W</creatorcontrib><creatorcontrib>Wood, Evan</creatorcontrib><creatorcontrib>Ti, Lianping</creatorcontrib><title>What impact did the COVID-19 pandemic have on the variability of fentanyl concentrations in the Vancouver, Canada illicit drug supply? An interrupted time-series analysis</title><title>BMJ Public Health</title><description>Background Increases in fatal overdoses were observed coinciding with the COVID-19 pandemic across the USA and Canada. Hypothesised explanations include pandemic-attributable healthcare service disruption, social isolation and illicit drug market disruption. Using data from a community drug checking service, this study sought to evaluate how COVID-19 pandemic measures affected the variability in fentanyl concentrations within the local illicit drug market.Methods Using a validated quantification model for fentanyl, Fourier-transform infrared spectra from fentanyl-positive drug checking samples in Vancouver, Canada were analysed to determine fentanyl concentration. An interrupted time-series analysis using an ordinary least squares model with autoregressive adjusted SEs was conducted to measure how the variance in monthly fentanyl concentrations changed following the declaration of the COVID-19 public health emergency in March 2020.Results Over the study period, 4713 fentanyl-positive samples were available for analysis. Monthly variance of fentanyl concentrations ranged from 7.9% in December 2017 to 159.2% in September 2020. An interrupted time-series analysis of variance in fentanyl concentrations increased significantly following the declaration of the COVID-19 public health emergency, with an immediate level change of 26.1 (95% CI 7.2 to 45.0, p=0.011) and a slope change of 15.8 (95% CI 10.2 to 21.4, p&lt;0.001).Conclusion Though community drug checking samples may not be generalisable to the wider illicit drug market, our study found that variance in fentanyl concentrations increased significantly following the declaration of the COVID-19 public health emergency. While it remains unclear whether the observed increase in the variability of fentanyl concentration in illicit opioids was a direct result of COVID-19 and related measures, the volatility of fentanyl concentrations is likely to have posed significant risk to people who used drugs in this setting.</description><issn>2753-4294</issn><issn>2753-4294</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpNkcFq3DAQhk1ooSHJA_SmB4hbybIs6VTCtk0WArmk6dGMpXFWiy0ZSbvgV-pTVtkNpXOZYeafbwb-qvrM6BfGePd1mPfLrm5ow2tKKdPyorpspOB12-j2w3_1p-ompX3RcE6los1l9ef3DjJx8wImE-ssyTskm6eX7feaabKAtzg7Q3ZwRBL8aXqE6GBwk8srCSMZ0Wfw60RM8KbUEbILPhF3Vr-AN-FwxHhLNuDBAnHT5Iwr1-LhlaTDskzrN3Lny0LGGA9LxvKFm7FOGB0mUramNbl0XX0cYUp4856vql8_fzxvHurHp_vt5u6xNkxrWZtR0bbjknUj7aRiRg525AqV1IPQvFGdsoMWTCAKqlB22AhgCLxVjCnb8qtqe-baAPt-iW6GuPYBXH9qhPjaQ8zOTNhjCStkYfKuZUIrFKI1UneSdgOlWFjszDIxpBRx_MdjtH_zrj95179515-9438BcKWOwg</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Tobias, Samuel</creator><creator>Grant, Cameron J</creator><creator>Laing, Richard</creator><creator>Lysyshyn, Mark</creator><creator>Buxton, Jane A</creator><creator>Tupper, Kenneth W</creator><creator>Wood, Evan</creator><creator>Ti, Lianping</creator><general>BMJ Publishing Group</general><scope>AAYXX</scope><scope>CITATION</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6051-8950</orcidid><orcidid>https://orcid.org/0000-0003-3281-073X</orcidid><orcidid>https://orcid.org/0000-0003-2470-438X</orcidid></search><sort><creationdate>20231201</creationdate><title>What impact did the COVID-19 pandemic have on the variability of fentanyl concentrations in the Vancouver, Canada illicit drug supply? An interrupted time-series analysis</title><author>Tobias, Samuel ; Grant, Cameron J ; Laing, Richard ; Lysyshyn, Mark ; Buxton, Jane A ; Tupper, Kenneth W ; Wood, Evan ; Ti, Lianping</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1997-cf80463716f06781c7bdf38e879b5932868db9515ee508e76e25a1ea348118d43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tobias, Samuel</creatorcontrib><creatorcontrib>Grant, Cameron J</creatorcontrib><creatorcontrib>Laing, Richard</creatorcontrib><creatorcontrib>Lysyshyn, Mark</creatorcontrib><creatorcontrib>Buxton, Jane A</creatorcontrib><creatorcontrib>Tupper, Kenneth W</creatorcontrib><creatorcontrib>Wood, Evan</creatorcontrib><creatorcontrib>Ti, Lianping</creatorcontrib><collection>CrossRef</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMJ Public Health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tobias, Samuel</au><au>Grant, Cameron J</au><au>Laing, Richard</au><au>Lysyshyn, Mark</au><au>Buxton, Jane A</au><au>Tupper, Kenneth W</au><au>Wood, Evan</au><au>Ti, Lianping</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>What impact did the COVID-19 pandemic have on the variability of fentanyl concentrations in the Vancouver, Canada illicit drug supply? An interrupted time-series analysis</atitle><jtitle>BMJ Public Health</jtitle><date>2023-12-01</date><risdate>2023</risdate><volume>1</volume><issue>1</issue><spage>e000197</spage><pages>e000197-</pages><issn>2753-4294</issn><eissn>2753-4294</eissn><abstract>Background Increases in fatal overdoses were observed coinciding with the COVID-19 pandemic across the USA and Canada. Hypothesised explanations include pandemic-attributable healthcare service disruption, social isolation and illicit drug market disruption. Using data from a community drug checking service, this study sought to evaluate how COVID-19 pandemic measures affected the variability in fentanyl concentrations within the local illicit drug market.Methods Using a validated quantification model for fentanyl, Fourier-transform infrared spectra from fentanyl-positive drug checking samples in Vancouver, Canada were analysed to determine fentanyl concentration. An interrupted time-series analysis using an ordinary least squares model with autoregressive adjusted SEs was conducted to measure how the variance in monthly fentanyl concentrations changed following the declaration of the COVID-19 public health emergency in March 2020.Results Over the study period, 4713 fentanyl-positive samples were available for analysis. Monthly variance of fentanyl concentrations ranged from 7.9% in December 2017 to 159.2% in September 2020. An interrupted time-series analysis of variance in fentanyl concentrations increased significantly following the declaration of the COVID-19 public health emergency, with an immediate level change of 26.1 (95% CI 7.2 to 45.0, p=0.011) and a slope change of 15.8 (95% CI 10.2 to 21.4, p&lt;0.001).Conclusion Though community drug checking samples may not be generalisable to the wider illicit drug market, our study found that variance in fentanyl concentrations increased significantly following the declaration of the COVID-19 public health emergency. While it remains unclear whether the observed increase in the variability of fentanyl concentration in illicit opioids was a direct result of COVID-19 and related measures, the volatility of fentanyl concentrations is likely to have posed significant risk to people who used drugs in this setting.</abstract><pub>BMJ Publishing Group</pub><doi>10.1136/bmjph-2023-000197</doi><orcidid>https://orcid.org/0000-0001-6051-8950</orcidid><orcidid>https://orcid.org/0000-0003-3281-073X</orcidid><orcidid>https://orcid.org/0000-0003-2470-438X</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2753-4294
ispartof BMJ Public Health, 2023-12, Vol.1 (1), p.e000197
issn 2753-4294
2753-4294
language eng
recordid cdi_crossref_primary_10_1136_bmjph_2023_000197
source BMJ Open Access Journals; DOAJ Directory of Open Access Journals
title What impact did the COVID-19 pandemic have on the variability of fentanyl concentrations in the Vancouver, Canada illicit drug supply? An interrupted time-series analysis
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T08%3A58%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-doaj_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=What%20impact%20did%20the%20COVID-19%20pandemic%20have%20on%20the%20variability%20of%20fentanyl%20concentrations%20in%20the%20Vancouver,%20Canada%20illicit%20drug%20supply?%20An%20interrupted%20time-series%20analysis&rft.jtitle=BMJ%20Public%20Health&rft.au=Tobias,%20Samuel&rft.date=2023-12-01&rft.volume=1&rft.issue=1&rft.spage=e000197&rft.pages=e000197-&rft.issn=2753-4294&rft.eissn=2753-4294&rft_id=info:doi/10.1136/bmjph-2023-000197&rft_dat=%3Cdoaj_cross%3Eoai_doaj_org_article_eeeed572863641598e554c796706b00e%3C/doaj_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rft_doaj_id=oai_doaj_org_article_eeeed572863641598e554c796706b00e&rfr_iscdi=true