Instruct: Identify the main category of Medrxiv papers based on the titles and abstracts
Query: Methadone overdoses increased 48% during the COVID-19 epidemic BackgroundThe United States (US) is in the middle of an opioid overdose epidemic that has spanned over two decades and continues to escalate. Methadone is long-acting full opioid agonist which has been approved to treat opioid use disorder (OUD). Methadone can cause respiratory depression that may result in mortality. The restrictions on methadone availability including take-home dosing were loosened during the COVID-19 pandemic although there have been concerns about the high street value of diverted methadone. This report examined how fatal overdoses involving methadone have changed over the past two-decades including during the pandemic.

MethodsThe Center for Disease Control and Preventions Wide-ranging Online Data for Epidemiologic Research (WONDER) database, which draws data from death certificates, was used to find the unintentional methadone related overdose death rate from 1999-2020. Unintentional methadone deaths were defined using the International Statistical Classification of Diseases (ICD), 10th revision codes: X40-44 with only data which was coded for methadone (T40.3). Data from the Automation of Reports and Consolidated Orders System (ARCOS) on methadone overall use, narcotic treatment programs use, and pain management use was gathered for all states, including the District of Columbia, for 2020 and corrected for population.

ResultsThere have been dynamic changes over the past two-decades in overdoses involving methadone. Overdoses increased from 1999 (0.9/million) to 2007 (15.9) and declined until 2019 (6.5). Overdoses in 2020 (9.6) were 48.1% higher than in 2019 (t(50) = 3.05, p < .005).

The correlations between overall methadone use (r(49) = +0.75, p < 0.001), and narcotic treatment program use (r(49) = +0.77, p < 0.001) were positive, strong, and statistically significant. However, methadone use for pain treatment was not associated with overdoses (r(49) = -.08, p = .57).

ConclusionsOverdoses involving methadone significantly increased by 48.1% in 2020 relative to 2019. This mortality increase is much larger than the 5.3% elevation in calls involving methadone reported to poison control centers in the year following the March 16, 2020 loosening of methadone take-home regulations. Policy changes that were implemented following the COVID-19 pandemic involving methadone may warrant reconsideration.
40
The categories of this paper are: geriatric
11
The categories of this paper are: policy
70
The categories of this paper are: otolaryngology
37
The categories of this paper are: aids
46
The categories of this paper are: therapeutics
43
The categories of this paper are: environmental
47
The categories of this paper are: care
26
The categories of this paper are: systems
25
The categories of this paper are: improvement
60
The categories of this paper are: addiction
65
The categories of this paper are: oral
6
The categories of this paper are: and
49
The categories of this paper are: intensive
64
The categories of this paper are: ophthalmology
0
The categories of this paper are: neurology
62
The categories of this paper are: orthopedics