{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T16:57:30Z","timestamp":1783443450257,"version":"3.54.6"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Public health measures introduced to contain the spread of the SARS\u2010CoV\u20102 virus likely affected opioid supply and demand, as well as the patterns and contexts of opioid use. We measured opioid\u2010related harms during the first 2\u2009years of COVID\u201019 restrictions in Victoria, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We adopted an interrupted time series analysis design using interventional autoregressive integrated moving average (ARIMA) models. Opioid\u2010related ambulance attendance data between January 2015 and March 2022 were extracted from the National Ambulance Surveillance System.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Victoria, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Patients (\u226515\u2009years) attended to by an ambulance for opioid\u2010related harms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Monthly opioid\u2010related ambulance attendances for three drug types: heroin, prescription opioids and opioid agonist therapy (OAT) medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>The monthly rate of heroin\u2010related attendances fell by 26% immediately after the introduction of COVID\u201019 restrictions. A reduced rate of heroin\u2010related attendances was observed during COVID\u201019 restrictions, resulting in 2578 averted heroin\u2010related attendances. There was no change in the rate of attendances for extra\u2010medical OAT medications or prescription opioids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Strict COVID\u201019 restrictions in Victoria, Australia appear to have resulted in a substantial reduction in heroin\u2010related ambulance attendances, perhaps because of border closures and restrictions on movement affecting supply, changing patterns of drug consumption, and efforts to improve access to OAT. Despite policy changes allowing longer OAT prescriptions and an increased number of unsupervised doses, we found no evidence of increased harms related to the extra\u2010medical use of these medications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16360","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T04:21:10Z","timestamp":1697084470000},"page":"348-355","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Opioid\u2010related ambulance attendances during the first 2\u00a0years of the COVID\u201019 pandemic in Victoria, Australia"],"prefix":"10.1111","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0465-176X","authenticated-orcid":false,"given":"Michael","family":"McGrath","sequence":"first","affiliation":[{"name":"Turning Point Eastern Health  Richmond Victoria Australia"},{"name":"Monash Addiction Research Centre and Eastern Health Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Stare","sequence":"additional","affiliation":[{"name":"Turning Point Eastern Health  Richmond Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyllis","family":"Chua","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8476-7123","authenticated-orcid":false,"given":"Rowan","family":"Ogeil","sequence":"additional","affiliation":[{"name":"Turning Point Eastern Health  Richmond Victoria Australia"},{"name":"Monash Addiction Research Centre and Eastern Health Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziad","family":"Nehme","sequence":"additional","affiliation":[{"name":"Ambulance Victoria  Blackburn Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University  Melbourne Victoria Australia"},{"name":"Department of Paramedicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"Scott","sequence":"additional","affiliation":[{"name":"Turning Point Eastern Health  Richmond Victoria Australia"},{"name":"Monash Addiction Research Centre and Eastern Health Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6747-1937","authenticated-orcid":false,"given":"Dan I.","family":"Lubman","sequence":"additional","affiliation":[{"name":"Turning Point Eastern Health  Richmond Victoria Australia"},{"name":"Monash Addiction Research Centre and Eastern Health Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12992-022-00807-7"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.13079"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-020-00370-7"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1747-597X-1-11"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2003.00248.x"},{"key":"e_1_2_10_7_1","unstructured":"DietzeP MillerP ClemensS MatthewsS GilmourS CollinsL.The course and consequences of the heroin shortage in Victoria. 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