{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:28:40Z","timestamp":1783006120118,"version":"3.54.5"},"reference-count":61,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T00:00:00Z","timestamp":1675814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale<\/jats:title><jats:p>Coronavirus (COVID\u201019)\u2010related stressors precipitated the mental health crisis and increased substance use in Canada and worldwide. As the pandemic continues to evolve, monitoring and updating substance use\u2010related ED visit trends is essential to ensure the stability and quality of ED services under the prolonged pandemic timeline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims and Objectives<\/jats:title><jats:p>This study examined the trends and characterization of substance use\u2010related ED visits during the pandemic among adolescents and young adults (aged 13\u201325 years) in Ontario, Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Descriptive statistics and binary logistic regression analyses were conducted using population\u2010based, repeated cross\u2010sectional data. The volume, patient characteristics (age and sex) and hospital\/ED visit features (triage to end time, timing of the visit, triage level and referral source) were compared before (2019) and during COVID\u201019 (2020 and 2021) by each substance type (alcohol, opioid, cannabis, sedatives, cocaine, stimulants and multiple psychoactive substances).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Substance use\u2010related ED visits decreased by 1.5 times during the pandemic compared to the prepandemic level. However, opioid\u2010related ED visits continued to show an increasing trend and did not recover to the prepandemic level in 2021. Moreover, a significant increase in emergent\/life\u2010threatening triage levels (Canadian Triage and Acuity Scales 1 and 2) in substance\u2010related ED visits is alarming (2019\u2009=\u200936.8%, 2020\u2009=\u200938.7% and 2021\u2009=\u200938.4%). We also found a general decrease in weekend visits, overnight visits and visits on statutory holidays, and substance use\u2010related ED patients tended to stay longer (over 6\u2009h) in the ED during the pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings indicate unmet substance use treatment needs due to the limited accessibility and heightened threshold for ED visits during the pandemic. Providing access to substance treatment\/programs outside ED is critical to reducing substance use\u2010related complications presenting in the ED. Also, policies addressing the pandemic\u2010related complexities in the ED and Health Human Resource challenges are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.13817","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T10:24:10Z","timestamp":1675851850000},"page":"447-458","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The COVID\u201019 impact and characterization on substance use\u2010related emergency department visits for adolescents and young adults in Canada: Practical implications"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9102-5814","authenticated-orcid":false,"given":"Soyeon","family":"Kim","sequence":"first","affiliation":[{"name":"Waypoint Research Institute Waypoint Centre for Mental Health Care Penetanguishene Ontario Canada"},{"name":"Department of Psychiatry and Behavioural Neurosciences McMaster University Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Rajack","sequence":"additional","affiliation":[{"name":"Waypoint Research Institute Waypoint Centre for Mental Health Care Penetanguishene Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6752-3485","authenticated-orcid":false,"given":"Shawn E.","family":"Mondoux","sequence":"additional","affiliation":[{"name":"Emergency Department St. Joseph's Healthcare Hamilton Hamilton Ontario Canada"},{"name":"Department of Medicine McMaster University Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitor S.","family":"Tardelli","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health University of Toronto Toronto Ontario Canada"},{"name":"Department of Psychiatry Universidade Federal de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan J.","family":"Kolla","sequence":"additional","affiliation":[{"name":"Waypoint Research Institute Waypoint Centre for Mental Health Care Penetanguishene Ontario Canada"},{"name":"Centre for Addiction and Mental Health University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Le Foll","sequence":"additional","affiliation":[{"name":"Waypoint Research Institute Waypoint Centre for Mental Health Care Penetanguishene Ontario Canada"},{"name":"Centre for Addiction and Mental Health University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlpt.2020.09.002"},{"key":"e_1_2_8_3_1","volume-title":"From Risk to Resilience: An Equity Approach to COVID\u201019","author":"Public Health Agency of Canada"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-046177"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0020764020915212"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000798"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.109150"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.09.098"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.08.001"},{"issue":"3","key":"e_1_2_8_10_1","first-page":"1","article-title":"Where are all the patients? 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