# COVID-19 Pandemic Mitigation, Community Economic and Social Vulnerability, and Opioid Use Disorder

> **NIH NIH U01** · UNIVERSITY OF ROCHESTER · 2022 · $756,521

## Abstract

PROJECT SUMMARY
Opioid use disorder (OUD) is a serious national crisis that affects public health and economic welfare, even
prior to the COVID-19 pandemic. The COVID-19 pandemic and the mitigation policies to prevent the spread of
SARS-CoV-2 upended social networks, healthcare access, led to historically high unemployment, and
amplified pre-existing community and economic vulnerability. Communities of color were hardest hit and
highlight pre-pandemic disparities in health, mortality, and well-being, including structural community
contextual factors that affect health. The pandemic also led to the highest overdose death toll since 2017.
While we know that social isolation can amplify and reinforce OUD, it is unclear which components of SARS-
CoV-2 mitigation efforts and resulting social, economic and healthcare disruptions differentially influenced
individuals with existing/at-risk of OUD. Additionally, we do not know if the impacts were concentrated in
communities with a higher pre-pandemic rate of OUD and/or were disproportionately adversely affected by
economic factors or COVID-19 cases/deaths. The goal of this study is to leverage large comprehensive
claims and electronic health data, capturing nearly half of the U.S. population from before the
pandemic through 2026, to test our hypothesis that social and economic vulnerabilities, as well as economic
side effects of the pandemic will escalate the prevalence of OUD and related harms. Building on our extensive
existing work, we use quasi-experimental methods to measure adverse OUD-related outcomes and worsening
health disparities using existing records capturing longitudinal OUD and COVID-19 incidence at the individual
patient and community levels. In Aim 1, we evaluate whether OUD outcomes during the first nine months have
been worse among communities that had been harder hit by the opioid epidemic pre-pandemic or have
experienced disparately higher incidence of COVID-19 morbidity/mortality during the pandemic. In Aim 2, we
evaluate longer-run OUD trajectories for communities that experienced 1) greater degrees of economic loss, 2)
higher COVID-19 morbidity/mortality, and 3) have disparate levels of vaccination uptake over the first five
years. We further examine disparities in OUD outcomes and leverage individual longitudinal data for
particularly vulnerable subpopulations (pregnancy, adolescents, disability, older adults). At the successful
completion of the proposed research, the expected outcomes are defined policy relevant factors that will reflect
the net health and mortality impacts of the COVID-19 pandemic on OUD diagnoses, treatment initiation and
adherence, utilization, and mortality over the short- and longer- terms. Ultimately, this research will support NIH
NIDA’s goals, identifying COVID-19’s impact on OUD and populations at risk for being medically underserved
in this complex yet vulnerable population.

## Key facts

- **NIH application ID:** 10520132
- **Project number:** 1U01DA057016-01
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** MEREDITH C. B. ADAMS
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $756,521
- **Award type:** 1
- **Project period:** 2022-07-01 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10520132

## Citation

> US National Institutes of Health, RePORTER application 10520132, COVID-19 Pandemic Mitigation, Community Economic and Social Vulnerability, and Opioid Use Disorder (1U01DA057016-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10520132. Licensed CC0.

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