# Understanding the short- and long-term effects of the COVID-19 pandemic on the overdose crisis

> **NIH NIH R01** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2024 · $998,506

## Abstract

Overdose has risen sharply during the COVID-19 pandemic, highlighting an urgent need to understand the
impact of disasters on overdose. We need research to identify the types of policy measures that can prevent a
similar increase in overdose in future disasters. We also need to understand why certain communities are
particularly vulnerable to experiencing rises in overdose during and after a disaster, so that we can optimally
target prevention and disaster response efforts. We propose to use Big Events Theory as a framework to: 1)
study the COVID-19 pandemic and its effects on overdose and related outcomes; 2) identify policy responses
to COVID-19 that affected individual-level overdose risk; and 3) examine how the pandemic's impact on
overdose risk varied across communities and populations. We hypothesize that COVID-19 containment
policies (e.g., workplace closings) contributed to social isolation, increasing the risk of consuming drugs alone
and limiting access to treatment and harm reduction services, thus increasing overdose risk. In contrast, public
health (e.g., take-home methadone waivers) and economic support policy responses to COVID-19 (e.g.,
housing eviction moratoria) may have eased access to health services for people who use drugs (PWUD) and
alleviated economic difficulties arising from the pandemic, blocking health and economic pathways through
which the pandemic could increase overdose risk. We hypothesize that communities with more structural
sources of despair (e.g., high rates of unemployment, poverty), and those that concurrently experienced other
major societal crises (natural disasters, political conflict, mass shootings) were more vulnerable to the effects
of COVID-19 on overdose. In contrast, social and economic policies enacted before the pandemic to protect
vulnerable populations (e.g., higher state Medicaid income threshold) may have reduced the impact of the
pandemic on overdose risk. Our Aims are to: (1) Determine how individual overdose risk in localities
(overall and by race/ethnicity) changed over 2019–2025 after county-level elevations in COVID-19 health
burden (hospitalizations, deaths). (2) Determine which county- and state-level policies targeting COVID-19
infection containment, public health of PWUDs, and economic support during the pandemic mediated
relations between changes in county-level COVID-19 burden and changes in overdose incidence, overall and
by race/ethnicity. (3) Identify which community conditions affected the strength of the relationships
between changes in county-level COVID-19 burden and individual overdose risk, overall and by race/ethnicity,
including: a) pre-existing community structural characteristics (e.g., poverty rate); b) pre-existing policies to
protect vulnerable populations (e.g., state Medicaid program income threshold); and c) intersecting crises. We
will build a multi-center cohort of ~2.4 million patients aged 18+ in six PCORnet® networks across the country
to track the impact ...

## Key facts

- **NIH application ID:** 10932904
- **Project number:** 5R01DA058991-02
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** Magdalena Cerda
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $998,506
- **Award type:** 5
- **Project period:** 2023-09-30 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10932904

## Citation

> US National Institutes of Health, RePORTER application 10932904, Understanding the short- and long-term effects of the COVID-19 pandemic on the overdose crisis (5R01DA058991-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10932904. Licensed CC0.

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