A Comparative Analysis of Opioid Overdose Hospitalizations Pre- and Post-Pandemic: Insights from the National Inpatient Sample Database

Authors

• Hassan Shakir, Resident Physician, Department of Internal Medicine, The Wright Center of Graduate Medical Education, Scranton, PA, 18505, USA
• Niloy Ghosh, Resident Physician, Department of Internal Medicine, University of New Mexico, Albuquerque, NM,
• Mohammed A Quazi, Assistant Professor | Statistician, Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, Morgantown, WV
• Tom Limanovich, Medical Student, School of Medicine, University of New Mexico, Albuquerque, NM,Follow
• Abdul Rafel Awan, Department of Internal Medicine, Nishtar Medical University, Multan, Pakistan
• Humza Saeed, Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan
• Adeel Nasrullah, Assistant Professor, Department of Medicine, Drexel University Director Advanced Asthma and Allergy Clinic, Division of Pulmonology and Critical Care Medicine, Allegheny Health Network, Pittsburgh, PA, USA
• Christopher R Smith, Associate Professor, Department of Internal Medicine, University of New Mexico, Albuquerque, NM
• Abu Baker Sheikh, Assistant Professor, Department of Internal Medicine, University of New Mexico, Albuquerque, NM,

Abstract

Background: The COVID-19 pandemic disrupted healthcare systems, affecting opioid overdose–related hospitalizations. National data examining how demographic and clinical outcomes evolved during this period, particularly by overdose intent, remain limited.

Methods: Using the National Inpatient Sample (2018–2021), we identified adult hospitalizations for opioid overdose using ICD-10 codes and categorized cases as intentional, unintentional, or unspecified. Patients were grouped into pre-COVID (2018–2019) and post-COVID (2020–2021) cohorts. Multivariable logistic and linear regression models adjusted for patient- and hospital-level factors evaluated demographic differences, complications, and outcomes

Results: Among 293,810 hospitalizations, intentional overdoses decreased over time, while unintentional overdoses remained predominant. Post-COVID hospitalizations had higher odds of, sudden cardiac arrest (5.53% vs 4.52%; aOR 1.18, 95% CI 1.09–1.27), vasopressor use (aOR 1.12, 95% CI 1.01–1.24), and cardiac dysrhythmias (aOR 1.08, 95% CI 1.02–1.14), with no mortality difference (aOR 1.00, 95% CI 0.92–1.08).

Intentional overdoses were more common among younger females and associated with better clinical outcomes.. Compared with unintentional overdoses, intentional cases had lower odds of in-hospital mortality (1.86% vs 4.90%; aOR 0.47, 95% CI 0.40–0.55), sudden cardiac arrest (aOR 0.26, 95% CI 0.22–0.31), invasive ventilation (aOR 0.80, 95% CI 0.76–0.85), and anoxic brain injury (aOR 0.41, 95% CI 0.35–0.47).

Conclusions: Despite a decline in opioid overdose–related hospitalizations, unintentional overdoses remained the dominant and more severe presentation. The increase in post-COVID complications suggests a shift toward greater clinical acuity, placing additional strain on inpatient healthcare resources.

Recommended Citation

Shakir, Hassan; Ghosh, Niloy; Quazi, Mohammed A; Limanovich, Tom; Awan, Abdul Rafel; Saeed, Humza; Nasrullah, Adeel; Smith, Christopher R; and Sheikh, Abu Baker (2026) "A Comparative Analysis of Opioid Overdose Hospitalizations Pre- and Post-Pandemic: Insights from the National Inpatient Sample Database," Journal of Community Hospital Internal Medicine Perspectives: Vol. 16: Iss. 4, Article 8.
DOI: https://doi.org/10.55729/2000-9666.1632
Available at: https://scholarlycommons.gbmc.org/jchimp/vol16/iss4/8

DOI

10.55729/2000-9666.1632