Drug Overdoses are Surging with COVID

Shadowbox Tech Offers Help to Struggling Addiction and Treatment Providers

February 17, 2021

By Gregory A. Stein and Andrea G. Barthwell, MD, DFASAM

The number of drug overdose deaths in the US reached a record high last spring, rising in tandem with the first wave of Coronavirus cases.  According to the U.S. Centers for Disease Control (CDC), more than 81,000 people died from an overdose in the 12 months ended May 2020 – the largest number ever recorded.

The US Department of Health and Human Services, the National Institutes of Health, the Centers for Disease Control, and the American Medical Association have each published reports on the significant impact the Coronavirus pandemic is having on mental health.  Interventions meant to flatten the coronavirus curve, such as travel restrictions, business constraints, and limitations on social gatherings (combined with personal prevention efforts such as mask wearing, social distancing, and frequent hand washing) have proven effective in reducing the transmission of the disease. That said, there are unintended mental health consequences caused by social isolation and a lack of group activities; these losses can be devastating to the nearly 18 million Americans battling substance use disorder.

In addition to the deaths caused by the virus itself, the pandemic is also linked to a surge in overdose deaths.  Whereas drug overdose deaths had been trending flat to declining since 2017, the onset of COVID triggered a resurgence of overdoses, reversed the trend, with recorded deaths increasing by  nearly 20% versus prior year.  This is occurring despite  a 37% decrease in opiate prescriptions since 2014.  In fact, more than 19,000 people died of an overdose in just the first three months of 2020.

This trend is likely to have accelerated, with a significant increase in total overdose deaths expected once full statistics are in for 2020.  One leading indicator was the release of a US DHH study revealing that a sample of a half million urine drug tests processed in the four months prior to March 2020 vs. tests processed in the four following months showed that patients were:

    • 67% more likely to test positive for fentanyl;
    • 33% more likely to test positive for heroin;
    • 23% more likely to test positive for methamphetamine;
    • 19% more likely to test positive for cocaine.

The numbers regarding fentanyl are particularly disturbing as they represent an ever-increasing proportion of drug related deaths due to its extremely powerful chemistry and inexpensive production costs.

As a result, it is more important than ever to enable access to treatment, and provide the support and resources to the nation’s more than 14,500 specialized drug treatment facilities and their clinical and front-line staff.  These facilities rely on three key resources to support their treatment plans:

    1. Definitive urine drug testing (UDT) identifies the substances that are present in a patient’s body to ensure safety and safeguard the welfare of patients and confirm they are responding to the current treatment plan and level of care.
    2. Prescription drug management databases (PDM) to protect patients from being prescribed drugs that cause unsafe drug-drug interactions and to account for how much is being taken by the patient during an interval of care.
    3. Predictive analytics regarding a patient’s potential for use of unprescribed medications or medications being used in ways other than intended that can proactively trigger a clinician intervention.

While each of these resources are independently valuable to treatment centers, they work best in concert.   At Shadowbox, we are introducing new technology, working in partnership with addiction and treatment providers, to simply and rapidly bring these resources together to enhance treatment, improve patient outcomes, and ultimately save lives.

Today, clinicians use Shadowbox to order thousands of urine drug tests and prescription drug management database reports every month.  These orders are automated and simplified by our patented low code interface technology. Shadowbox is poised to launch the third component –the collaboration of information across systems (patient information in the clinic’s electronic health record [EHR] system, UDT results data, and PDM reports) that will ultimately feed an Artificial Intelligence (AI) engine and respond with evidence based predictive analytics that can be used by the provider to check in with the patient to assess if more support is needed.  The beauty of the Shadowbox architecture is that as new data sources come online, they can be quickly added to the Shadowbox application and used to improve the predictive value of the AI.

With many of the nation’s UDT providers rapidly pivoting last year to also provide high quality molecular diagnostic tests to diagnose COVID-19, it is now possible to include positive test results in the analytics and measure the significance of contracting the disease has on patient outcomes.

We are just getting started with the interoperability potential enabled by Shadowbox technology and are excited to apply our innovation to help save and improve lives.

For more information about Shadowbox, please schedule a demo.


Gregory A. Stein is CEO of Shadowbox

Andrea G. Barthwell, MD, DFASAM, is a former Deputy Director of the US Office of National Drug Control Policy and serves on the Shadowbox Board of Advisors