# Changes in Substance Use Diagnoses in the Great Plains during the COVID-19 Pandemic

## TL;DR

This study examines how healthcare visits for substance use disorders changed in the Great Plains during the pandemic, highlighting demographic and geographic patterns.

## Contribution

The study identifies specific demographic and geographic trends in substance use disorder diagnoses and remission during the pandemic in the Great Plains region.

## Key findings

- Males were more likely to receive Alcohol Use Disorder diagnoses, while females were more likely to receive Opioid or Stimulant Use Disorder diagnoses.
- Metropolitan patients were more likely to receive Alcohol Use Disorder diagnoses, while non-metropolitan patients were more likely to receive Opioid Use Disorder diagnoses.
- Stimulant Use Disorder remission odds increased during the pandemic, while Alcohol and Opioid Use Disorder remission odds decreased.

## Abstract

As drug overdose mortality rises in the United States, healthcare visits present critical opportunities to mitigate this trend. This study examines changes in healthcare visits for substance use disorders (SUDs) and remission prior to and during the COVID-19 pandemic in the Great Plains, with a focus on identifying the characteristics of those served. Data were analyzed from 109,671 patient visits (mode = one visit per patient), encompassing diverse demographics, including sex, age, race, ethnicity, and geographic location. Visits analyzed included those for Alcohol Use Disorder (AUD), Opioid Use Disorder (OUD), or Stimulant Use Disorder (StUD) and those in remission of these disorders between March 2019 and March 2021. Patient demographic information and geographic factors, like rurality and Medicaid expansion status, were considered, and logistic regression was utilized. Visits were primarily by White (70.83%) and Native American (21.39%) patients, non-Hispanic (91.70%) patients, and males (54.16%). Various demographic, geographic, and temporal trends were observed. Findings indicated that males were more likely to receive an AUD diagnosis, while females were more likely to receive an OUD or StUD diagnosis. Metropolitan-residing patients were more likely to receive an AUD diagnosis, while non-metropolitan patients were more likely to receive an OUD diagnosis. Remission odds increased for StUD during the pandemic but decreased for AUD and OUD. These findings illuminate the demographic and geographic patterns of SUD-related healthcare visits, suggesting critical touchpoints for intervention. The results emphasize the urgent need for targeted healthcare strategies, especially in rural and underserved areas, to address persistent health disparities.