COVID‐19 restrictions and the incidence and prevalence of prescription opioid use in Australia – a nationwide study

Abstract

The COVID‐19 pandemic has disrupted seeking and delivery of healthcare. Different Australian jurisdictions implemented different COVID‐19 restrictions. We used Australian national pharmacy dispensing data to conduct interrupted time series analyses to examine the incidence and prevalence of opioid dispensing in different jurisdictions. Following nationwide COVID‐19 restrictions, the incidence dropped by −0.40 (95% confidence interval [CI]: −0.50, −0.31), −0.33 (95% CI: −0.46, −0.21) and −0.21 (95% CI: −0.37, −0.04) per 1000 people per week and the prevalence dropped by −0.85 (95% CI: −1.39, −0.31), −0.54 (95% CI: −1.01, −0.07) and −0.62 (95% CI: −0.99, −0.25) per 1000 people per week in Victoria, New South Wales and other jurisdictions, respectively. Incidence and prevalence increased by 0.29 (95% CI: 0.13, 0.44) and 0.72 (95% CI: 0.11, 1.33) per 1000 people per week, respectively in Victoria post‐lockdown; no significant changes were observed in other jurisdictions. No significant changes were observed in the initiation of long‐term opioid use in any jurisdictions. More stringent restrictions coincided with more pronounced reductions in overall opioid initiation, but initiation of long‐term opioid use did not change.

Changes in opioid agonist treatment initiation among people prescribed opioids for pain following voluntary and mandatory prescription drug monitoring program implementation: A time series analysis

“…The impact of stringent COVID‐19 lockdown restrictions in Victoria, placing pressure on healthcare services, may have also potentially contributed to reduced OAT initiation [31] . Time pressures and limited interactions with patients while using telehealth may have further impeded opportunities for prescribers to identify patients who may benefit from OAT.…”

Association of state‐level prescription drug monitoring program implementation with opioid prescribing transitions in primary care in Australia

“…This included reduced surgeries, reduced face‐to‐face consultation and reduced hospital attendance. It is possible that those restrictions may have impacted overall prescription opioid initiation and lowered acute opioid prescribing 35 . Although the daily OME was estimated using a 90‐day moving average approach, which removes noise due to ongoing fluctuations due to overlapping prescriptions or small intervals between prescription fills, it may be affected by variations in opioid supply due to these changes in the healthcare system due to COVID‐19.…”