Substitution of Nonpharmacologic Therapy With Opioid Prescribing for Pain During the COVID-19 Pandemic

Abstract

IMPORTANCEDuring the pandemic, access to medical care unrelated to COVID-19 was limited because of concerns about viral spread and corresponding policies. It is critical to assess how these conditions affected modes of pain treatment, given the addiction risks of prescription opioids. OBJECTIVE To assess the trends in opioid prescription and nonpharmacologic therapy (ie, physical therapy and complementary medicine) for pain management during the COVID-19 pandemic in 2020 compared with the patterns in 2019. DESIGN, SETTING, AND PARTICIPANTS This retrospective, cross-sectional study used weekly claims data from 24 million US patients in a nationwide commercial insurance database (Optum's deidentified Clinformatics Data Mart Database) from January 1, 2019, to September 31, 2020. Among patients with diagnoses of limb, extremity, or joint pain, back pain, and neck pain for each week, patterns of treatment use were identified and evaluated. Data analysis was performed from April 1, 2021, to September 31, 2021. MAIN OUTCOMES AND MEASURESThe main outcomes of interest were weekly rates of opioid prescriptions, the strength and duration of related opioid prescriptions, and the use of nonpharmacologic therapy. Transition rates between different treatment options before the outbreak and during the early months of the pandemic were also assessed.

Pharmaceuticalization to Opioid Pharmacovigilance: A Qualitative Investigation of the Impact of Opioid-related Policy Changes and the Perspectives of Residents and Chronic Non-cancer Pain Patients

“…Conversely, it may be the case that medical professionals are more often treating CNCP through non-pharmaceutical treatments, which would imply depharmaceuticalization. However, it seems the opposite may be true as several studies have highlighted an increase in opioid prescriptions due the coronavirus disease 2019 (COVID-19) pandemic (Lee et al 2021), which began after we collected our data. Put another way, even if there was a degree of depharmaceuticalization taking place, the pandemic ultimately wiped out these changes.…”

Quality of online video resources concerning patient education for neck pain: A YouTube-based quality-control study

“…While most acute episodes resolve spontaneously, more than 30% of patients experience mild symptoms or relapse more than a year later, with genetic and psychosocial factors being persistent risk factors ( 11 ). To make matters worse, management of neck pain has been severely affected during the COVID-19 pandemic ( 18 , 52 – 55 ). Given the explosive growth of the Internet as a fast and wide source of medical information in all areas of life, an increasing number of orthopedic patients have searched for medical information on YouTube, while the overall quality and reliability of relevant videos is poor.…”

“…Unfortunately, the current COVID-19 pandemic and concomitant restrictions have contributed to a severe shortage of conventional medical care ( 15 – 18 ). Given the explosive growth of the Internet as a source for quick and extensive information in all areas of life, 80% of netizens have searched the Internet for health information ( 19 ), and up to 30% of orthopedic patients have searched for medical information online ( 20 ), which has greatly facilitated consultation and medical treatment during the epidemic.…”

The COVID Era Unveils Flaws in Pain Treatment

“…COVID-19 has brought a new phenomenon into our lives: a further monadization of human beings who already in many parts of the world were painfully experiencing the phenomenon of social isolation. The further distancing and separation of people has led to an aggravation of the inability and impossibility of expressing oneself, of reclaiming one's right to health and pain relief, provoking a decrease of access to analgesic therapies [8,9]. Many reports show how the level of suffering and social fear has drastically increased, also because the isolation of people was the only criterion adopted for the first months to prevent the pandemic, while waiting for the vaccine or suitable antiviral drugs [10].…”