(H) Incidence and Prevalence of Prescription Opioid Use During Australian COVID-19 Restrictions

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall E South

Publication Number: 298

Presenting Author(s)

Monica Jung
– Monash University (Monash Addiction Research Centre; Centre for Medicine Use and Safety), Frankston, Victoria, Australia

Co-Author(s)

Dickson Lukose, PhD
– Professor of Practice, Monash Data Futures Institute, Monash University, Victoria, Australia
Suzanne Nielsen, BPharmSc(Hons), PhD
– Associate Professor, Monash Addiction Research Centre, Monash University, Melbourne, Victoria, Australia
J. Simon Bell
– Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia, Australia
Geoffrey Webb, PhD
– Research Director, Monash Data Futures Institute, Monash University, Victoria, Australia
Jenni Ilomaki, PhD
– Senior Lecturer, Monash University, Parkville, Victoria, Australia

Background: The COVID-19 pandemic has disrupted seeking and delivery of healthcare with less frequent face-to-face medical visits, cessation of non-urgent medical procedures, and reduced presentations of injury and trauma. Moreover, an increase in the prevalence of pain and mental health problems has been identified during the COVID-19 pandemic. These may impact pain management and in turn, the use of prescription opioids.

Objectives: To investigate changes in the incidence and prevalence of opioid dispensing coinciding with different jurisdiction-based COVID-19 restrictions.

Methods: We conducted a retrospective cohort study of people dispensed opioid analgesics for non-cancer pain between January 2018 and December 2020 using Australian national pharmacy dispensing data. Interrupted time series analyses were performed using Auto-Regressive Integrated Moving Average approach to examine changes in levels and trends for Victoria, New South Wales (NSW) and other Australian jurisdictions at introduction of nationwide COVID-19 restrictions (March 2020), and at the end of the Victorian lockdown (October 2020).

Results: Following COVID-19 restrictions, the opioid incidence dropped by -0.402 [-0.497, -0.308], -0.332 [-0.455, -0.208] and -0.207 [-0.370, -0.043] /1000 people/week in Victoria, NSW and other jurisdictions, respectively. Prevalence dropped by -0.847 [-1.386, -0.309], -0.541 [-1.008, -0.073] and -0.624 [-0.994, -0.254] /1000 people/week in Victoria, NSW and other jurisdictions, respectively, following COVID-19 restrictions. Incidence and prevalence increased by 0.286 [0.134, 0.438] and 0.721 [0.110, 1.331] /1000 people/week, respectively in Victoria post-lockdown; no significant changes were observed in other jurisdictions. COVID-19 restrictions did not coincide with significant changes in the initiation of long-term opioid use in any jurisdictions.

Conclusions: COVID-19 restrictions corresponded with a reduction in prescription opioid initiation and use. Incidence rebounded to pre-pandemic levels, with a more gradual increase in Victoria compared to other jurisdictions. Prevalence remained stable in all jurisdictions. Patterns of people initiating on long-term opioid use did not change during COVID-19 restrictions.