How a Pandemic Impacts an Epidemic

The enormous focus on mitigating the impact of COVID-19 comes with a cost. It threatens to worsen the opioid epidemic, a public health crisis that continues to devastate the lives of many Americans. The COVID pandemic and the opioid epidemic are a combination some have called a “perfect storm for folks who are substance dependent.”

Opioid prescriptions grew in 2020, and at least 30 states reported increases in opioid fatalities since the start of the pandemic. Pandemic-related stress, anxiety, social isolation, and depression are common themes that span across all age groups, increasing the risk of opioid misuse and abuse among individuals and injured workers.

COVID-19 may have played a role, as increased prescriptions may be coming from hesitation in seeking alternative pain management treatments, such as chronic pain services, deemed non-essential due to the pandemic.

Increased Opioid Usage in Workers’ Compensation

The National Council of Compensation Insurance (NCCI) recently issued a Research Brief that evaluated COVID-19’s Impact on Medical Treatment in Workers’ Compensation. A key observation from the brief was that an increase in the utilization of opioids has been one of the factors contributing to the rise in drug share of medical costs.

The Brief noted that in 2018 and 2019, the share of drug claims with at least one opioid prescription declined at an average rate of 3% per quarter. The average Morphine Milligram Equivalents (MME) – the metric used to gauge the overdose potential – also showed a similar trend during this time.

But during the second quarter of 2020, the downward trend subsided, with a 10% spike in the average MME per opioid claim. And one out of three workers’ compensation drug claims included opioid prescriptions.

This means that injured workers received more pain medications at higher doses and increased the associated risk of opioid abuse, misuse, and overdose.

Avoiding an Extended Opioid Crisis

The opioid epidemic can’t be overlooked as we muster all our resources to fight the COVID-19 pandemic.

Access to care that was previously limited by safer-at-home orders has increased with the growing acceptance of virtual care platforms. During the COVID-19 pandemic, the Drug Enforcement Agency (DEA) adopted policies which allow providers to prescribe opioids via telemedicine without a prior in-person visit.

Giving providers the ability to see patients via telemedicine means better control over dose management and monitoring for signs of misuse.

Now more than ever, it is important for healthcare professionals to educate individuals, injured workers, and family members about opioid misuse and the symptoms of abuse.

The clinical circle of practitioners, pharmacists, worker’s compensation providers, case managers, and nurses must work together to closely monitor total MME for the duration of treatment as well as other risk factors that may potentiate opioid use such as stress, anxiety, and depression associated with the COVID-19 pandemic.

Staci Watts, MSN, APRN, FNP-C
SVP, CPO® Workers’ Compensation Clinical Operations