Comparing actual and forecasted numbers of unique patients dispensed select medications for opioid use disorder, opioid overdose reversal, and mental health, during the COVID-19 pandemic, United States, January 2019 to May 2020. (1st February 2021)

• Record Type: Journal Article
• Authors: Jones, Christopher M.; Guy, Gery P.; Board, Amy
• Is Part Of: Drug and alcohol dependence. Volume 219(2021)
• Publication Date: 2021-02-01
• Subjects: Substance use -- Overdose -- Opioid use disorder -- Mental health -- Depression -- Anxiety; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2020.108486
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: COVID-19 community mitigation measures may disrupt access to access to treatment. Number of patients dispensed buprenorphine was within forecasted estimates in March-May 2020. Number of unique patients dispensed naloxone was within forecasted estimates in March-May 2020. Number of patients dispensed ER intramuscular naltrexone was below forecasted estimates in March-May 2020. Innovative strategies to facilitate access to treatment are needed during COVID-19. Abstract: Background: COVID-19 community mitigation measures (e.g., stay-at-home orders) may worsen mental health and substance use-related harms such as opioid use disorder and overdose and limit access to medications for these conditions. We used nationally-representative data to assess dispensing of select substance use and mental health medications during the pandemic in the U.S. Methods: IQVIA Total Patient Tracker data were used to calculate U.S. monthly numbers of unique patients dispensed buprenorphine, extended-release (ER) intramuscular naltrexone, naloxone, selective serotonin or serotonin-norepinephrine reuptake inhibitors, benzodiazepines, and for comparison, HMG-CoA reductase inhibitors (statins) and angiotensin receptor blockers (ARBs) between January 2019-May 2020. Forecasted estimates of number of unique patients dispensed medications, generated by exponential smoothing statistical forecasting, were compared to actual numbers of patients by month to examine access during mitigation measures (March 2020-May 2020). Results: Between March 2020-May 2020, numbers of unique patients dispensed buprenorphine and numbers dispensed naloxone were within forecasted estimates. Numbers dispensed ER intramuscular naltrexone were significantly below forecasted estimates in March 2020 (-1039; 95 %CI:-1528 to -550), April 2020 (-2139; 95 %CI:-2629 to -1650), and May 2020 (-2498; 95 %CI:-2987 to -2009). Numbers dispensed antidepressants and benzodiazepines were significantly above forecasted estimates in March 2020 (977, 063; 95 %CI:351, 384 to 1, 602, 743 and 450, 074; 95 % CI:189, 999 to 710, 149 additional patients, respectively), but were within forecasted estimates in April 2020-May 2020. Dispensing patterns for statins and ARBs were similar to those for antidepressants and benzodiazepines. Conclusions: Ongoing concerns about the impact of the COVID-19 pandemic on substance use and mental health underscore the need for innovative strategies to facilitate continued access to treatment.