COVID-19 survivors are in danger from a attainable second pandemic of opioid habit, given the excessive charge of painkillers being prescribed to those sufferers, well being specialists say.
A new examine in Nature discovered alarmingly excessive charges of opioid use amongst COVID-19 survivors with lingering signs at Veterans Well being Administration amenities. About 10% of COVID-19 survivors develop a mysterious situation often called lengthy COVID, scuffling with typically disabling well being issues even six months or longer after a prognosis.
For each 1,000 lengthy COVID sufferers who had been handled at a Veterans Affairs facility, medical doctors wrote 9 extra prescriptions for opioids than they in any other case would have. In addition they wrote 22 extra prescriptions for benzodiazepines, which embody Xanax and different addictive tablets used to deal with anxiousness.
Though earlier research have discovered many COVID-19 survivors — also called lengthy haulers — expertise persistent well being issues, the brand new examine is the primary to indicate they’re utilizing extra addictive medicines, stated Dr. Ziyad Al-Aly, the lead writer.
He’s involved that even an apparently small enhance within the inappropriate use of addictive ache tablets will result in a resurgence of the prescription opioid disaster, given the big variety of COVID-19 survivors. Greater than 3 million of the nation’s 31 million survivors develop long-term signs, which might embody fatigue, shortness of breath, melancholy, anxiousness and reminiscence issues often called mind fog.
The brand new examine additionally discovered many sufferers have vital muscle and bone ache.
The frequent use of opioids was stunning, given considerations about their potential for habit, stated Al-Aly, chief of analysis and training service on the VA St. Louis Well being Care System.
“Physicians now are speculated to draw back from prescribing opioids,” he stated.
Al-Aly studied greater than 73,000 sufferers within the VA system. When he noticed the variety of opioid prescriptions, he stated, he thought to himself, “Is that this actually taking place another time?”
Docs have to act earlier than “it’s too late to do one thing,” Al-Aly stated. “We don't need this to balloon right into a suicide disaster or one other opioid epidemic.”
As extra medical doctors grew to become conscious of their addictive potential, new opioid prescriptions fell by greater than half since 2012. However U.S. medical doctors nonetheless prescribe much more of the medicine — which embody OxyContin, Vicodin and codeine — than physicians in different nations, stated Dr. Andrew Kolodny, medical director of opioid coverage analysis at Brandeis College.
Some sufferers who grew to become hooked on prescription painkillers switched to heroin, both as a result of it was cheaper or as a result of they may not acquire opioids from their medical doctors. Overdose deaths surged lately as drug sellers started spiking heroin with the highly effective artificial opioid fentanyl.
Greater than 88,000 People died from overdoses throughout the 12 months ending in August 2020, in keeping with the Facilities for Illness Management and Prevention. Well being specialists now advise medical doctors to keep away from prescribing opioids for lengthy durations.
The brand new examine “suggests to me that many clinicians nonetheless don’t get it,” Kolodny stated. “Many clinicians are underneath the misunderstanding that opioids are applicable for persistent ache sufferers.”
Hospitalized COVID-19 sufferers typically obtain loads of remedy to manage ache and anxiousness, particularly in intensive care items, stated Dr. Greg Martin, president of the Society of Essential Care Drugs. Sufferers positioned on ventilators, for instance, are sometimes sedated to make them extra comfy.
Martin stated he’s involved by the examine’s findings, which counsel sufferers are unnecessarily persevering with medicines after leaving the hospital.
“I fear that COVID-19 sufferers, particularly those that are severely and critically unwell, obtain loads of medicines throughout the hospitalization, and since they've persistent signs, the medicines are continued after hospital discharge,” he stated.
Whereas some COVID-19 sufferers are experiencing muscle and bone ache for the primary time, others say the sickness has intensified their preexisting ache.
Rachael Sunshine Burnett has suffered from persistent ache in her again and ft for 20 years, ever since an accident at a warehouse the place she as soon as labored. However Burnett, who first was recognized with COVID-19 in April 2020, stated the ache quickly grew to become 10 occasions worse and unfold to the realm between her shoulders and backbone.
Though she was already taking long-acting OxyContin twice a day, her physician prescribed a further opioid known as oxycodone, which relieves ache instantly. She was reinfected with COVID-19 in December.
“It’s been a horrible, horrible yr,” stated Burnett, 43, of Coxsackie, N.Y.
Docs ought to acknowledge that ache will be part of lengthy COVID, Martin stated. “We have to discover the correct non-narcotic therapy for it, identical to we do with different types of persistent ache,” he stated.
The CDC recommends plenty of alternate options to opioids, together with bodily remedy, biofeedback, over-the-counter anti-inflammatory medicine, antidepressants and anti-seizure medicines that additionally relieve nerve ache.
The nation additionally wants an total technique to deal with the wave of post-COVID-19 issues, Al-Aly stated
“It’s higher to be ready than to be caught off guard years from now, when medical doctors notice … ‘Oh, we now have a resurgence in opioids,’” Al-Aly stated.
Al-Aly famous that his examine could not seize the total complexity of survivors’ wants. Though girls make up nearly all of lengthy COVID sufferers in most research, most sufferers within the VA system are males.
The examine of VA sufferers makes it “abundantly clear that we aren't ready to satisfy the wants of three million People with lengthy COVID,” stated Dr. Eric Topol, founder and director of the Scripps Analysis Translational Institute. “We desperately want an intervention that can successfully deal with these people.”
Al-Aly stated COVID-19 survivors may have look after years.
“That’s going to be an enormous, vital burden on the healthcare system,” Al-Aly stated. “Lengthy COVID will reverberate within the well being system for years and even many years to come back.”
This text was produced by Kaiser Well being Information (KHN), a nationwide newsroom that gives in-depth protection of well being points and that is without doubt one of the three main working packages at Kaiser Household Basis. KHN is the writer of California Healthline, an editorially unbiased service of the California Well being Care Basis.
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