EPH198 The Sustained Impact of COVID-19 on Opioid Dispensing in California

Abstract

Opioid overprescribing played a major role in the onset of the American opioid epidemic. During the COVID-19 pandemic, healthcare access had dramatic changes that potentially impacted high-risk opioid prescribing among healthcare providers and high-risk opioid seeking behaviors among opioid recipients. The study aims to assess the impact of the COVID-19 pandemic on trends in opioid dispensing during the 14 months before COVID-19 and 21 months after in California. Analyzing dispensing data from California’s Controlled Substance Utilization Review and Evaluation System (CURES)-Prescription Drug Monitoring Programs (PDMPs), the study harnessed a segmented regression model to measure changes in temporal trends in high-risk opioid dispensing associated with the onset of the COVID-19 pandemic. Four measures of high-risk opioid utilization were analyzed: (1) multiple provider episodes, (2) overlapping opioid prescription for seven or more days, (3) overlapping opioid and benzodiazepine for seven or more days, and (4) high standardized dosage of opioid prescriptions per month. The study assessed dispensing records from 1,737,984 recipients before the pandemic period from January 18, 2019, to December 17, 2021, and 1,873,962 recipients during the pandemic period from January 18, 2019, to December 17, 2021. The segmented regression analysis showed that the onset of the pandemic significantly changed the decreasing trend on high-risk measurements of (1) multiple provider episodes (P-value=0.0125) and (4) high standardized dosage of opioid prescriptions (P-value=0.0312). Although all four indices presented a decreasing trend from the study initiating time, the model findings show that COVID-19 significantly resisted such long-term declining trends. We observed a gradual decrease in opioid dispensing in recent years. The COVID-19 pandemic had a sustained effect on high-risk opioid dispensing behavior, decelerating the declining trend of high-risk behavior occurrences.