Prescription fill patterns for benzodiazepine and opioid drugs during the COVID-19 pandemic in the United States

Constanza de Dios; Brisa S. Fernandes; Kristine Whalen; Shruti Bandewar; Robert Suchting; Michael F. Weaver; Sudhakar Selvaraj

doi:10.1016/j.drugalcdep.2021.109176

Prescription fill patterns for benzodiazepine and opioid drugs during the COVID-19 pandemic in the United States

Constanza de Dios, Brisa S. Fernandes, Kristine Whalen, Shruti Bandewar, Robert Suchting, Michael F. Weaver, Sudhakar Selvaraj

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

Background: COVID-19 and resulting mitigation measures in the United States (US) brought about limited access to medical care that has been linked to increases in mental health problems, excessive substance use, and drug overdoses. The increase in co-prescription of benzodiazepines and opioids may indicate population-level changes in health behaviors that can be exacerbated by limited access, hence necessitating the tracking of these drugs during COVID-19. We evaluated the impact of the declaration of COVID-19 as a US national emergency on prescription patterns in 2020. Methods: Prescriptions of benzodiazepines and opioids were analyzed using data aggregated on a weekly basis across 38 states over the January 2019-December 2020 period. Data were from Bamboo Health Prescription Drug Monitoring Program and covered all individuals regardless of insurance status. Generalized additive models estimated the effects of the March 13, 2020 declaration on proportion of prescriptions to all controlled substances by comparing volumes before to after the week of March 13 in 2020 (range: January 27-May 24) and comparing this trend to its 2019 counterpart. Results: When comparing the January 27-March 9 period to the March 16-May 24 period in 2020, there was a statistically significant 2.0% increase in the proportion of benzodiazepine dispensations to all controlled substances, and a significant 1.7% mean decrease in proportion of opioid dispensations to all controlled substances. A significant return approaching pre-declaration levels was observed only for opioids (beginning week of May 18, 2020). Conclusions: The results suggest significant impacts of the COVID-19 pandemic on dispensations of benzodiazepines and opioids across the US. Continued monitoring of prescription trends and maintenance of adequate and accessible access to mental healthcare are important for understanding public health crises related to substance use.

Original language	English (US)
Article number	109176
Journal	Drug and Alcohol Dependence
Volume	229
DOIs	https://doi.org/10.1016/j.drugalcdep.2021.109176
State	Published - Dec 1 2021

Keywords

Benzodiazepines
Coronavirus-19
Generalized additive models
Opioids
Prescription drugs

ASJC Scopus subject areas

Toxicology
Pharmacology
Psychiatry and Mental health
Pharmacology (medical)

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10.1016/j.drugalcdep.2021.109176

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@article{a6744c0f2a5744e1b595fd29a332cac6,

title = "Prescription fill patterns for benzodiazepine and opioid drugs during the COVID-19 pandemic in the United States",

abstract = "Background: COVID-19 and resulting mitigation measures in the United States (US) brought about limited access to medical care that has been linked to increases in mental health problems, excessive substance use, and drug overdoses. The increase in co-prescription of benzodiazepines and opioids may indicate population-level changes in health behaviors that can be exacerbated by limited access, hence necessitating the tracking of these drugs during COVID-19. We evaluated the impact of the declaration of COVID-19 as a US national emergency on prescription patterns in 2020. Methods: Prescriptions of benzodiazepines and opioids were analyzed using data aggregated on a weekly basis across 38 states over the January 2019-December 2020 period. Data were from Bamboo Health Prescription Drug Monitoring Program and covered all individuals regardless of insurance status. Generalized additive models estimated the effects of the March 13, 2020 declaration on proportion of prescriptions to all controlled substances by comparing volumes before to after the week of March 13 in 2020 (range: January 27-May 24) and comparing this trend to its 2019 counterpart. Results: When comparing the January 27-March 9 period to the March 16-May 24 period in 2020, there was a statistically significant 2.0% increase in the proportion of benzodiazepine dispensations to all controlled substances, and a significant 1.7% mean decrease in proportion of opioid dispensations to all controlled substances. A significant return approaching pre-declaration levels was observed only for opioids (beginning week of May 18, 2020). Conclusions: The results suggest significant impacts of the COVID-19 pandemic on dispensations of benzodiazepines and opioids across the US. Continued monitoring of prescription trends and maintenance of adequate and accessible access to mental healthcare are important for understanding public health crises related to substance use.",

keywords = "Benzodiazepines, Coronavirus-19, Generalized additive models, Opioids, Prescription drugs",

author = "{de Dios}, Constanza and Fernandes, {Brisa S.} and Kristine Whalen and Shruti Bandewar and Robert Suchting and Weaver, {Michael F.} and Sudhakar Selvaraj",

note = "Funding Information: Constanza de Dios, Brisa S. Fernandes, Robert Suchting, and Michael F. Weaver declare no conflicts of interest. Kristine Whalen and Shruti Bandewar are employees of Bamboo Health. SS has received grants/research support from NIH and SAMHSA, Compass Pathways, LivaNova, received speaking honoraria from Global Medical Education, honoraria from British Medical Journal Publishing Group, and owns shares at Flow Med Tech (received research support from outside the submitted work). All other authors have no conflicting interests to disclose. Funding Information: We thank Katrina Sitkovits of Bamboo Health for her assistance in data extraction. Funders: Research supplement funds from The University of Texas Health Science Center at Houston to Sudhakar Selvaraj were utilized for this study. The University of Texas Health Science Center at Houston had no role in the study's design and conduct; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. This study's content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or SAMHSA. Publisher Copyright: {\textcopyright} 2021 Elsevier B.V.",

year = "2021",

month = dec,

day = "1",

doi = "10.1016/j.drugalcdep.2021.109176",

language = "English (US)",

volume = "229",

journal = "Drug and Alcohol Dependence",

issn = "0376-8716",

publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - Prescription fill patterns for benzodiazepine and opioid drugs during the COVID-19 pandemic in the United States

AU - de Dios, Constanza

AU - Fernandes, Brisa S.

AU - Whalen, Kristine

AU - Bandewar, Shruti

AU - Suchting, Robert

AU - Weaver, Michael F.

AU - Selvaraj, Sudhakar

N1 - Funding Information: Constanza de Dios, Brisa S. Fernandes, Robert Suchting, and Michael F. Weaver declare no conflicts of interest. Kristine Whalen and Shruti Bandewar are employees of Bamboo Health. SS has received grants/research support from NIH and SAMHSA, Compass Pathways, LivaNova, received speaking honoraria from Global Medical Education, honoraria from British Medical Journal Publishing Group, and owns shares at Flow Med Tech (received research support from outside the submitted work). All other authors have no conflicting interests to disclose. Funding Information: We thank Katrina Sitkovits of Bamboo Health for her assistance in data extraction. Funders: Research supplement funds from The University of Texas Health Science Center at Houston to Sudhakar Selvaraj were utilized for this study. The University of Texas Health Science Center at Houston had no role in the study's design and conduct; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. This study's content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or SAMHSA. Publisher Copyright: © 2021 Elsevier B.V.

PY - 2021/12/1

Y1 - 2021/12/1

N2 - Background: COVID-19 and resulting mitigation measures in the United States (US) brought about limited access to medical care that has been linked to increases in mental health problems, excessive substance use, and drug overdoses. The increase in co-prescription of benzodiazepines and opioids may indicate population-level changes in health behaviors that can be exacerbated by limited access, hence necessitating the tracking of these drugs during COVID-19. We evaluated the impact of the declaration of COVID-19 as a US national emergency on prescription patterns in 2020. Methods: Prescriptions of benzodiazepines and opioids were analyzed using data aggregated on a weekly basis across 38 states over the January 2019-December 2020 period. Data were from Bamboo Health Prescription Drug Monitoring Program and covered all individuals regardless of insurance status. Generalized additive models estimated the effects of the March 13, 2020 declaration on proportion of prescriptions to all controlled substances by comparing volumes before to after the week of March 13 in 2020 (range: January 27-May 24) and comparing this trend to its 2019 counterpart. Results: When comparing the January 27-March 9 period to the March 16-May 24 period in 2020, there was a statistically significant 2.0% increase in the proportion of benzodiazepine dispensations to all controlled substances, and a significant 1.7% mean decrease in proportion of opioid dispensations to all controlled substances. A significant return approaching pre-declaration levels was observed only for opioids (beginning week of May 18, 2020). Conclusions: The results suggest significant impacts of the COVID-19 pandemic on dispensations of benzodiazepines and opioids across the US. Continued monitoring of prescription trends and maintenance of adequate and accessible access to mental healthcare are important for understanding public health crises related to substance use.

AB - Background: COVID-19 and resulting mitigation measures in the United States (US) brought about limited access to medical care that has been linked to increases in mental health problems, excessive substance use, and drug overdoses. The increase in co-prescription of benzodiazepines and opioids may indicate population-level changes in health behaviors that can be exacerbated by limited access, hence necessitating the tracking of these drugs during COVID-19. We evaluated the impact of the declaration of COVID-19 as a US national emergency on prescription patterns in 2020. Methods: Prescriptions of benzodiazepines and opioids were analyzed using data aggregated on a weekly basis across 38 states over the January 2019-December 2020 period. Data were from Bamboo Health Prescription Drug Monitoring Program and covered all individuals regardless of insurance status. Generalized additive models estimated the effects of the March 13, 2020 declaration on proportion of prescriptions to all controlled substances by comparing volumes before to after the week of March 13 in 2020 (range: January 27-May 24) and comparing this trend to its 2019 counterpart. Results: When comparing the January 27-March 9 period to the March 16-May 24 period in 2020, there was a statistically significant 2.0% increase in the proportion of benzodiazepine dispensations to all controlled substances, and a significant 1.7% mean decrease in proportion of opioid dispensations to all controlled substances. A significant return approaching pre-declaration levels was observed only for opioids (beginning week of May 18, 2020). Conclusions: The results suggest significant impacts of the COVID-19 pandemic on dispensations of benzodiazepines and opioids across the US. Continued monitoring of prescription trends and maintenance of adequate and accessible access to mental healthcare are important for understanding public health crises related to substance use.

KW - Benzodiazepines

KW - Coronavirus-19

KW - Generalized additive models

KW - Opioids

KW - Prescription drugs

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ER -

Prescription fill patterns for benzodiazepine and opioid drugs during the COVID-19 pandemic in the United States

Abstract

Keywords

ASJC Scopus subject areas

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