The impact of the COVID-19 pandemic was especially challenging for vulnerable populations, such as those with chronic long-term health conditions, mental health conditions, and substance use disorders. Lockdowns and fear of spread led to barriers for patients whether they were accessing methadone through opioid treatment programs or being prescribed buprenorphine.

A systematic review first published online in October 2022 sought to identify whether there was a change in opioid use and misuse outcomes during the COVID-19 pandemic. Authors Siddartha Simha, MD, and Mark C. Bicket, MD, PhD, joined RAPM Editor-in-Chief Brian Sites, MD, to discuss their article, “Impact of the COVID-19 pandemic on opioid overdose and other adverse events in the USA and Canada: a systematic review,” published October 2022 (https://rapm.bmj.com/content/48/1/37). The authors found that opioid-related emergency medicine use increased in most studies for both service calls and emergency department visits. Urine drug testing positivity results increased in all studies for fentanyl, and in most studies for heroin and oxycodone. Naloxone dispensation was unchanged and decreased in one study. The authors concluded that efforts to curb the spread of COVID-19 aligned with an increase in the opioid crisis severity, which has implications for future pandemic responses.

Dr. Siddartha Simha is a third-year anesthesiology resident at Michigan Medicine in Ann Arbor. Originally from Troy, MI, he obtained his medical degree from Oakland University William Beaumont School of Medicine in Auburn Hills, MI. Dr. Simha has a strong interest in acute and chronic pain management and research with plans to pursue a clinical fellowship in pain medicine.

Dr. Mark C. Bicket is the co-director of the Opioid Prescribing Engagement Network and an assistant professor at the University of Michigan Medical School with a joint appointment in the School of Public Health. A clinician scientist and practicing physician, his work has been supported by the National Institutes of Health, the Substance Abuse and Mental Health Services Administration, the Foundation for Anesthesia Education and Research, and the Patient-Centered Outcomes Research Institute.

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