Rising number of doctors prescribing opioids for COVID long-haulers, how Pa. is prepared

Opioid Crisis

(KTVI, WHTM) – St. Louis medical researchers are worried about a possible spike in the opioid crisis because a growing number of doctors are prescribing painkillers to COVID-19 long-haulers.

A joint study by the Washington University School of Medicine and the Veterans Health Administration is encouraging doctors to seek alternative treatments for long-hauler instead of opioids.

“This may cascade down to be a bigger problem down the road,” said lead researcher Dr. Ziyad Al-Aly, Washington University and the Veteran’s Health Administration.

Al-Aly said the study showed long-haulers were taking more opioids to manage pain than other VA patients.

A COVID-19 long-hauler is someone whose symptoms last weeks or even months.

Here in the Midstate, Cumberland, Dauphin, York, Lebanon, and Lancaster Counties have all been hotspots for the opioid crisis. And, during the pandemic, it’s been spiking once again.

While not as high as 2017, 2020’s death toll was over 4,800. And it’s no secret the pandemic is to blame.

Pa. government officials spent last summer putting together a detailed plan to combat the epidemic. Officials continue to ask residents to carry naloxone to save lives. Back in March, the Opioid Command Center launched the Statewide Naloxone Request Portal.

“It really allows organizations that come into contact with individuals who may be at additional high risk,” Department of Drug and Alcohol Deputy Secretary Ellen DiDomenico said to abc27 in April.

“Even amidst a national pandemic, the opioid crisis has continued, and in some ways become more of a challenge,” former Secretary of Health Dr. Rachel Levine said in July 2020. “Our commitment to addressing the opioid crisis remains steadfast, and to assist those with the disease of addiction. We want those affected to know that help is available, treatment works, and recovery is possible.”

In Philadephia, a new study from Penn Medicine showed deaths among the African-American community went up to almost 50 deaths a month.

“The results of this study are sobering,” Eugenia South, M.D., and author of the study said. “The Black community has been hit incredibly hard since the start of the pandemic — both with the illness itself and the social and economic fallout, which includes increased gun violence, job loss, and closure of small businesses. We believe the increase in fatal and non-fatal opioid overdoses is a symptom of that.”

South says a lack of access to recovery treatment due to inequalities is to blame.

“Philadelphia has been devastated by the opioid crisis, which was experienced previously more acutely in the white community,” the study’s lead author, Utsha Khatri, M.D., a fellow in the National Clinician Scholars Program at Penn and an Emergency Medicine physician said. “Recently, however, we tracked a disturbing trend toward higher rates of fatal and non-fatal overdoses among Black Philadelphia residents. These differential trends in opioid overdose suggest that racial inequities were exacerbated by the pandemic.”

“We were hoping that opioid prescriptions were going down nationwide, and they were before the pandemic hit,” Al-Aly said. “Now we see with long COVID, some people are coming back with pain and are being prescribed opioids. That sort of raises some alarm bells of us.”

Al-Aly said more than 3 million of the 31 million Americans infected with the coronavirus have developed long-term symptoms.

“I still exhibit the brain fog,” said Mary Coleman, a COVID long-hauler patient.

Coleman, a St. Charles County resident, does not use opioids. She tested positive in January after her father died of COVID. She still has symptoms, including extreme fatigue.

“Can you imagine that if everybody that has been diagnosed with COVID and, six or eight or nine months later, are still dealing with symptoms and then you give them the opportunity to take opioids to address some of their issues? It’s just such a slippery slope,” Coleman said.

Al-Aly said opioids should be used as a last resort, at a low dose, and for a short period of time. He said there are effective alternatives.

“Long COVID is real. The pain is real and must be treated, however, it should be treated with non-steroidals. Some patients are responding favorable to non-steroidals,” he said. “There are other options, including Tylenol and physical therapy. Some form of physical therapy that’s tailored specifically for long COVID patients.”

According to the Centers for Disease Control and Prevention, the drug overdose death toll rose by nearly 5% from 2018 to 2019 and has quadrupled since 1999. More than 70% of the 70,630 deaths in 2019 involved an opioid, the agency said.

In addition, the CDC estimates that the total “economic burden” of prescription opioid misuse in the U.S. is $78.5 billion a year.

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