The use of opioids increased significantly during the pandemic as patients waited for surgeries such as hip and knee replacements, research reveals.
The University of Aberdeen study found the numbers of patients using opioids while waiting for surgery increased by 40% compared to pre-pandemic levels.
The waiting time for surgery was an average of 90 days longer during the height of the pandemic as hospitals shifted to focus on providing acute care.
Long-term opioid use before surgery is associated with increased risk of complications related to the operation, poorer outcomes, and ongoing opioid dependence, the researchers said.
HuffPost UK has previously reported on the rise of opioid use in the UK, which includes drugs such as morphine and strong codeine, which are only available on prescription.
The number of opioid drugs being prescribed to patients in England has been steadily rising since 2010, and prescription figures are higher in poorer areas, compared to more affluent ones.
Patients who developed addition to prescription opioids shared how they obtained the drugs illegally when prescriptions ran out. One man, who was prescribed codeine while recovering from a broken hand, lost his job, his driving license and his family, telling us opioid use “can ruin livesâ€.
Opioids such as morphine and tramadol are sometimes prescribed for pain management in conditions such as osteoarthritis. However, the latest study says there is growing evidence this can be of limited benefit and even cause long-term detriment to health, especially in older adults.
Luke Farrow, clinical research fellow at the University of Aberdeen’s Institute of Applied Health Sciences, who led the research, said alternative ways of managing severe arthritis pain must be found “urgently†for those waiting for this kind of surgery.
“Our work provides evidence of potential for an emerging opioid problem associated with the influence of Covid-19 on elective orthopaedic services,†he said.
“With continued delays in the provision of timely total hip and knee arthroplasty expected for some time due to the considerable backlog of patients awaiting surgery, patients will need to seek alternative treatment options to manage their symptoms.
“We would advocate that healthcare professionals and patients avoid the use of opioid medication if at all possible due to the known lack of effect in this setting and potential for harm.â€
The study looked at data collected from 452 NHS patients from the north east of Scotland who were on the waiting list for hip and knee replacement surgery and compared the numbers of patients who had been prescribed opioids with those who had surgery before the pandemic.
The pandemic led to the widespread postponement of elective orthopaedic procedures as hospitals focused on acute care. Researchers said that patients awaiting hip and knee replacements, as one of the most common elective procedures, have been disproportionally affected.
HuffPost previously interviewed Adam, a 26-year-old from south west Scotland, who developed an addiction to codeine aged 19 after he was prescribed it while he was recovering from knee reconstruction surgery.
When he realised he was growing dependent and weaned himself off the drug, but in 2019, his GP re-prescribed codeine while he awaited a hip operation. “I’m not in great pain,†said Adam, who chose not to share his surname. “I take them purely for pleasure now.â€
Estimated figures suggest that more than six million elective orthopaedic procedures were cancelled worldwide during the first peak of the pandemic.
Farrow added: “Whilst these changes have served to flatten the curve and reduce some of the harm associated with Covid-19 infection, there has undoubtedly been an impact on patients whose elective procedures were postponed.
“Covid-19 has had a significant detrimental effect on access to hip and knee surgery, and work by others has suggested this has been associated with worsening pain and quality of life for patients.â€
The research is published in the BMJ Quality & Safety.
