Trends in Prescription Chronic Pain Medication Use before and during the First Wave of the COVID-19 Pandemic in Québec, Canada: An Interrupted Time Series Analysis

Int J Environ Res Public Health. 2023 Aug 1;20(15):6493. doi: 10.3390/ijerph20156493.

Abstract

Background: In Canada, a state of health emergency was declared in May 2020 as a result of the COVID-19 pandemic. This study aimed to assess trends in the use of prescription medication for pain management by people living with chronic pain before and during the first wave of the pandemic.

Methods: Participants (n = 177) were adults reporting chronic pain who had completed a web-based questionnaire in 2019 and for whom complete longitudinal private and public insurance prescription claims were available. The monthly prevalence of medication use for nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and prescribed cannabinoids was assessed. An interrupted time series analysis was then performed to evaluate if the COVID-19 pandemic had had an impact on trends in pain medication use.

Results: The beginning of the first wave of the pandemic was associated with the onset of a downward trend in opioid use (p < 0.05); no such association was found regarding NSAIDs. However, point prevalence of opioid use at the beginning (Nov. 2019) and at the end (Mai 2020) of the study period remained somewhat stable (17.0% vs. 16.4%). Regarding prescribed cannabinoids, a gradual increase in use was observed over the entire study period independently from the impact of the first wave of the pandemic (15.3% vs. 22.6%, p < 0.05).

Conclusion: While the occurrence of the first wave did have an impact on opioid use among people living with chronic pain, access to and use of opioids appear to have returned to normal before the end of the first wave of COVID-19.

Keywords: analgesics; cannabinoids; drug claims; nonsteroidal anti-inflammatory drugs; opioids; pain management.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • COVID-19* / epidemiology
  • Canada
  • Chronic Pain* / drug therapy
  • Chronic Pain* / epidemiology
  • Humans
  • Interrupted Time Series Analysis
  • Opioid-Related Disorders* / drug therapy
  • Pandemics
  • Prescription Drugs*
  • Prescriptions
  • Quebec / epidemiology

Substances

  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Prescription Drugs

Grants and funding

The implementation of the COPE Cohort was supported by the Quebec Network on Drug Research and the exploitation of its data was co-funded by the Quebec Pain Research Network, two thematic networks of the Fonds de recherche du Québec—Santé (FRQS).