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Opioid use rose during pandemic as patients waited longer for surgery


By Isabel Shaw

15 Sep 2021

The use of opioids increased by 40% during the pandemic while some patients were forced to wait longer for orthopaedic surgeries, new research has found.  

Researchers from the University of Aberdeen discovered that patients using opioids — such as morphine and tramadol — while waiting for knee and hip surgeries increased by 40% compared to pre-pandemic levels.  

This comes as hospitals across the country were forced to prioritise acute care, which in turn lead to the widespread postponement of elective orthopaedic procedures.  

The study, published in the BMJ Quality and Safety, looked at data collected from 452 NHS patients from the north east of Scotland. 

Researchers associated the longer waiting times — which averaged an additional 90 days — with the surge in opioid use for pre-operative pain. 

Previous studies on long-term opioid use pre-surgery have found the drug increases risk of complications related to the operation, poorer outcomes, and ongoing opioid dependence.  

Luke Farrow, clinical research fellow at the University of Aberdeen’s Institute of Applied Health Sciences, who led the research, urged healthcare professionals to avoid prescribing opioid medication due to the ‘known lack of effect in this setting and potential for harm’.  

He added: ‘We urgently need to find better alternative methods for managing severe arthritis pain for those awaiting this type of surgery and work to recover the backlog of associated operative cancellations during Covid-19 to prevent more widespread opioid use. 

‘Our work provides evidence of potential for an emerging opioid problem associated with the influence of Covid-19 on elective orthopaedic services.   

‘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.’ 

In August, NICE published new draft guidance which said healthcare professionals should avoid prescribing opioids for chronic pain because there was limited evidence of their effectiveness.  

Instead, NICE recommended alternatives such as certain antidepressants, an exercise programme, CBT or acupuncture should be considered possible treatments. 

In 2019, the health secretary announced that all opioid medicines in the UK would carry addiction warnings on their labels, after a 60% rise in prescriptions of opioids in England and Wales over the past 10 years.  

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