Primary care physicians noted increased stress among patients during the pandemic and worry that telehealth visits may have hidden signs of drug misuse.
Deaths from drug overdoses in the US surpassed 100 000 for the first time over a 12-month period, according to provisional data released this week by the National Center for Health Statistics of the US Centers for Disease Control and Prevention (CDC).
The report shows the death toll increased by 28.5% over the 12-month period ending April 2021, rising from 78 056 recorded during the same time the previous year to an estimated 100 306.
Results of research just released by Quest Diagnostics suggest that the NCHS statistics confirm what many primary care clinicians most feared for some of their patients during the COVID-19 pandemic--that the stress and anxiety could fuel prescription and illicit drug use and abuse, even leading to addiction.
In fact the Quest Health Trends® Drug Misuse in America 2021 report found that more than two-thirds of 500 primary care physicians surveyed worried that they have missed signs of drug use disorders among their patients during the pandemic, a fear rooted in the reality that nearly half of all patients (48%) tested in 2020 showed signs of drug misuse; 50% of those cases involved drug combining.
The slides below offer the Quest report's topline findings for you, at-a-glance.
The full report "Drug Misuse in America 2021: Physician Perspectives and Diagnostic Insights on the Drug Crisis and COVID-19," combines an analysis of nearly 5 million de-identified aggregated Quest Diagnostics test results, including more than 475,000 from 2020 alone, with a survey from the Harris Poll of more than 500 primary care physicians. The Partnership to End Addiction was an advisor to the development of the report.
PCPs afraid they missed signs of drug misuse and use disorders among more than one of their patients during the pandemic.
Patient distress may lead to drug misuse, physicians worried; nearly all report seeing more patients experiencing stress, anxiety or other mental health issues because of the pandemic.
All physicians surveyed say misuse of all controlled substances is a concern while 75% say opioid misuse is of concern.
Telehealth has limitations--while it was necessary to ensure consistent care during the pandemic, 75% of physicians believe telehealth visits limit the ability to assess patients for potential or current misuse of prescription drugs.
Drug misuse is harder to detect via telehealth and while most physicians are confident they can spot warning signs during a clinic visit, only half report the same level of confidence via telehealth visits.
Gabapentin was prescribed for chronic pain by the majority of clinicians during the past 6 months while roughly two-thirds prescribed opioids for pain management.
Use of illicit fentanyl if prescription medications could not be obtained is a fear voiced by more than three-quarters of respondents and a majority worry the synthetic opioid will be more deadly than prescribed opioids.
Clinical drug testing by Quest Diagnostics found that positive results for non-prescribed fentanyl increased by 35% during the pandemic (from 4.3% to 5.8%) in tested patients.
But, while clinicians feel confident about detecting patient drug misuse, Quest lab data show nearly half of patients tested in 2020 showed signs of drug misuse, half of those results showing combinations of drugs used.
Clinical drug testing is critical to preventing overdose deaths, agree the majority of physicians surveyed, and they say testing helps them feel confident that they can safely prescribe abuse-prone medications.
Clinical drug testing would be used more equitably, the majority of physicians agree--half strongly--if guidelines were more instructive.
Prescription drug addiction management would be improved with access to more tools that allow clinicians to better address racial and ethnic health disparities.