'Significant increase' in opioids dispensed to Ontario long-term care homes during COVID-19: Study

A new study of opioids in some long-term care homes in Ontario found there was a "statistically significant increase" in the medication being dispensed during the first year of the COVID-19 pandemic.

But, the researchers note, the study doesn't answer why dispensations were up and it's far too early to conclude that opioid use in long-term care facilities is problematic.

The researchers did two studies, with the first looking at how the pandemic impacted how various kinds of medications were dispensed. The second study, which was released last month in the Journal of the American Medical Directors Association, looked specifically at opioids.

The researchers looked at the prescriptions claims for medication that were covered for payment by the Ontario Drug Benefit Program in long-term care and nursing homes from March 2017 to March 2021. The researchers used clinical and health administrative databases for the study.

They found an overall 1.77 per cent increase in opioids being dispensed between March 2020 and March 2021.

Dispensed means that a prescription for the medication was filled by a pharmacy for a resident in a long-term care home.

"Although absolute differences were small, they were more pronounced for residents without dementia or frailty," the researchers wrote.

For example:

The study's findings are significant because before the pandemic, opioid use was on a downward trend in these facilities, said one of the study's authors Colleen Maxwell, a University of Waterloo professor at the School of Pharmacy and School of Public Health Sciences.

"Initially, the small increase we saw, we thought, well, that's not necessarily inappropriate and then when we did our second study … we did see that the increase persisted over the second wave, even during a time when we could hypothesize the stresses and strains might have been less because death had gone down, vaccinations were happening," Maxwell told CBC News.

"That did raise some concerns because, the obvious question is: Are these medications that may have been started appropriately being continued inappropriately?"

The study did not answer the question about why opioid dispensation was up.

The researchers wrote in the conclusion an in-depth investigation on that angle is still needed, but said possible consequenses of increased opioid use "include a higher risk of falls and worsening frailty among this population."

Maxwell noted there could be legitimate reasons more opioids were dispensed, including that more people were feeling pain, there may have been more fractures or there may have been more need to use them for palliative care.