COVID-19 restrictions and the incidence and prevalence of prescription opioid use in Australia – a nationwide study

The COVID-19 pandemic has disrupted seeking and delivery of healthcare. Different Australian jurisdictions implemented different COVID-19 restrictions. We used Australian national pharmacy dispensing data to conduct interrupted time series analyses to examine the incidence and prevalence of opioid dispensing in different jurisdictions. Following nationwide COVID-19 restrictions, the incidence dropped by −0.40 (95% confidence interval [CI]: −0.50, −0.31), −0.33 (95% CI: −0.46, −0.21) and −0.21 (95% CI: −0.37, −0.04) per 1000 people per week and the prevalence dropped by −0.85 (95% CI: −1.39, −0.31), −0.54 (95% CI: −1.01, −0.07) and −0.62 (95% CI: −0.99, −0.25) per 1000 people per week in Victoria, New South Wales and other jurisdictions, respectively. Incidence and prevalence increased by 0.29 (95% CI: 0.13, 0.44) and 0.72 (95% CI: 0.11, 1.33) per 1000 people per week, respectively in Victoria post-lockdown; no significant changes were observed in other jurisdictions. No significant changes were observed in the initiation of long-term opioid use in any jurisdictions. More stringent restrictions coincided with more pronounced reductions in overall opioid initiation, but initiation of long-term opioid use did not change.