NPR's Scott Simon speaks to Kaiser Health News reporter Liz Szabo about the use of opioids to treat patients suffering from long-haul COVID-19 symptoms.
SCOTT SIMON, HOST:
Almost 10% of those who survive COVID-19 still have a battle ahead, what's now called long COVID. Symptoms include exhaustion, brain fog, stubborn loss of taste or smell and persistent bone and muscle pain. Now a new study in the scientific journal Nature says a treatment could present another epidemic among this group - opioid addiction.
Liz Szabo is a senior correspondent for Kaiser Health News and joins us now. Liz, thanks so much for being with us.
LIZ SZABO: Great to be here.
SIMON: What did this study reveal about opioid prescriptions for those dealing with long-term COVID symptoms?
SZABO: Yeah, researchers were surprised that quite a few patients with long COVID are taking opioids. There was an increase above and over what other VA patients were taking of about 9 extra prescriptions per 1,000 patients. They thought that was a small but concerning increase because the general trend in opioid prescribing has been to go down.
SIMON: Hasn't there also been an increase in prescriptions for anxiety medications?
SZABO: That's right. They found an increase of 22 extra anxiety drugs called benzodiazepines - these are like Valium and Xanax - for every 1,000 patients. And that's above and beyond what other VA patients were taking.
SIMON: This paper, of course, focused on long-hauler patients treated at Veterans Affairs facilities. Can you tell us more about the scope and, for that matter, the limitations of the study?
SZABO: Sure. Well, this is really one of the biggest studies that I've seen. It had 73,000 veterans who were treated at VA facilities. The great thing about the VA is that it's got its own record system, so they could look really carefully at exactly how much care, how many hospital days, what prescriptions people were taking. The limitation is, of course, that the VA serves mostly men. And that's an issue with any disease that affects mostly women, as long COVID does.
SIMON: You spoke with the lead author of the paper, Dr. Ziyad Al-Aly. What concerns him so much about this increase in opioid prescriptions?
SZABO: Well, the general trend in opioid prescriptions for about the past decade is that doctors were prescribing fewer. That's what they should be doing to try to prevent overdoses. So when he saw this uptick in what appears to be the first paper to find this, he was concerned. He said that long-haulers are very sick. And what we don't want is to have any reigniting of the opioid crisis.
SIMON: Are there alternatives? Because I must say, I know every time we've done a story talking about the destructive nature of opioids, we hear from people who say, if you had the kind of pain I have, you would risk that not to live with that pain.
SZABO: Yeah. The CDC does recommend that opioids not really be used for chronic pain except as a last resort. They really recommend that you try physical therapy or nonsteroidal anti-inflammatories like ibuprofen or Tylenol. You can get nerve injections, pressure point injections. There are lots of things you can try. And they'd really like you to try all of those before you try opioids.
SIMON: Liz, I wonder, after all your reporting, what's your impression of any kind of strategy for treating a wave of long COVID patients? And is it possible that the treatment becomes another epidemic?
SZABO: Yeah. Well, there are a lot of people who say we need a strategy. People are trying a lot of things like physical therapy, speech therapy, occupational therapy, some of the therapies used in brain rehab such as for people who have traumatic brain injuries. They're really very low-tech, high-touch sorts of therapies.
SIMON: And can we tell how they work?
SZABO: Yeah. Well, I talked to a long-hauler who developed stuttering. So she was really helped by speech therapy. Other people may have some numbness or problems moving around or a loss of muscle tone just from being in bed in the ICU for a long time. So various kinds of physical therapy can really help them. Again, it's very low-tech compared to the fantastic technology in our vaccines. But that's what we have right now.
SIMON: Liz Szabo, senior correspondent for Kaiser Health News, thanks so much for being with us.
SZABO: Thank you.
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