Comparing actual and forecasted numbers of unique patients dispensed select medications for opioid use disorder, opioid overdose reversal, and mental health, during the COVID-19 pandemic, United States, January 2019 to May 2020

Drug Alcohol Depend. 2021 Feb 1;219:108486. doi: 10.1016/j.drugalcdep.2020.108486. Epub 2021 Jan 6.


Background: COVID-19 community mitigation measures (e.g., stay-at-home orders) may worsen mental health and substance use-related harms such as opioid use disorder and overdose and limit access to medications for these conditions. We used nationally-representative data to assess dispensing of select substance use and mental health medications during the pandemic in the U.S.

Methods: IQVIA Total Patient Tracker data were used to calculate U.S. monthly numbers of unique patients dispensed buprenorphine, extended-release (ER) intramuscular naltrexone, naloxone, selective serotonin or serotonin-norepinephrine reuptake inhibitors, benzodiazepines, and for comparison, HMG-CoA reductase inhibitors (statins) and angiotensin receptor blockers (ARBs) between January 2019-May 2020. Forecasted estimates of number of unique patients dispensed medications, generated by exponential smoothing statistical forecasting, were compared to actual numbers of patients by month to examine access during mitigation measures (March 2020-May 2020).

Results: Between March 2020-May 2020, numbers of unique patients dispensed buprenorphine and numbers dispensed naloxone were within forecasted estimates. Numbers dispensed ER intramuscular naltrexone were significantly below forecasted estimates in March 2020 (-1039; 95 %CI:-1528 to -550), April 2020 (-2139; 95 %CI:-2629 to -1650), and May 2020 (-2498; 95 %CI:-2987 to -2009). Numbers dispensed antidepressants and benzodiazepines were significantly above forecasted estimates in March 2020 (977,063; 95 %CI:351,384 to 1,602,743 and 450,074; 95 % CI:189,999 to 710,149 additional patients, respectively), but were within forecasted estimates in April 2020-May 2020. Dispensing patterns for statins and ARBs were similar to those for antidepressants and benzodiazepines.

Conclusions: Ongoing concerns about the impact of the COVID-19 pandemic on substance use and mental health underscore the need for innovative strategies to facilitate continued access to treatment.

Keywords: Anxiety; Depression; Mental health; Opioid use disorder; Overdose; Substance use.

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Angiotensin Receptor Antagonists / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Benzodiazepines / therapeutic use
  • Buprenorphine / therapeutic use
  • COVID-19 / psychology*
  • Drug Utilization / statistics & numerical data*
  • Forecasting
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Naloxone / therapeutic use
  • Naltrexone / therapeutic use
  • Opiate Overdose / drug therapy
  • Opioid-Related Disorders / drug therapy
  • Pandemics
  • SARS-CoV-2
  • United States


  • Analgesics, Opioid
  • Angiotensin Receptor Antagonists
  • Antidepressive Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Benzodiazepines
  • Naloxone
  • Buprenorphine
  • Naltrexone