those with chronic long-term health conditions, mental health conditions, and substance use disorders.

Lockdowns and fear of spread led to barriers for patients whether they were accessing methadone

through opioid treatment programs or being prescribed buprenorphine.

A systematic review first published online in October 2022 sought to identify whether there was a

change in opioid use and misuse outcomes during the COVID-19 pandemic. Authors Siddartha Simha,

MD, and Mark C. Bicket, MD, PhD, joined RAPM Editor-in-Chief Brian Sites, MD, to discuss their article,

“Impact of the COVID-19 pandemic on opioid overdose and other adverse events in the USA and

Canada: a systematic review,” published October 2022 (https://rapm.bmj.com/content/48/1/37). The

authors found that opioid-related emergency medicine use increased in most studies for both service

calls and emergency department visits. Urine drug testing positivity results increased in all studies for

fentanyl, and in most studies for heroin and oxycodone. Naloxone dispensation was unchanged and

decreased in one study. The authors concluded that efforts to curb the spread of COVID-19 aligned with

an increase in the opioid crisis severity, which has implications for future pandemic responses.

Dr. Siddartha Simha is a third-year anesthesiology resident at Michigan Medicine in Ann Arbor. Originally

from Troy, MI, he obtained his medical degree from Oakland University William Beaumont School of

Medicine in Auburn Hills, MI. Dr. Simha has a strong interest in acute and chronic pain management and

research with plans to pursue a clinical fellowship in pain medicine.

Dr. Mark C. Bicket is the co-director of the Opioid Prescribing Engagement Network and an assistant

professor at the University of Michigan Medical School with a joint appointment in the School of Public

Health. A clinician scientist and practicing physician, his work has been supported by the National

Institutes of Health, the Substance Abuse and Mental Health Services Administration, the Foundation for

Anesthesia Education and Research, and the Patient-Centered Outcomes Research Institute.

*The purpose of this podcast is to educate and to inform. The content of this podcast does not

constitute medical advice, and it is not intended to function as a substitute for a healthcare

practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of

the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this

podcast. Listeners should also be aware that professionals in the field may have different opinions. By

listening to this podcast, listeners agree not to use its content as the basis for their own medical

treatment or for the medical treatment of others.

Podcast and music produced by Dan Langa. Find us on Twitter @RAPMOnline.