Evaluating the Effect of COVID-19 on Outpatient Opioid Utilization Among Health First Colorado Members and a National Non-Medicaid Cohort: An Interrupted Time Series Analysis.

Objective: COVID-19, coinciding with the opioid epidemic in the United States, has had significant impacts on health-care utilization. While mixed, early analyses signaled a potential resurgence in opioid use following the pandemic. The primary study objective was to assess the association of the COVID-19 pandemic with opioid utilization among Health First Colorado (Colorado's Medicaid Program) members and a non-Medicaid managed care cohort who did not have a diagnosis of cancer or sickle cell disease. Patients and Methods: Using an interrupted time series and segmented regression analysis, this population-level study assessed the association of the COVID-19 pandemic on prescribed utilization of long- and short-acting opioid analgesics among Health First Colorado members and a random sample of non-Medicaid managed care members. Pharmacy claims data for both cohorts were assessed between October 1, 2018, and September 30, 2021, with April 2020 identified as the interruption of interest. We evaluated the following monthly opioid use measures separately for short-acting and long-acting opioids: number of members filling an opioid, total fills, and total days supplied. Results: Short- and long-acting opioid utilization was significantly decreasing among Health First Colorado members in the 18 months prior to the start of COVID-19. After the onset of the pandemic, utilization stabilized and slopes were not significantly different from zero. Among the non-Medicaid managed care cohort, short- and long-acting opioid utilization significantly decreased in the 18 months leading up to the onset of the pandemic. After the onset of the pandemic, utilization of long-acting opioids stabilized, while utilization of short-acting opioids significantly increased. Conclusion: While we observed an increase in opioid utilization measures post-pandemic in the non-Medicaid managed care cohort, a similar increase was not observed in Health First Colorado members suggesting that thoughtful opioid policies put in place pre-pandemic may have been effective at controlling potential inappropriate opioid utilization.

Comparison of the partitioning of pesticides relative to the survival and behaviour of exposed amphipods.

Pesticides sprayed on farmlands can end up in rivers and be transported into estuaries, where they could affect aquatic organisms in freshwater and marine habitats. A series of experiments were conducted using the amphipod Corophium volutator Pallas (Amphipoda, Corophiidae) and single pesticides, namely atrazine (AT), azinphos-methyl (AZ), carbofuran (CA) and endosulfan (EN) that were added to sediments and covered with seawater. Our goal was to compare the concentrations affecting the survival of the animals relative to potential attractant or repellent properties of sediment-spiked pesticides. The avoidance/preference of contaminated/reference sediments by amphipods was examined after 48 and 96 h of exposure using sediments with different organic carbon content. The octanol-water partition coefficients (log K(ow)) ranked the pesticides binding to sediments as EN > AZ > AT > CA. LC(50) and LC(20) covered a wide range of nominal concentrations and ranked toxicity as CA-AZ > EN > AT. Under the experimental set up, only EN initiated an avoidance response and the organic carbon normalised concentration provided consistent results. Using the present data with wide confidence limits, >20% of a population of C. volutator could perish due to the presence of EN before relocation or detecting CA or AZ in sediments by chemical analysis.