At the beginning of the pandemic, patients nationwide canceled doctor’s visits for a range of medical issues as public health authorities recommended delaying non-urgent in-person medical care. During this time, clinical drug testing by Quest Diagnostics plummeted by 70%, while contributors to substance use disorders like job loss, economic hardship, and mental health issues soared.[i]

Now, nearly 2 years later, we are seeing the effects of the triple threat of COVID-19, worsened mental health, and increased drug misuse. Drug overdoses took the lives of an estimated 100,000 individuals between April 2020 and 2021, an unprecedented annual high, devastating families and communities across the country.[ii]

How did this happen—and is further worsening of the overdose crisis preventable? The answer is yes, but only if physicians can optimize the right tools needed to address the issue. One of these tools is clinical drug testing.

Physician Attitudes Toward Testing

A new Health Trends report from Quest Diagnostics, based on a survey of 500 physicians with The Harris Poll, uncovered novel insights into the concerns physicians felt about their patients’ potential drug misuse during the pandemic—and the value physicians place on testing to reduce risk.

Two-thirds of physicians surveyed (67%) shared a worry that signs of drug misuse and substance use disorders among one or more of their patients were missed during the pandemic, which is a troubling statistic when combined with the 94% of physicians who reported seeing more patients experiencing stress, anxiety, or other mental health issues (which have been shown to raise the risk for drug misuse and use disorders[iii]) because of COVID-19.[iv]

Despite this, 88% of physicians report feeling confident they can identify patients at risk for drug misuse. However, nearly half of patients tested showed signs of misuse, and half of those patients show signs of drug combining. Clearly, physicians are concerned about their patients who are prescribed controlled medications, but are also overly confident in their ability to identify at-risk patients. As most physicians (85%) believe testing provides confidence they are prescribing safely, clinical drug testing can link these dynamics, providing insights to uncover problematic drug use the provider may miss before the worst outcomes can occur.

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Getting Patients Back to Care

Now that stay-at-home orders appear to be easing, organizations that recommended postponing non-essential medical care (including drug testing) in early 2020 should remind clinicians of the utility of drug testing.

In Quest’s November report, physicians expressed concerns about telehealth while worrying they have missed signs of drug misuse during the pandemic. A majority (75%) of those surveyed believe telehealth visits limit the ability to determine whether patients are at risk for, or are already misusing, prescription drugs. More startlingly, while nearly all (91%) physicians felt confident they could recognize the signs of prescription drug misuse during in-office interactions, only half (50%) reported the same confidence via telehealth visits.

Telehealth can be used to help treat and monitor patients who are misusing prescription drugs, but physicians need help to understand how to use virtual care in this capacity. Research suggests telehealth is emerging as a complement to, rather than a replacement for, in-person care, and flexible care models should aim to maximize the value of both.

It is critical that patients return to in-person care before conditions worsen. According to an additional Quest Health Trends report from December 2020, most U.S. adults (60%) skipped or delayed some in-person medical treatments or appointments during the COVID-19 pandemic.[v] Other data show steep declines in clinical drug testing, as well as testing for cancer, hepatitis, and diabetes, during much of 2020.

We are at a precarious time and stand in the crossroads of utilizing clinical care to help prevent unfortunate outcomes. Most physicians surveyed—80%—cited worry that some patients who are at high risk for drug misuse or use disorders stopped seeing their doctor during the pandemic and, potentially, permanently. In fact, the same 80% of physicians believe that the lack of drug testing during the pandemic put more people at risk for undetected drug misuse or use disorders.

Testing is one of the most vital tools physicians have to uncover behavioral insights regarding substance misuse. The pandemic has not only worsened the drug crisis; it has reduced access to important clinical care. Encouraging patients to return to their physicians, so they can receive critical preventative care like prescription drug monitoring, is vital to curbing the climbing number of overdose deaths, and for our nation’s pandemic recovery. These patients need support, and testing can help provide it—before it’s too late.