The Opioid Dilemma in Long COVID Treatment


COVID-19 has taken a devastating toll on societies the world over. Millions have lost their lives, with millions more losing livelihoods. The silver lining amid all the sorrow has been the considerably high recovery rate among patients who have tested positive.

Statistically, nearly nine out of ten COVID-19 patients recover. While this is a good reason for optimism, some suffer debilitating symptoms long after recovering from the disease. Healthcare practitioners refer to this condition as long COVID.

Long COVID Symptoms

According to the National Institute for Health, long COVID patients experience lingering symptoms for over 12 weeks. Using information from the COVID study app, researchers  formed two distinct patient groups. The first group featured respiratory symptoms such as breathlessness and coughing, but also included headaches and fatigue. The second set of symptoms affected different parts of the body such as the brain, heart, and gut. Participants in the second group commonly reported an increased heart rate, palpitations, numbness, a tingly sensation in their extremities, and an inability to focus also known as ‘brain fog.’

Treating Long COVID

Given the novel nature of COVID-19, many experienced healthcare professionals lack definitive answers for how and why the virus caused these lingering symptoms in some patients. Cohorts of patients present a wide spectrum of symptoms affecting various organ systems, with symptoms differing from patient to patient. This volatility creates a sense of limbo for clinicians, leading to the adoption of a list of therapies in the hope of finding an effective panacea treatment.

Cue Opioids

According to a study in Nature, a journal publishing original monthly peer-reviewed research articles, doctors treating patients at Veterans Health Administration facilities wrote nine more prescriptions per 1,000 patients than they would normally have. Dr. Ziyad Al-Aly, the article’s lead author, says that the article sheds light on how many COVID survivors are taking more addictive medication. His concern is that this small increase might be the portent to a resurgence of the opioid crisis.

Clinicians Could Unknowingly Be Exacerbating the Situation

The findings of the new study suggest that a lot of clinicians don’t fully grasp the gravity of the situation at hand. For many of these health care providers, opioids are an appropriate therapy for pain management. With so many long-haulers suffering from pain, be it chronic migraines, joint pains, or muscle aches, a lot of doctors are prescribing more opioids such as oxycodone, codeine, and hydrocodone.

The Ethical Dilemma

Some long COVID patients suffered from chronic pain pre-infection. Now, with the after-effects of the viral disease ravaging their bodies, patients report an exponential increase in pain levels. For these patients, opioids have played a massive role in improving their quality of life. A radical reduction in opioid prescription could prove detrimental as more patients would potentially turn to the black market, creating the possibility of more frequent overdoses.

What Can Be Done?

Experts suggest implementing alternatives to opioids. One excellent substitute experts suggest is physical therapy, more specifically a program known as Post Acute COVID-19 Exercise and Rehabilitation, or PACER in short. The program was developed by the Physical Rehabilitation Network and focuses on simple physical activities and breathing exercises to help long-haulers deal with joint or muscle aches, fatigue, and shortness of breath.

The standout benefit of PACER is its gradual rehabilitation pace. Variability among patients presents a unique challenge in the rehabilitation process and PACER addresses that issue by adjusting the needs of each individual. The treatment areas include exercise training, manual therapy, and Personalized Blood Flow Restriction Training (PBFRT).

The benefits of PBFRT are numerous. The therapy lowers oxidative stress consequently lowering systemic inflammation alongside improved vascular and peripheral blood circulation. PBFRT also creates systemic responses that counter the impact of COVID-19. Other viable opioid alternatives include anti-depressants, anti-inflammatories, biofeedback, and anti-seizure medication to alleviate nerve pain.

In Conclusion

Long COVID continues to puzzle many in the medical field, but over time, health care providers are coming to grips with the condition. While opioids offer a means of pain management, they shouldn’t be a long-term solution. The opioid crisis left many scars, and it would be a catastrophe if the pandemic acts as a catalyst for its resurgence. As that famous adage goes, prevention is better than cure.


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