IMPORTANCEThe COVID-19 pandemic disrupted medical care, impacting prescribing of opioid analgesics and buprenorphine for opioid use disorder. Understanding these patterns can help address barriers to care. OBJECTIVE To evaluate how prescribing of opioid analgesics and buprenorphine for opioid use disorder changed throughout the COVID-19 pandemic among both new and existing patients. DESIGN, SETTING, AND PARTICIPANTSIn this cross-sectional study, use of opioid analgesics and buprenorphine for opioid use disorder from March 18 to September 1, 2020, was projected using a national database of retail prescriptions from January 1, 2018, to March 3, 2020. Actual prescribing was compared with projected levels for all, existing, and new patients. EXPOSURESThe data include prescriptions to patients independent of insurance status or type and cover 90% of retail prescriptions, 70% of mail-order prescriptions, and 70% of nursing home prescriptions. MAIN OUTCOMES AND MEASURESPrescriptions for opioid analgesics and buprenorphine for opioid use disorder. Outcomes included total number of prescriptions, total morphine milligram equivalents, mean morphine milligram equivalents per prescription, mean dispensed units per prescription, and number of patients filling prescriptions. RESULTSA total of 452 691 261 prescriptions for opioid analgesics and buprenorphine for opioid use disorder were analyzed for 90 420 353 patients (50 921 535 female patients [56%]; mean [SD] age, 49 [20] years). From March 18 to May 19, 2020, 1877 million total morphine milligram equivalents of opioid analgesics were prescribed weekly vs 1843 million projected, a ratio of 102% (95% prediction interval [PI], 94%-111%; P = .71). The weekly number of opioid-naive patients receiving opioids was 370 051 vs 564 929 projected, or 66% of projected (95% PI, 63%-68%; P < .001). Prescribing of buprenorphine was as projected for existing patients, while the number of new patients receiving buprenorphine weekly was 9865 vs 12 008 projected, or 82% (95% PI, 76%-88%; P < .001). From May 20 to September 1, 2020, opioid prescribing for new patients returned to 100% of projected (95% PI, 96%-104%; P = .95), while the number of new patients receiving buprenorphine weekly was 10 436 vs 11 613 projected, or 90% (95% PI, 83%-97%; P = .009). CONCLUSIONS AND RELEVANCEIn this cross-sectional study, existing patients receiving opioid analgesics and buprenorphine for opioid use disorder generally maintained access to these medications during the COVID-19 pandemic. Opioid prescriptions for opioid-naive patients decreased briefly and then rebounded, while initiation of buprenorphine remained at a low rate (continued) Key Points Question How has prescribing of opioid analgesics and buprenorphine for opioid use disorder changed throughout the COVID-19 pandemic? Findings This cross-sectional study analyzed prescriptions from 90 420 353 patients and found that from March 18 to May 19, 2020, total morphine milligram equivalents of opioid analgesics prescribed to existing patients followed ...

This cross-sectional study uses data from the Ohio Department of Health to evaluate trends in drug overdose mortality in that state by type of drug and user age during the first 7 months of the COVID-19 epidemic.

Topological semimetals exhibit band crossings near the Fermi energy, which are protected by the nontrivial topological character of the wave functions. In many cases, these topological band degeneracies give rise to exotic surface states and unusual magneto-transport properties. In this paper, we present a complete classification of all possible nonsymmorphic band degeneracies in hexagonal materials with strong spin-orbit coupling. This includes (i) band crossings protected by conventional nonsymmorphic symmetries, whose partial translation is within the invariant space of the mirror/rotation symmetry; and (ii) band crossings protected by off-centered mirror/rotation symmetries, whose partial translation is orthogonal to the invariant space. Our analysis is based on (i) the algebraic relations obeyed by the symmetry operators and (ii) the compatibility relations between irreducible representations at different high-symmetry points of the Brillouin zone. We identify a number of existing materials where these nonsymmorphic nodal lines are realized. Based on these example materials, we examine the surface states that are associated with the topological band crossings. Implications for experiments and device applications are briefly discussed.

The COVID-19 pandemic significantly altered individual behaviors, including the consumption of health care. I study utilization and mortality in the largest integrated healthcare system in the United States, the Veterans Health Administration, and find that between the middle of March and the beginning of May 2020, emergency department and inpatient hospital visits declined by 37 percent and 46 percent, and remained 10 percent and 17 percent below expected levels by the end of October. Declines were more pronounced for nonurgent and non-life-threatening conditions, although urgent and life-threatening conditions also dropped by a quarter during the early months. Conditional on arrival at the emergency department, conditions were more severe at presentation. In the first two months of the pandemic, veteran mortality increased by 19.5 percent, yet non-COVID-19 mortality in VA inpatient settings declined. I find suggestive evidence that hospital avoidance may have resulted in higher non-COVID-19 mortality. By focusing on counties with no official COVID-19 deaths by May 19, 2020, I estimate that an upper bound of 7.9 percent of excess veteran deaths in the first two months of the pandemic were due to hospital avoidance.