Flu Season and COVID-19 Complicate Diagnosing Opioid Withdrawal

As flu season begins to ramp up this year, it is being complicated by the ongoing COVID-19 pandemic. For healthcare providers and those involved in diagnosing and treating opioid use disorder (OUD), their jobs will become more difficult as certain withdrawal symptoms for OUD are shared by flu and COVID-19. This difficulty is compounded by the recent increase in OUD. NPR has reported that data gathered in the US confirm drug overdoses have risen by nearly 20% during the coronavirus pandemic.1

Challenges of Similar Symptoms

According to the CDC, symptoms of flu and COVID-19 are similar, making it hard to distinguish and diagnose between them based on symptoms alone. Those suffering from opioid withdrawal will experience some, but not all, of these same symptoms. Knowing where they differ can aid in diagnosis.

Common symptoms that COVID-19 and seasonal flu share are outlined in the table below, with the final column showing symptoms associated with opioid withdrawal.

Symptom

Flu

COVID-19

OUD

Fever or feeling feverish/chills

*

*

*

Cough

*

*

Shortness of breath or difficulty breathing

*

*

Increased respiration rate

Fatigue (tiredness)

*

*

Sore throat

*

*

Runny or stuffy nose

*

*

*

Muscle pain or body aches

*

*

*

Headache

*

*

Possible vomiting and diarrhea

*

*

*

 

Proper Diagnosis Is Critical

Sorting through and distinguishing among these three to determine proper treatment options can be difficult, but it is important as treatment protocols vary significantly. The CDC suggests that diagnostic testing can help determine if the patient is sick with the flu or COVID-19.

If a provider suspects the symptoms may be caused by opioid withdrawal, the patient should be monitored by a clinician using the Clinical Opiate Withdrawal Scale (COWS) which rates the severity of both the OUD patient’s opioid usage and the withdrawal symptoms. The symptoms may be managed in a hospital, treatment center, or at home with medication-assisted treatment or through non-invasive devices.

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Source:

  1. https://www.npr.org/sections/coronavirus-live-updates/2020/08/13/901627189/u-s-sees-deadly-drug-overdose-spike-during-pandemic

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