Was non-pharmacologic therapy (i.e., physical therapy and complementary medicine) - a low-risk alternative treatment for acute and chronic pain - replaced by prescription opioid analgesics during the COVID-19 pandemic? This retrospective observational study of weekly claims data from 24 million commercially-insured patients in the US finds evidence for substitution of non-pharmacologic therapy with increased opioid prescribing, accompanied by more potent and longer prescriptions, both at the population and individual level during the early months of the COVID-19 pandemic. Progress toward reversing the opioid epidemic may have been stalled by the pandemic as providers resorted to higher levels of opioid prescribing to control pain in the absence of less-risky alternatives.