Is the COVID-19 Crisis Increasing America's Drug Overdoses?
The following article deals with opioid addiction, suicide and mental health issues, which may cause strong feelings in some readers. If you’re in need of help or advice regarding one of these issues, call the National Suicide Prevention Lifeline at 1-800-273-8255. You can also contact the Crisis Text Line by texting 741741.
While the COVID-19 outbreak poses a serious challenge to healthcare systems around the globe, one other pandemic hasn’t gone away: the opioid crisis. COVID-19 has put stress on healthcare systems and the economy alike, and the result is a perfect storm of harmful conditions for those dealing with drug addiction.
What Experts Are Seeing
While social distancing can help slow the spread of COVID-19, the inability to see friends and family has a direct impact on mental health. The loneliness and isolation stemming from pandemic lockdown orders are potentially life-threatening for people working to overcome addiction. "We have to face the reality," says Dr. Nora Volkow, director of the National Institute on Drug Abuse, "that...isolation is particularly hard for people suffering from substance use disorders, depression or other psychiatric disorders." And there appears to be a correlation between the pandemic and overdoses: According to data from the Centers for Disease Control and Prevention, more than 76,000 people died of drug overdoses between April 2019 and April 2020 — an increase of nearly 10,000 compared to the period lasting April 2018 to April 2019.
Another problem stemming from social isolation is that it makes it more difficult to identify and help those at risk of an overdose. Before the pandemic, people experiencing an overdose were more likely to be found by others and given emergency treatment. With most people now staying in their own homes, that's no longer the case.
Overwhelmed Health Care Systems Can Make Problems Worse
Since the pandemic began, people have been reluctant to run the risk of visiting a hospital, and those with substance use disorders are no different. Some people may decide that it’s better to deal with addiction alone than to risk catching or spreading a potentially lethal disease, and they subsequently decide to stay home. In other cases, unemployment caused by the pandemic (which is yet another factor that can contribute to social isolation) means they can’t afford necessary medical help with addiction even if they want it.
When at-risk people do seek out help, however, they can’t always access the same range and quality of care that they were getting before the pandemic. That's because hospitals and medical centers in many areas are overcrowded and overworked. Some treatment centers and recovery programs have been forced to scale back services or even shut down, which affects not only people who are currently addicted, but also those in recovery who rely on such services to stay healthy. With fewer and more distracted medical staff available, suicidal ideation and other mental health issues are more likely to go undiagnosed or untreated.
Disruptions to the Drug Trade
Another unexpected side effect of the pandemic is that it disrupted the production and movement of drugs, both legal and otherwise. The shuttering of clinics and medical offices can make it difficult to obtain substances like methadone, buprenorphine and naltrexone that are used to treat opioid addiction.
However, it’s the absence of illegal drugs that’s the biggest problem. Closed borders mean that many of the drugs that people with substance use disorders used are no longer available. To satisfy their compulsion, they may turn to other substances of all kinds. According to the Association of American Medical Colleges, urine drug tests performed by one national laboratory service saw a 32% increase for the use of nonprescribed fentanyl, a 20% increase for methamphetamine and a 10% increase for cocaine — and that’s just from mid-March through May. The use of increasingly dangerous substances has also made drug overdoses significantly more likely to lead directly to death rather than hospitalization.
The Federal Government May Be the Best Solution
Even with the pressures of the pandemic, helping curb addiction is still possible. One part of the way to move forward is to continue creating social support systems for people with substance use disorders. While they may tend to be less trusting of others due to the stigma of drug use, social groups — even remote ones — can make a real difference in recovery rates. Similarly, teletherapy can help people access the services they need even during a pandemic.
Numerous organizations are already working to provide such care. However, without state and federal funding, these programs can be difficult to sustain, as can other services that normally support at-risk people. With individual states particularly strapped for cash, the best hope for taming the opioid crisis both during the pandemic and more generally could be the federal government.
One federal policy that has already made a difference is the Substance Abuse and Mental Health Services Administration’s (SAMSHA) choice to allow patients to fill medication prescriptions for up to 28 days if they’re stable or 14 if they’re less stable but still safe enough to manage medications. Doing so allows people with substance use disorders to receive the drugs they need without exposing themselves to COVID-19 more than they already are. More work needs to be done, both to combat COVID-19 and opioid addiction, but such policies are a start.