The COVID-19 crisis has us facing many difficult truths. Beyond the direct health consequences of the virus itself, the secondary effects of the pandemic on our mental, social and economic well-being have already proven to be profound — and will no doubt be long-lived.
As those on the front lines work to combat what quickly became the most pressing issue in healthcare, other global health issues have faded to the background. The problem is, these issues haven’t gone away with the emergence of the coronavirus; worse, some may actually be exacerbated by its derivative effects. The opioid epidemic is one such example, as many of the risk factors contributing to opioid misuse are being amplified in the swell of COVID-19.
Physical & Social Determinants of Health Intensified by COVID-19
In a recent opinion article published in the Annals of Internal Medicine, Nora D. Volkow, MD, Director of the National Institute on Drug Abuse at the National Institutes of Health, notes that individuals with opioid use disorder (OUD) may have an increased risk of severe outcomes of COVID-19 due to several risk factors. Equally, she says, compromised lung function resulting from COVID-19 may place those with OUD at a higher risk of a fatal overdose.
In addition to the medical risks, there are a number of environmental, behavioral and socioeconomic factors that may increase vulnerability to OUD. An HMS white paper on combatting opioid abuse named several risk factors leading to potential opioid misuse and addiction. Among the many listed, of particular note are:
- History of severe depression or anxiety
- Stressful circumstances
With the jobless rate soaring to unprecedented heights — nearly 17 million people in the U.S. have filed for unemployment from mid-March 2020 to the time of writing in April 2020 — these factors are becoming ever more pronounced and worrying. Social distancing protocols and interruptions in care are further fueling the risks, as many of the critical health and social support services on which people rely must be modified. Overdoses, which often occur alone, could prove more common and fatal as access to treatment and support becomes more difficult.
What’s Being Done?
Healthcare organizations, providers and advocacy groups are actively working to ensure continuity of resources and support for individuals with OUD during the COVID-19 crisis.
The American Society of Addiction Medicine (ASAM) has amassed a network of experts dedicated to addressing the needs of patients during the pandemic. With its Caring for Patients During the COVID-19 (CPDC) Task Force, ASAM is currently sharing COVID-19-specific addiction treatment resources in real time via its website. ASAM is also providing guidance around access to and participation in online support groups while social distancing measures are in place.
Additionally, the Drug Enforcement Agency (DEA) has eased some of the restrictions around methadone and buprenorphine to facilitate continued access to opioid addiction treatment during COVID-19.
Influencing the Future
Unsurprisingly, the concurrence of the COVID-19 pandemic and the opioid epidemic has healthcare and addiction professionals concerned; however, some experts are hopeful that current measures enabling greater access to treatment may endure once the eye of the storm has passed.
If there is any good to be found in the current health crisis, it is perhaps just that — understanding how we can better address these pressing global issues. Waging these battles simultaneously means taking into consideration the myriad factors both leading to and resulting from opioid dependence to improve health outcomes among this vulnerable population.