Opioid Crisis during the COVID Pandemic

To date, the COVID-19 pandemic has sickened at least 189 million people and claimed more than 4 million lives around the world. Given the scope of this human tragedy, it is easy to understand why most other public health crises have been ignored. Unfortunately, other issues like the opioid crisis do not pause merely because a much greater health emergency is sweeping the nation.

In fact, the opioid crisis appears to have grown in scale, at least, partly due to the COVID-19 pandemic. The number of opioid overdose deaths reached 46,802 in 2018, on par with the prior year, but jumped up to 49,860 in 2019. Opioids were linked to 70 percent of all drug overdose fatalities in 2019.

Most of these deaths are related to prescription opioids like oxycodone or morphine. It has been estimated that in 2017 almost 1.6 million Americans had an opioid use disorder, and that 10.1 million misused prescription opioids.

Roots of the Opioid Crisis

Opioids have been used for centuries among medical practitioners and the public to treat a variety of maladies, but it wasn’t until the 1990s that prescription opioid abuse became a serious public health issue.

A decade earlier, the American Pain Society advocated recognizing pain as the “fifth vital sign.” During this period, many states passed laws that shielded physicians from prosecution for pain treatment with controlled substances.

The number of opioid prescriptions began to rise in the 1980s, but it was the introduction of OxyContin in the mid-1990s that helped fuel the explosion in opioid prescriptions. Purdue Pharma, the maker of OxyContin, falsely claimed that the drug was less addictive than other painkillers.

The health care system at the time also helped promote prescription opioid use. Most physicians were in private practices that relied on patient volume. Physicians were incentivized to keep patients happy and pain management was a common, short-term solution. Furthermore, prescription opioids were cheap and often covered by insurance, while more expensive treatments like physical therapy were not.

In the 2000s, more physicians’ groups began modifying their opioid prescription guidelines, and while this helped stabilize prescription opioid abuse, it led to a surge in heroin use. In 2013, fentanyl—a very powerful and lethal synthetic opioid—began appearing in heroin and cocaine.

How COVID-19 Has Exacerbated the Opioid Crisis

There is no doubt that the COVID-19 pandemic has worsened the opioid crisis. Many health experts are predicting that 2020 will be the worst year for opioid overdose deaths in the U.S. so far. According to the CDC, there was a 38.4 percent increase in opioid-related deaths in the 12 months leading up to June 2020 compared to the same period a year earlier. There are many reasons for this, including

  • More powerful drugs—although prescription opioid use is falling, more opioid addicts are turning to illicit street drugs because they are easier to obtain. However, many drug dealers are mixing in powerful drugs like fentanyl and methamphetamine without telling their buyers who may more easily overdose.
  • Overtaxed health care system—because so much of our health care infrastructure is now targeted on COVID-19, many substance abusers are not getting the care they need from frontline healthcare professionals and addiction treatment programs.
  • Financial challenges—more people are facing serious financial barriers that limit access to critical health care as well as resources like transportation or high-speed internet. This has prevented access to key resources like naloxone.
  • Stressors—long periods of social isolation, financial uncertainty and relationship issues have pushed many people who were stable or improving on substance abuse problems into risky behavior.
  • Loss of focus—the pandemic has not only taken the spotlight off of the opioid crisis for much of the public, but it has redirected much needed resources. Caregivers may be more concerned about COVID-19 than the possibility of substance abuse and misuse powerful opioid medications. Furthermore, many treatment facilities are closing due to limited funding and lack of qualified personnel.
  • Declining mental health—there is no doubt that there has been a deterioration of mental health among the public as the pandemic has gone along. As more people experience anxiety and depression, the risk of abusing available substances like opioids becomes greater.
  • Stigma—many people will not accept help from medical professionals because it would stigmatize them as an addict. The social isolation that the pandemic has engendered has only heightened this because it has removed friends and coworkers that could ease the process of getting help.

If You Think You Have a Substance Use Disorder

Many people have found themselves using alcohol or other potentially addictive substances to help blunt the challenges of the pandemic. The tragedy is that a significant fraction of these people will acquire a substance use disorder and will be unable to attain sobriety without help from a health care professional.

It can be difficult to know if you are suffering from SUD, but if you are exhibiting any of the following symptoms, you should see a doctor.

  • Compulsion to use drugs daily or regularly
  • If your need for drugs overrides other priorities
  • You find yourself increasing the dosage to achieve the same feeling
  • Maintaining a steady supply
  • Spending money on drugs that you can’t afford
  • Ignoring professional or personal obligations
  • Committing acts like stealing
  • Performing risky actions like driving under the influence
  • Inability to stop using the drug
  • Experiencing withdrawal symptoms if you try to stop

If you suspect that you may have a substance use disorder, please consider taking the following actions:

  • Talk to your doctor and discuss getting on withdrawal medications
  • Open dialogue with family or friends
  • Join an addiction recovery program
  • Obtain counseling or psychotherapy to remediate any unresolved mental health issues
  • Participate in an Alcoholics Anonymous group
  • Obtain one or more doses of naloxone in case you do overdose

You should call 911 for emergency aid if you think you may have overdosed or are exhibiting the following symptoms:

  • Have difficulty breathing
  • Are experiencing changes in consciousness
  • Having seizures or convulsions
  • Having chest pains

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA, and you should not post any of your private health information.