Update on the Opioid Epidemic during Covid

Update on the Opioid Epidemic during Covid

The past year has revolved around COVID-19, but there have been some important advances against this lethal pandemic. The rollout of many revolutionary vaccines has stymied illness saturation in some parts of the world. New medications are also emerging which could make COVID-19 treatment much more effective.

However, the enormous spotlight on COVID-19 has taken focus away from the other major public health crisis in the U.S. The opioid epidemic continues to kill thousands of Americans annually, with the CDC estimating that nearly 3 out of 4 overdose deaths in the U.S. are due to opioids. In a recent report, the CDC states that during the 12 months following March 2020—the start of lockdowns—saw a 38 percent increase in opioid-related overdose deaths. The American Medical Association reported in December of 2020 that 40 states had experienced an increase in the number of opioid-related fatalities.

An Already Terrible Tragedy

Even before COVID-19 shut down much of society in the United States, the opioid crisis was taking its toll on communities in every state. In 2018, the number of Americans with a substance use disorder had reached 20 million with 2 million of these suffering from opioid addiction. However, 70 percent or 50,000 deaths of a total 71,000 overdose deaths were related to opioids.

These staggering figures reflect the hit-or-miss ineffectiveness of addiction treatment programs in most of the nation. The Surgeon General reported in 2016 that only about 1 in 10 people with a substance use disorder actually obtained the substance abuse treatment that they needed.

Primary Drivers of Substance Abuse during the Pandemic

There are many reasons why the number or people turning to substance abuse or relapsing during the pandemic is increasing.

• Declining mental health—prior to the pandemic, about one in five American adults suffered from mental health issues, but during the pandemic, this has doubled. A greater prevalence of anxiety and depression has fueled a surge in alcohol and illicit substance abuse.
• Loss of social support—many recovering addicts rely on a strong social support to prevent a relapse, but the ongoing isolation that many people endure deprives them of critical emotional aid. Isolation also presents other risks like overdosing due the absence of others who can call for help.
• Limited treatment options—even for people who recognize that they need medical intervention for their SUD, there may be no help available. Much of the resources that might have gone towards abuse treatment has been diverted to COVID-19 programs. Furthermore, many treatment facilities are understaffed due to lingering COVID-19 fears.
• COVID-19 concerns—new research suggests that many people struggling with substance abuse are reluctant to visit treatment facilities due to fears of becoming infected with COVID-19.
• Stress—for most people, the pandemic has made life considerably more difficult, and, of course, this has added to stress levels. Fears about income, food insecurity, rental payments, and health care costs have pushed many people into substance abuse.
• High-risk behavior—many opioid users are resorting to unknown alternatives like heroin as physicians have less time for non-urgent appointments. These substitutes often carry hidden risks because there may be other substances like the lethal fentanyl mixed in or new users may not know how much to use.
• New delivery methods—more people are finding new ways to obtain drugs as even drug dealers shift to contactless delivery. More online drug markets are becoming available, and people are using postal services to deliver their opioids.
• More powerful opioids—more people are turning to the very potent and commonly lethal opioid fentanyl. Many users often equate fentanyl to other opioids, vastly underestimating its potency and then overdosing.

Some Benefits from the COVID-19 Pandemic

Not every aspect of the COVID-19 pandemic has been detrimental to SUD patients.

• Absence of triggers—for some recovering addicts, the absence of other people has eliminated some of the social triggers that prompted opioid use. For patients who rely on substance abuse to ease social interaction, the pandemic has actually proven a boon.
• More flexible treatment options—although most SUD treatment services continue to rely on in-person interactions, some programs are using telemedicine to reach more patients. Counselors are now able to engage in more meaningful ways and keep patients accountable without a face-to-face meeting.
• Greater access to medicinal opioid therapies—surprisingly, the medical community has increased access to key opioid treatment medicinal compounds methadone and buprenorphine during this period of crisis, which is enabling more SUD patients to resist the pull of opioids.

How to Lower Your Risk of an Overdose

If you are willing to take a few steps, you may be able to prevent an overdose.

• Enroll in Medication-Assisted Treatment (MAT)—one of the most effective ways to treat opioid cravings is to use methadone or buprenorphine, medications that quell the need for opioids. More MAT programs are delivering these medications to program enrollees, rather than requiring in-person treatment.
• Obtain naloxone—one of the most successful ways of preventing an overdose opioid death is to administer a naloxone shot or nasal spray. Naloxone is an opioid antagonist which binds to opioid receptors and reverses the effects of opioids. You need to ask your doctor for a prescription in order to obtain naloxone.
• Don’t mix medications—many overdoses occur when patients mix various drugs like opioids, benzodiazepines, and alcohol. If you are on a sedative or opioid, learn how you should use it and ask your doctor before using it another way. Tell your doctor about all medications you are taking.
• Never use alone—it may be difficult to have this conversation with your family or roommates, but it may be an issue of life or death. You should discuss your use of opioids, especially how much and how often you use. Ask others to look in on you regularly so that if you do overdose, there is always someone available to call for help. If you live alone, ask someone who knows how to use naloxone to visit you regularly.

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.