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The Relationship Between the COVID-19 Pandemic and the Opioid Epidemic

COVID-19 pandemic and opioid epidemic in pills

By Ken Perez, VP of Healthcare Policy, EnlivenHealth™

It is hard to put into words the profound impact of the coronavirus pandemic on almost every area of life globally. The worldwide loss of human life, economic destruction, social upheaval, and political instability created by COVID-19 are unprecedented. Consequently, other problems have taken a backseat to the coronavirus, in the realms of the media and politics.

The opioid epidemic is one such problem, significant and worsening as a result of COVID-19. In March, when COVID-19 was declared a pandemic by the World Health Organization, one writer observed that “… mere weeks ago, the opioid epidemic was the biggest health concern in our country—and it’s still here, with patients and providers alike facing new serious challenges.”1

According to preliminary data from the Centers for Disease Control and Prevention (CDC), drug overdose deaths in the United States rose 4.6% in 2019 to 70,980. Of those, 50,042 or 71% involved opioids.2 A New York Times analysis of mortality data from state and local governments covering 40% of the U.S. population indicates that drug deaths were rising by 13% during the first half of 2020,3 and more than 40 states have reported increases in opioid-related mortality.4

The causal relationship between the COVID-19 pandemic and the opioid epidemic—with the former exacerbating the latter—has been described in various ways, including as a collision between a pandemic and an epidemic.5 The National Institute of Environmental Health Sciences (NIEHS) states bluntly, “The COVID-19 pandemic is fueling the opioid crisis!” According to the NIEHS, nearly half of Americans report the coronavirus crisis is negatively impacting their mental health, and there has been a 1,000% increase in emotional distress reported to emergency hotlines.6 Peter Grinspoon, a physician on the staff of Massachusetts General Hospital who himself has recovered from opiate addiction, observes, “Two great epidemics of our generation are intersecting in ways that are additively deadly…”7 and the Times calls the coronavirus pandemic “a national relapse trigger.”8

For the more than 20 million Americans who have a substance use disorder, COVID-19 has left many of them locked down, laid off, and surrounded by uncertainty. One writer states, “Anxiety, grief, isolation, financial worries, changes at home and work, and an ongoing sense of uncertainty can all threaten people with a substance use disorder (SUD) as well those at risk of developing one.”9

In addition to such behavioral health diagnoses, COVID-19-driven stay-at-home orders dissuade people from going to clinics to obtain methadone or other medications for treating addiction. In addition, social isolation deters people from attending peer-support groups, which play a key role in providing emotional and spiritual support to people trying to stay in recovery.10

In September, the World Health Organization, former FDA Commissioner Scott Gottlieb, and CDC Director Robert Redfield all projected that a COVID-19 vaccine would not be available in the U.S. until mid-2021. Given those sobering predictions, the road ahead for both the fight against the coronavirus as well as its exacerbation of the opioid epidemic will be long and arduous, thus increasing the importance of connecting with at-risk individuals, through various forms of outreach, telehealth, retail pharmacy interactions, and online meetings.

Footnotes

  1. Wedge, Dave, “Epidemics at Odds: Preventing the Next Wave of the Opioid Crisis During COVID-19,” HealthCity, https://www.bmc.org/healthcity/population-health/preventing-next-wave-opioid-crisis-during-covid-19, March 23, 2020.
  2. American Hospital Association, “CDC: Drug overdose deaths up 4.6% in 2019,” https://www.aha.org/news/headline/2020-07-16-cdc-drug-overdose-deaths-46-2019, July 16, 2020.
  3. Katz, Josh, et al., “In Shadow of Pandemic, U.S. Drug Overdose Deaths Resurge to Record,” New York Times, https://www.nytimes.com/interactive/2020/07/15/upshot/drug-overdose-deaths.html, July 15, 2020.
  4. American Medical Association, “Issue brief: Reports of increases in opioid-related overdose and other concerns during COVID pandemic, https://www.ama-assn.org/system/files/2020-09/issue-brief-increases-in-opioid-related-overdose.pdf, Sept. 8, 2020.
  5. Weimer, Stacy, “COVID-19 and the opioid crisis: When a pandemic and an epidemic collide,” https://www.aamc.org/news-insights/covid-19-and-opioid-crisis-when-pandemic-and-epidemic-collide, July 27, 2020.
  6. National Institute of Environmental Health Sciences, “The COVID-19 Pandemic is Fueling the Opioid Crisis!” https://tools.niehs.nih.gov/wetp/public/hasl_get_blob.cfm?ID=12121, accessed Sept. 17, 2020.
  7. Grinspoon, Peter, “A tale of two epidemics: When COVID-19 and opioid addiction collide,” Harvard Health Blog, https://www.health.harvard.edu/blog/a-tale-of-two-epidemics-when-covid-19-and-opioid-addiction-collide-2020042019569, April 20, 2020.
  8. Hoffman, Jan, “With Meetings Banned, Millions Struggle to Stay Sober On Their Own,” New York Times, https://www.nytimes.com/2020/03/26/health/coronavirus-alcoholics-drugs-online.html, March 26, 2020.
  9. Weimer, loc. cit.
  10. Grinspoon, loc. cit.