As Coronavirus Disease 2019 (COVID-19) looms large, disrupting the lives and livelihoods of billions of people, it has pushed other public health conditions to deteriorate in its shadows. The pandemic has disrupted the normal operations of health systems globally, leading to drops in vaccination coverage, gaps in the management of chronic conditions, and service interruptions for those with substance use disorders. Anxiety, grief, isolation, and financial worries have had a domino effect in public health, threatening people who have a substance use disorder, and putting more people at risk of developing one. A survey of U.S. adults released by the Centers for Disease Control and Prevention (CDC) showcases how these epidemics are now intertwined, with 13 percent of respondents in June stating they had started or increased substance use to deal with stress or emotions related to COVID-19. This year, more than 40 states reported increases in opioid-related mortality. The consequences of one epidemic cannot be siloed, and the impacts of their synergistic effects will have complex policy implications moving forward.
Opioid overdoses remain a major challenge for the U.S., killing over 46,800 people in 2018. The opioid epidemic’s transition from prescription opioids, to heroin, to synthetic opioids—like fentanyl—have considerably increased the number of lives lost in recent years. The drug deaths are adding to the pandemic’s toll, which includes more than 188,000 infection-related fatalities. Disruptions from COVID-19 can be seen in the long lines of testing sites and treatment centers aiming to maintain social distancing, and in the cancellation of in-person therapy groups. While the federal government has loosened restrictions to increase access to medication-assisted treatments, like buprenorphine, through telemedicine, patients may still need to pick up their medication in-person. As current operations figure out how to retain the effectiveness of in-person treatment as much as possible during this period, the use of telemedicine for substance use disorder allows providers to continue the critical work of seeing patients during the pandemic.
According to medical experts reporting in the Journal of the American Medical Association (JAMA), the health of populations will ultimately depend on policies implemented locally, through state and municipal governments, with the help of clinicians and public health experts. Substance use and mental health require the expansion of community outreach and social services, increasing access to providers through telemedicine, and making medication-assisted treatments much more readily available. While the approach to mitigating the impacts of COVID-19 has been to distance and isolate, the key to improving mental health and substance use outcomes will be to give more access and give smarter care.
To learn more about the opioid epidemic, explore GHELI’s Resource Pack on the U.S. Opioid Epidemic.