Given the totally upending effects of the COVID-19 crisis, it may be easy to forget that it started during another public health crisis, the opioid epidemic—but now we’re starting to see the devastating impact of the confluence of the two. While the pandemic presents innumerable direct and indirect challenges to different people in different ways, people struggling with substance abuse disorder face a particularly steep challenge during this time. This is because of the specific ways that addiction can reshape the human brain.
As Harvard Medical School professor John Kelly told STAT News, “People in recovery can have a hypersensitivity to stress and a diminished capacity to experience normal levels of reward. That’s a really tough combination.” We are tragically seeing the effects of this challenge in some stark statistics: according to a CDC report last month, 81,003 people died from drug overdoses in the 12-month period ending last June. That represents a 20% increase from the year before and the highest number of overdose deaths in the U.S. ever recorded in one year.
A study in JAMA Psychiatry showed that overdose-induced trips to the ER went up by as much as 45% during the pandemic.
Medication-assisted treatment is generally considered an ideal mode of addiction recovery. But 1.6 million people had an opioid abuse disorder in 2019, and only about 18% had access to a medication like buprenorphine, one of a few FDA-approved drugs to help with recovery from substance abuse. There are three main reasons for this: these drugs can be difficult to find in many parts of the U.S.; physicians have to jump through hoops to be licensed to prescribe it; and there remains stigma around treating addiction, dissuading people from obtaining life-saving care. According to Shawn Ryan of the American Society of Addiction Medicine, “Medication-assisted treatment should be a part of every treatment plan for opiate use disorder, period.”
Buprenorphine, in fact, is the only FDA-approved addiction-fighting therapy that can be prescribed without an in-person visit to the doctor. Given the new and growing prominence of telemedicine and the decline of in-person visits due to pandemic restrictions, making the drug easier to prescribe and access could save thousands of lives during this time.
Addiction crises stem from a number of issues that only worsened during COVID-19. Seton Hall public health professor Jennifer Oliva explained to Bloomberg that, “Policy solutions that focus predominantly or exclusively on overprescribing also ignore the root causes of drug crises, such as economic deprivation, social isolation, and failure of the health care system to effectively address complex pain and substance use disorders.”
It’s easy to see how the pandemic made these issues more pronounced. As an example, an Alabama-based psychiatrist shared that he had a Spanish-speaking patient who had been successfully recovering from addiction for several months before the pandemic. But his all-Spanish addiction-recovery support group was unable to move online, and without his support system, he relapsed. The day-to-day effects of the pandemic seemingly make recovery harder than ever. It behooves life sciences leaders to find out where their support and resources can alleviate patient and provider struggles as we become more aware of the impact of COVID-19 on specific populations.