Dueling Crises – The Coronavirus Pandemic and the Opioid Epidemic

2020 has been an unprecedented year in so many ways.  Every day we see stories and news reports about COVID19 but that is not the only crisis we are facing.  The Opioid Epidemic continues and has only worsened since the Pandemic began.  Between March and May, 42 states and territories issued mandatory stay at home orders which led many Americans to begin work from home, virtual learning or unemployment.  For those deemed “essential workers”, work continued under uncertainty, fear and increased use of Personal Protective Equipment (PPE).

The effects of the Coronavirus vary from individual to individual but common experiences include feelings of social stress, isolation, fear, grief, concerns about job security, finances and health.  All these factors, plus countless others, have played a roll in what state officials predict will be a year of record overdose deaths in Connecticut.  The Chief Medical Examiner predicts the total number of overdoses in the state in 2020 to exceed 1300, over 100 more than last year.  Through October 2020, Connecticut reported a 13% increase in overdose deaths over the same period in 2019.  Fatal and nonfatal overdoses nationwide spiked in May 2020 with a 42% increase compared to May 2019.

It is impossible to know all of the correlations between COVID19 and substance use but some things we know for sure.  Alcohol and cannabis sales have both increased during the Pandemic as many individuals are reporting new or increased alcohol and drug use as a coping method.  Alcohol sales were deemed essential during the Pandemic as alcohol withdraw can be deadly.  So what do we know about why overdoses, especially fatal ones, have increased?  Isolation is a key factor.  Individuals who may have once used drugs with others were often isolated and using alone.  If an overdose occurs while someone is alone, there is no one to call for help or administer the lifesaving overdose reversal, Naoloxone.  Even if someone is present, the fear of going to the hospital during COVID19 may have prevented individuals from seeking help.  The existing stigma around SUD can impact willingness to seek treatment that could prevent a future overdose.

While organizations such as Liberation Programs were deemed essential and not forced to close, fear of leaving the house and being around others became a new barrier to treatment.  Fortunately, governmental mandates were changed to allow for an increase in take home medication such as Methadone which curbs opioid cravings.  Additionally, telehealth services were able to be implemented to provide treatment and support from an individual’s residence.  However, if someone has no access to a phone or internet, this was not an easy solution.  We have adapted and made changes to provide lifesaving treatment during the Pandemic, but there is much work left to be done.

Individuals with Substance Use Disorders (SUD) often have co-morbidities that can worsen symptoms in those who contract COVID19 as well as make individuals more susceptible to the virus.  Unfortunately, minorities have been disproportionately affected by COVID19 and Substance Use Disorders.  A study by the National Institute of Drug Abuse (NIDA), found that African Americans with Substance Use Disorder and COVID19 had worse outcomes for hospitalizations and mortality.  Another study showed that Black patients had a larger portion of Opioid overdoses during the Pandemic.  This disparity in access and treatment must be addressed in order to save lives.

So what are we doing at Liberation Programs to address the Coronavirus Pandemic and Substance Misuse?  We have never closed our doors to Recoverees and are fully utilizing allowances for take home medications and telehealth – something we hope to incorporate even once the Pandemic is behind us.  Our Mobile Wellness Van continues to operate throughout Fairfield County 5 days per week providing life saving Narcan (Naloxone), syringe exchange, harm reduction supplies, education and referrals to those seeking support.  We have trained all staff as well as many in the community and local government in Narcan, including providing Narcan kits, so that we can get as many people as possible equipped to save lives.  We remain committed to meeting people where they are, saving lives and showing that Recovery is Possible.