COVID’s Impact on the Opioid Crisis
The global COVID-19 pandemic brought about many changes in our society, and not only in the lives of front-line workers. People from all walks of life have grappled with job losses, health scares, and isolation, exacerbating mental health issues. Constant cycles of fear and stress increased rates of depression and anxiety across the board, resulting in elevated alcohol and drug use.
With the United States already fighting an unprecedented opioid crisis, the ramifications of COVID-19 on drug use are quickly making themselves known.
The Opioid Crisis, Pre-COVID
Opioids are strong pain relievers, usually prescribed by doctors after an injury or surgery, including name-brand drugs like OxyContin, Morphine, and Vicodin. The main ingredients in these drugs are oxycodone, hydrocodone, and acetaminophen.
Opioids began growing in popularity in the late 1990s. Pharmaceutical companies were touting their powerful pain relief benefits, assuring physicians that there were no addictive side effects. As a result, the medical community increased their rate of opioid prescriptions, making them suddenly and widely available to patients.
Unfortunately, these reassurances were unfounded. Opioids soon showed themselves as highly addictive, and the rate of opioid misuse and abuse quickly skyrocketed. However, they are still widely prescribed. For context, in 2017, doctors in the United States wrote more than 191 million prescriptions for these drugs. And in the same year, more than 47,000 Americans died as a result of an opioid overdose.
COVID's Impact on Mental Health and Substance Abuse
For years, it has been common for those with mental illness to misuse drugs, legal or illegal, as a form of self-medication. This impulse to self-medicate played strongly into the original growth of the opioid crisis and has only increased with the recent advent of COVID-19.
In general, stress and anxiety cause many to experience difficulty sleeping and eating, which leads to increased alcohol and drug consumption and worsening chronic health issues. And unfortunately, this relationship between depression and opiate abuse is a vicious cycle. The Annals of Family Medicine found that 10% of people prescribed opioids developed depression after a month of taking the drugs. The longer opioids were used, the greater the risk of developing depression became.
The worldwide impact of COVID-19 also left its mark on this cycle. The Kaiser Family Foundation (KFF), a nonprofit organization focusing on national health issues, reports that from January to June 2019, 1 in 10 adults said they experienced symptoms of anxiety or depression. But from July 2020 through July 2021, those numbers increased to 4 out of 10. Isolation, fear, and job loss were the three main reasons cited for this increase, directly in response to the pandemic. The groups seeing the highest impact were young adults, parents with children at home, people of color, and essential workers.
This uptick in anxiety fed directly into dangerous opioid usage. In a survey published in the International Journal of Drug Policy, 47% percent of respondents reported that their substance use had increased during the COVID-19 pandemic. Of even greater concern, 38% said they believed they were at higher risk of overdose because they lived alone and that drugs were becoming harder to get, causing them to seek them out from uncharted avenues.
Opioid-Related Overdoses and Deaths in the Era of COVID-19
When COVID-19 struck, economic shock, social isolation, depression, and increased fear of the unknown were just a few of the conditions that experts predicted could lead to an increase in drug overdoses and death. Quarantine and broken supply lines also spurred some drug users to inadvertently put themselves at additional risk. With limited access to their usual drugs of choice, some users elected to take or mix narcotics they might not take typically. Many have also reported indulging in a larger quantity of intoxicants than their bodies are accustomed to taking.
The Centers for Disease Control and Prevention (CDC) confirmed experts' fears when they reported that from May 2019 to May 2020, there were approximately 81,230 drug overdose deaths in the United States alone. This is the most significant number of drug-related deaths ever recorded in a single year. Opioids are the primary driver of this increase, accounting for about 75% of these deaths.
While some of these statistics predate the onset of COVID-19, the CDC definitively states in the same report, "The increases in drug overdose deaths appear to have accelerated during the COVID-19 pandemic." Quarantine only compounded this issue. With no one around to call 911 or administer Naloxone, the antidote to an opioid overdose, people who overdosed had no outlet for help and increasingly ended up dying alone.
On top of the risk of overdose, opioid use also affects pulmonary and respiratory health. This makes users more susceptible to contracting COVID-19 and, therefore, more likely to suffer from complications.
COVID-19 and Rehab Programs
For many opioid abusers, being admitted to an in-patient rehab facility is paramount in their recovery process. Under the supervision of medical professionals and therapists, the patient has the best chance of addressing the underlying mental and health issues and getting and staying clean.
However, the pandemic has created new barriers for people in need of rehabilitation, therapy, and other health services. Mental health facilities and drug rehab centers have had to implement coronavirus protocols to protect both patients and staff members. Some of these measures include:
- Implementing a 14-day quarantine either at the facility upon patient admittance or before the patient arrives
- Testing for COVID-19 upon arrival to the facility
- Regular and thorough cleaning and sanitation
- Continuing to monitor staff and patients' health for signs of COVID-19 symptoms
- Having cleaning supplies and hand sanitizer readily available
- Wearing of PPE equipment
- Maintaining social distancing in therapy sessions, at meals, and in bedrooms and common areas
These extra measures can put extra stress on both patients and staff, even making assistance unattainable for some people in need of help.
As the opioid crisis continues to grow, and with potential complications from world events such as COVID-19, the need for risk reduction strategies is now more critical than ever. Both drug users and their loved ones are advised to find ways to reduce risk factors. Some of these methods include:
- Ensuring that Naloxone is available and teaching members of the drug user's support system how to administer it in case of an overdose
- Having friends and loved ones performing regular check-ins on those who are known to be chronic drug users
- Providing information to communities, school officials, parents, students, family, and friends about exposure to highly potent opioids and the increasing risks for overdose
- Sharing resources such as online support groups
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