Understanding COVID-19 Effects on Opioid Addiction

While the COVID-19 pandemic was undeniably the largest health crisis for the global community over the past several decades, it did not erase other crises that existed before the pandemic began. The opioid addiction crisis in particular continues to affect millions of lives across the country and was only exacerbated by the COVID-19 pandemic.

This crisis dates back to the late 1990s, when misinformation led healthcare providers to prescribe opioid pain relievers at higher rates, resulting in the widespread misuse of both prescription and nonprescription opioids. Although prescription practices have changed, the misuse of these drugs persists.

In 2018 alone, 10.3 million people misused prescription opioids and 2 million people had an opioid use disorder. Between 1999 and 2018, nearly 450,000 people died from an overdose involving an opioid, including both prescription and illicit opioids.

As the COVID-19 pandemic raged on, so too did the nation’s battle with substance use. Data indicated that the pandemic possibly contributed to 75,000 additional deaths from alcohol, drug misuse, and suicide. And many argue that this estimate is low.

Labeled “deaths of despair,” these casualties were tied to job loss, uncertainty, and isolation that stemmed from to the pandemic. These effects highlight the impact the coronavirus had on mental health and substance use disorders.

COVID-19’s impact on mental health

The relationship between COVID-19 and mental health is at the forefront of many recent health discussions. In a poll conducted in July 2019, 53% of U.S. adults surveyed said that stress and worry related to the pandemic harmed their mental health. This percentage was significantly higher than a poll conducted in March 2019, when only 32% of respondents voiced concern.

Epidemics have been shown to induce stress across populations as a result of social isolation, loneliness, job loss, and income insecurity, all of which can contribute to depression, anxiety, and low self-esteem. When paired with high levels of fear and uncertainty, these unprecedented times create a toxic culmination of circumstances that can lead to new mental health challenges and exacerbate existing ones.

Unfortunately, more mental health conditions due to the coronavirus also meant more substance use disorders. In fact, more than one-in-four adults with a serious mental health condition also has a substance use disorder. There are several reasons why mental health and substance use disorders frequently co-occur:

• Some individuals with mental health conditions use alcohol or drugs to self-medicate. While this may provide individuals with short-term relief, it often intensifies their symptoms in the long run.
• Numerous illegal drugs can cause individuals with substance use disorders to experience one or more symptoms of several mental health conditions, including depression and anxiety.
• Mental and substance use disorders share several underlying causes. This includes genetic vulnerabilities and early exposure to trauma, increasing the chances they will occur simultaneously.

COVID-19 and its effects on addiction

For many, the pandemic brought grief, anxiety, isolation, financial challenges, disruptions to daily routines, and an ongoing sense of uncertainty. All of these can threaten individuals with a substance use disorder as well as those at risk of developing one.

Because substance use affects an individual’s central nervous system, those with a substance use disorder have a physiological hypersensitivity to stress, meaning they get stressed more easily than other people do. Additionally, when a person’s brain is chronically exposed to drugs like opioids, their ability to experience normal reward levels decreases. When combined with stress and isolation, this can make it exceedingly difficult for a person to resist substance use.

While definitive data on the pandemic’s effects on substance use is not yet available, early numbers are concerning. In the first few months of the pandemic, alcohol sales rose by 27%. National laboratory service Millennium Health also reported a 32% increase for nonprescribed fentanyl, a 20% increase for methamphetamine, and a 10% increase for cocaine from mid-March through May 2020, after they analyzed 500,000 definitive urine drug tests.

A national tracking system run out of the University of Baltimore further supports these findings. The system identified an 18% increase in suspected drug overdoses during the same time period. The isolation that social distancing imposes means that many of these overdoses occurred when the individual was alone, with no one around to call 911 or administer naloxone, an opioid-overdose antidote. Many believe that this contributed to the 11% increase in drug overdose-related deaths during the first four months of 2020.

How the pandemic perpetuated substance use disorders

While many factors contributed to spikes in opioid and other substance use cases and overdoses during the COVID-19 pandemic, three of the most important ones to understand the pandemic’s effects on addiction are:

Disrupted access to treatment

When the country suddenly shut down in an effort to reduce the spread of the coronavirus, numerous substance use treatment programs closed their doors. This left many recovering individuals without access to the critical substance use counseling and support they needed. Even in cases where treatment centers remained open, some individuals avoided them for fear of contracting COVID-19 and potentially infecting their loved ones.

Limited access to peer support

Social distancing and lockdowns limit individuals’ contact with friends, mentors, and other close members of their community, fostering feelings of isolation and loneliness that can contribute to substance use. Social distancing and lockdowns also interfere with individuals’ ability to attend group sessions, which are an important part of the treatment process for substance use disorders.

Loss of employment

Job loss can lead to a lack of structure and home foreclosures and evictions, all of which can increase psychological stress which can, in turn, increase substance use. According to a Kaiser Family Foundation poll from mid-May 2020, 46% of adults in households that had experienced income or job loss as a result of the pandemic said that the pandemic has negatively impacted their mental health.

How to prevent opioid addictions in life after the COVID-19 pandemic

While it is impossible to completely prevent opioid addiction and other substance use, several federal agencies have initiated new policies designed to make treatment for substance use disorders more accessible following the pandemic, adjusting regulations regarding medication for opioid use treatment and Medicare and Medicaid coverage for telehealth services.

Many health and human services organizations are leveraging this support to better assist their clients during the pandemic. By expanding access to virtual care, these organizations are providing support at a time when many people are still wary about in-person healthcare appointments. Other benefits of teletherapy include:

No commuting

Teletherapy eliminates time spent commuting to and from appointments, allowing individuals to focus solely on their treatment. This is especially important for individuals living in rural areas or busy cities, who may have previously had to travel up to an hour or more for treatment.

Minimizing shame

Despite the efforts of many healthcare and nonprofit organizations, the stigma surrounding substance use persists across the country. Teletherapy allows individuals worried about being seen at a treatment facility to access the care they need, free from the eyes of those in their community.

Combatting staffing shortages

Teletherapy can help to combat the shortage of behavioral health specialists and increase the number of clients they support. With teletherapy, fewer behavioral health specialists can see more clients more efficiently.

Bringing people together

Individuals who have dealt with substance use say that those who have gone through it or are going through it understand it best. This is particularly true for opioid use, making group therapy sessions a crucial part of the recovery process. Health and human services organizations can continue running these groups virtually. This will allow them to invite new members who previously could not attend due to lengthy commutes, work obligations, etc.

Get help managing opioid use in the wake of the COVID-19 pandemic

The COVID-19 pandemic upended even the most basic tenets of treatment for substance use, challenging healthcare professionals across the country. Organizations must find new ways to engage with their clients and provide them with the compassionate, knowledgeable support they need.

At Relias, we offer a variety of opioid management solutions. These resources will help you deliver better care, ease pressure on your staff, and improve the lives of persons served.