As the United States continues to battle the national public health crisis presented by the COVID-19 global pandemic, our nation’s ongoing opioid epidemic is worsening.
To date there have been more than 17 million confirmed cases of COVID-19 in the U.S., and more than 310,000 deaths. In addition to high infection rates and the devastating death toll, the secondary health repercussions of the pandemic have been profound. Increased stress, economic hardship, social isolation, and disruption to healthcare services, among others, have presented significant challenges for many Americans, but perhaps even more so for those battling substance use disorders, including opioid addiction.
Drug Overdoses are Increasing Dramatically
According to the Substance Abuse and Mental Health Services Administration, more than 20 million Americans struggle with a substance use disorder. Based on provisional data from the Centers for Disease Control (CDC), nearly 72,000 Americans died of drug overdoses in 2019, nearing record numbers.
During the first three months of 2020, drug overdose fatalities increased by roughly 10%, according to preliminary numbers from the CDC. If this trend continues, the CDC estimates there will be more than 75,000 drug-related deaths in 2020, which would set a grim record for the second consecutive year.
Compared to the same time periods in 2019, the Overdose Detection Mapping Application Program, a federal initiative that collects data from ambulance teams, hospitals, and police, found that overdose deaths jumped 18% in March, 29% in April, and 42% in May.
When looking at opioid-related deaths specifically, more than 40 states have reported increases in opioid-related fatalities since the COVID-19 pandemic began.
Stress is Taking a Toll on Our Mental Health
According to a CDC survey conducted in June, 13% of U.S. adults said they had started or increased substance use to deal with the stress of COVID-19. In addition, the percentage of Americans reporting symptoms of depression has more than tripled during the coronavirus pandemic.
Due to social distancing guidelines, many Americans are finding themselves increasingly isolated from family, friends, and other support networks, and it is harder for loved ones who don’t live together to physically check in on each other. Because addiction is a disease of uncertainty, isolation, and anxiety, all of these issues can negatively affect people with substance use disorders.
Record-High Unemployment is Creating Economic Distress
In April, the U.S. economy lost 20.5 million jobs, the largest and most sudden decline since the government began tracking the data in 1939, and the unemployment rate soared to 14.7%.
Every 1% hike in the unemployment rate will likely produce a 3.3% increase in drug-overdose deaths and a 0.99% increase in suicides, according to data from the National Bureau of Economic Research and the medical journal The Lancet.
Unemployment, furloughs, salary cuts, loss of health insurance, and other consequences of economic hardship can all contribute to stress, depression, anxiety, and loss of access to healthcare, putting people with substance use disorders at greater risk for relapse and/or overdose.
Access to Treatment & Support Has Been Disrupted
The social isolation imposed by the COVID-19 pandemic hasn’t just interrupted our personal connections with family and friends but has also disrupted access to services for people with mental illness and substance use disorders. These services include doctor’s visits, treatment, counseling, 12-step programs and other addiction support groups, residential programs, and more, leaving huge gaps in the safety net that many people with substance use disorders depend on.
To combat this disruption, many services have transitioned to being delivered online or via telemedicine. In addition, federal and state agencies are realizing the downstream impact of these disruptions in care, and at the federal level, new legislation is being introduced to help people access treatment and recovery programs, including reimbursing telehealth visits and changing in-person prescribing to virtual/remote. However, some services, such as support groups, are hard to replicate on Zoom and also require reliable internet access, which not everyone has. We also don’t yet know how telemedicine may be changing providers’ prescribing patterns.
People with Substance Use Disorders are at Increased Risk for COVID-19
A National Institutes of Health-funded study published September 14 found that people with addiction disorders are at greater risk for COVID-19, and if infected, more likely to be hospitalized or die. This is due, at least in part, to the fact that many substance users have preexisting conditions that would worsen their prognosis. The effect was strongest among those with opioid use disorder, followed by tobacco use disorder, according to the findings.
During the study, the researchers analyzed non-identifiable electronic health records of more than 73 million patients in the U.S. They found that people with addiction disorders accounted for just over 10% of those in the study, but nearly 16% of COVID-19 cases.
In addition, because people with addiction are often already marginalized, it can be even harder for them to access healthcare services when they need them.
Treatment and Prevention are Key to Managing Both Crises
Both COVID-19 and the opioid epidemic are public health problems that require public health solutions. The first part of the solution is making sure we can treat these conditions. For COVID-19, that means having enough hospital beds, ventilators, supplies, and staff to treat sick patients. For opioid use disorder, it’s making sure that people have access to care, treatment programs, medications, and support.
The second part of the solution is prevention. As the COVID-19 pandemic has continued, there have been national discussions around increased testing, increased surveillance, contact tracing, mask mandates, and recently, vaccines have started to become available. For opioid use disorder, the key to prevention is to better understand who is most at risk for opioid addiction and then taking action to prevent it. If personalized risk information is available, affordable, and accessible, then the patient and their provider can make more informed decisions about pain management before that first opioid prescription is ever written.
SOLVD Health is Helping Combat the Opioid Crisis
At SOLVD Health, we’re working to develop and commercialize a potentially groundbreaking genetic test designed to assess a patient’s risk of opioid use disorder prior to receiving oral opioids for short durations, including after procedures such as elective or non-emergent surgeries. Our decision to develop this test was a direct response to the human cost we are seeing in communities across the United States.
Currently, providers often don’t have enough contextual, relevant, and objective information about the patient to identify those at high risk for opioid addiction before it occurs. We believe that unlocking this type of information and identifying individuals who may be at increased risk for opioid use disorder could prevent addiction, save lives, and make a significant impact on curbing the opioid epidemic.