Two Public Health Emergencies

As the coronavirus pandemic continues across the United States, another public health crisis worsens. The opioid crisis has been exacerbated by COVID-19, with multiple states reporting that they have seen more opioid overdose deaths this year than last year. Under social distancing requirements, it has become more challenging for patients to receive treatment and less likely for those who overdose to get help in time. 

While the United States fights COVID-19, the opioid crisis must be addressed because social distancing increases the likelihood of overdosing alone, clinics and syringe-exchange programs have been interrupted, and access to treatment, such as daily medication or rehab, has been limited.  Therefore, governments and healthcare providers must prepare resources for an increase in opioid overdoses and be flexible when providing treatment for those with opioid use disorder (OUD).

The Opioid Crisis In The United States

The opioid crisis is considered one of the major public health issues of the United States. Approximately 2 million Americans struggle with OUD, and research from the Centers for Disease Control and Prevention (CDC) states that about 450,000 people have died from an opioid overdose between 1999-2018. In 2018, nearly 47,000 deaths involved opioids, which was about six times the amount of opioid overdose deaths in 1999. On average, 130 Americans die every day from an opioid overdose, and drug overdose is the leading cause of accidental death in the United States. This has been an ongoing public health crisis, but the coronavirus could be making it worse. 

Communities across the country have been reporting increases in overdose deaths for this year in comparison to last year. The American Medical Association has claimed that more than 30 states have reported an increase in opioid overdose deaths. As of May 2020 in Cook County, Illinois, which includes Chicago, there have been about 900 overdose deaths so far this year, yet there were 461 deaths at the same time last year. Smaller communities are reporting increases as well. In Niagara County, New York, 16 people have died from overdoses as of May 2020, which was an increase from 11 deaths at the same time in May 2019. These increases suggest there may be a nation-wide rise in opioid overdoses in 2020. 

Stigma towards opioid use may cause the opioid epidemic to be overlooked as coronavirus continues. While the COVID-19 response certainly needs the nation’s resources, funding, and attention, the opioid crisis cannot be forgotten. The opioid epidemic is a major public health crisis that is becoming more urgent during the pandemic. While the number of deaths may not be as drastic as the coronavirus, the opioid crisis needs to be combatted because it is an ongoing, and intensifying, issue. 


How Coronavirus Emphasizes The Opioid Crisis

The pandemic could be negatively impacting the opioid crisis in multiple ways. According to medical experts, the anxiety of social distancing and a global pandemic can trigger drug use. Social distancing also means people who use are more likely to use alone, so if they overdose, there is no one to call an ambulance or administer naloxone, which can counteract the effects of an overdose.

Treatment has been impacted as well. Clinics and syringe-exchange programs have been disrupted by COVID-19, which makes it more difficult for OUD patients to receive the necessary medications and resources. With the pandemic requiring many clinics to reduce capacity or staff, receiving medication such as methadone has become more challenging. Methadone is used to treat drug addiction, but it usually requires the patient to visit a clinic for a daily dose and is heavily regulated. Other treatment options such as rehab facilities have decreased their new admissions or closed programs in fear of spreading the virus. It is becoming more difficult for OUD patients to receive treatment or to get help if they overdose. Therefore, the deadly impact of the opioid crisis on communities should not be overlooked. 


Possible Solutions

The American Medical Association is recommending that states are flexible for evaluating and prescribing through telemedicine. They also suggest that barriers to receiving necessary medications should be removed. For example, one policy from the Substance Abuse and Mental Health Services (SAMHSA) allows “stable” patients to get four weeks of take-home medication so that they do not need to make daily visits to a clinic. They also suggest that states should support harm-reduction programs, such as lessening barriers for people to access sterile needle and exchange service programs. In general, communities should think of ways they can support OUD treatment, including adding resources or funding towards treatment programs, and should prepare for a potential increase in overdoses, such as by making naloxone more accessible. 


The Future

During this unprecedented pandemic, states and healthcare providers must work together to be flexible in treating patients who struggle with substance-use disorders and should prepare resources to possibly deal with an increase in overdose cases. It is too early for the United States to know the complete impact of COVID-19 on the opioid crisis, but the increase in overdoses across numerous states suggests the crisis will only worsen if it is not immediately addressed.