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June 26, 2020

The Other Health Crisis: What the Coronavirus means for those Battling Opioid Addiction.

While the nation is focused on the growing coronavirus epidemic, another epidemic—opioid addiction—is resurfacing with renewed vigor.

The two health crises have become intertwined as individuals in need of addiction treatment, or those who are in recovery and receiving medication-assisted treatment (MAT), find key support sources disrupted.

Social distancing policies, while necessary for stemming the spread of the virus, have inadvertently added barriers to treatment, with outpatient services suddenly unavailable in the usual clinical settings. Individuals who are reliant on the availability of methadone and buprenorphine were also met with challenges to procure these important medications.

One of the most significant challenges for those battling opioid addiction during the coronavirus event has been the adverse psychological effect associated with social isolation. While some made the shift to participation in online recovery meetings, such as A.A., N.A., SMART Recovery, and others, many found themselves unmoored due to the sudden absence of physical fellowship and access to a therapist. This has led to a sharp increase in depression, anxiety, and despair—all triggers for relapse.

Fortunately, lockdown measures are currently in the process of relaxing, allowing for the treatment industry to broaden their services incrementally. Physicians were given leeway to relax regulations on MAT supplies, providing 14-day or 28-day supplies of medication for patients considered stable, as this reduces daily exposure to the virus. The all-important sources of peer support, such as group meetings and 12-step communities, are slowly moving from Zoom back to live formats with safety measures adhered to.

That being said, it is highly likely that video conferencing platforms that have helped fill the gap during the pandemic will continue to be widely accessed as ongoing virus outbreaks continue.

Opioid Addiction on the Rise During the Pandemic

Opioid addiction itself results in isolating behaviors. Being in long-term quarantine either to help prevent community spread of the COVID-19 virus or as a result of contracting the virus, only exacerbates the feelings of loneliness that contribute to substance use disorders. While these policies have been necessary to help prevent a more tragic coronavirus scenario, for individuals in recovery or active opioid addiction, isolation is a recipe for disaster.

With access to both addiction and mental health services impacted, particularly outpatient services, people struggling with the daily challenges encountered in recovery have had to make do with alternative recovery support sources. Even still, the lack of person-to-person interaction has been detrimental. Those who relapse might not have a loved one there to administer life-saving naloxone, and may die alone unattended. Even if someone calls for help, with first responder services often delayed due to the added call burden caused by coronavirus health emergencies, naloxone may arrive too late.

In Pennsylvania, opioid-related deaths tripled between January 2020 and March 2020, and April’s overdose deaths were on track to surpass the March totals. The local Cumberland County coroner, Charles Hall, stated, “At this rate, the county will far surpass last year’s number of opioid-related deaths.”

In Roanoke County, Virginia dispatchers have responded to twice the number of fatal overdoses in the first five months of 2020 compared to 2019. Other forensic experts have reported significant increases in overdose deaths While these policies have been necessary to help prevent a more tragic coronavirus scenario, for individuals in recovery or active opioid addiction isolation is a recipe for disaster. in Milwaukee, Wisconsin, and Shelby County, Tennessee. Although the official data will not be available for months, it is evident that a rising tide of opioid addiction and overdose death during coronavirus is occurring.

Support for Individuals Battling Opioid Addiction During COVID-19

The list of life-threatening hazards related to opioid misuse is only added to during the current health crisis. According to a recent interview with addiction expert Dr. Nora Volkow, “One of the things opioids do is they depress your respiration. If it’s severe enough, they stop breathing. That’s what leads to death. Whether you overdose or not, when you are taking opioids, the frequency of your breathing is down, and the oxygen in your blood tends to be lower. The [COVID] infection targets the respiratory tissues in the lungs. It interferes with the capacity to transfer oxygen into the blood.”

The additional health risks posed to someone who has an opioid use disorder or who has relapsed, and potentially being exposed to coronavirus, should not be minimized.

So how can these individuals be provided with enhanced support during the pandemic?

Telehealth services.
Rehabs have responded to the needs of individuals in recovery by offering addiction and mental health services via online teleconferencing platforms. In addition to psychotherapy, outpatient rehabs, slightly modified to adapt to the limitations caused by COVID-19, provide intensive outpatient programming.

Online recovery meetings.
While in some states restrictions have been lifted, allowing for a return to in-person 12-step meetings, there may be limited access to these as the pandemic continues. Recovery communities can continue to meet over the Zoom platform from the comfort of their home and have a wide range of meetings to select from for recovery support.

Staying connected.
Whether it is you, or a loved one, who has the opioid use disorder, it is imperative to remain socially connected. Isolation and loneliness present a serious risk factor for relapse. Keep connected to an addicted loved one by checking in with them regularly, and encourage him or her to remain in touch with mentors, sponsors, or trusted friends throughout the coronavirus event.

Recovery apps.
Technology has provided a variety of recovery-oriented digital apps as an additional tool that can offer mentors, coaches, cognitive behavioral therapy, and group support. Check out COR-12, ReSET-O, Sober Grid, Nomo, and SoberTool for access to real-time recovery support and relapse prevention.

Residential treatment.
For individuals who are in need of intensive therapeutic intervention, residential treatment programs have been up and running during the pandemic. Safety protocols are in place to provide a treatment environment that is adhering to the CDC guidelines to reduce the risk of exposure to the virus.

While as a nation we continue to navigate this historic COVID-19 health crisis, it is critical that the needs of loved ones battling opioid addiction are also being attended to.

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