How COVID-19 is Affecting the Opioid Epidemic

When the novel coronavirus reached the U.S., the economy and many facets of American’s lives came to a seeming halt. As the economy shut down and widespread closures swept the nation, one existing epidemic responsible for killing thousands of people each year continued to rage on. Although much of our lives are on pause right now, COVID-19 has affected the opioid epidemic and access to treatment in a variety of ways. 

Overall, more than 2 million Americans suffer from opioid use disorder and more than 130 people die every day from an opioid-related overdose. However, due to the implications of COVID-19 on the opioid epidemic, overdose deaths are on the incline in some Ohio counties, and likely, across the United States. For example, WKYC reports that “The Cuyahoga County Medical Examiner’s Office…saw fatalities spike 45% from 33 overdose deaths in February, to 48 in March, when the COVID-19 pandemic began.” The article notes that this trend is consistent with what addiction experts and county coroners are reporting nationwide. 

Implications of COVID-19 on the Opioid Epidemic

While the COVID-19 pandemic affects people of all walks of life, people who are caught in the midst of the opioid epidemic are met with a variety of unique risks. For example, opioids are central nervous system suppressants, so they directly affect breathing and brain activity. As a result, people who abuse copious amounts of opioids are at risk of a life-threatening or fatal overdose if their breathing or heart rate slows to a dangerously low rate. Due to a lack of sufficient oxygen supply to the brain, both brain cells and the respiratory system can sustain long-term damage. As a result, people with a history of opioid abuse may be at higher risk for developing diminished lung capacity or other life-threatening comorbidities if they contract COVID-19.

Furthermore, the National Institute on Drug Abuse notes that the COVID-19 pandemic poses additional risks for people with opioid use disorder, including housing insecurity, increased likelihood of incarceration, and poor access to healthcare. First, when people are experiencing homelessness or are serving time for a crime, they are exposed to environments that are typically unsanitary and in close quarters with other people. These types of environments increase the risk of disease transmission and add to the heavy burden already faced by essential workers and healthcare providers. 

To add to this burden, the increase in overdose rates reported across Ohio pose a potential threat to healthcare workers and hospital capacity. When overdose patients are rushed to the hospital, it can stress an already overloaded healthcare system to the point where patients are underserved or turned away, ultimately resulting in an even higher death toll from both COVID-19 and the opioid epidemic.

Risks of Social Isolation Among People With Opioid Use Disorder

While it might seem obvious that people with opioid use disorder are more likely to contract viral illnesses like the coronavirus, these individuals are also facing unique challenges as a result of the pandemic for a variety of social and environmental reasons. 

One popular quote in the recovery community is that “addiction is a disease of isolation.” People who suffer from addiction tend to isolate themselves from their loved ones, while people in recovery are told not to isolate because it increases the risk for relapse. In addition to being told to stay home and avoid unessential errands – many recovery support groups and 12-step meetings have ceased in-person sessions, forcing people to turn to online platforms for support. 

However, this shift in support isn’t easy and not everyone has access to the technologies required to participate in online meetings. When combined with a general heightened state of anxiety and concern over the pandemic, this lack of social support can lead to isolation, loneliness, and even more opioid overdose deaths. 

Moreover, Harvard Health notes that people who adopted harm reduction techniques or were relying on medication-assisted treatment are now using drugs alone or are at risk of relapse, thereby increasing the risk of overdosing alone and experiencing a fatality. If someone has been sober for a while but relapses, their tolerance is low and they are more likely to overdose. If they overdose alone, nobody is there to notify 911 or administer Narcan – so these overdoses are more likely to turn fatal. Plus, many harm reduction programs across the country are working at reduced capacity while lacking the PPE, medications, and supplies needed to provide life-saving support. As a result, making sure that no addict goes forgotten and that everyone has access to the medications, supplies, and support needed to stay sober is more important than ever. 

COVID-19 and the Opioid Epidemic in Ohio: What We Know So Far

Sadly, Cuyahoga County isn’t the only county in Ohio seeing an increase in overdoses. CNN reports that Franklin County, Ohio reported a 50% increase in fatal overdoses between January 2020 to April 15, 2020. Emergency responders, law enforcement officers, and county coroners across the state are concerned that this surge in overdose deaths is inevitably connected to the environmental and societal challenges people are facing as a result of COVID-19.

In an effort to expand access to treatment and provide support to people affected by the opioid epidemic, SAMHSA is temporarily allowing opioid addiction treatment programs to provide patients with extended doses of medication. This prevents people from having to visit a clinic and risk transmitting the virus while maintaining access to essential medications. At the same time, the DEA has taken steps to relax buprenorphine prescribing restrictions to help people stay sober during the pandemic. 

Although efforts are being made, harm reduction organizations in Ohio, Kentucky, and West Virginia have seen a significant increase in demand for Naloxone, an over-dose reversing medication, while they are also running low on sterile syringes. This lack of supplies and a growing demand only suggests that the COVID-19 pandemic is exacerbating the already devastating opioid epidemic.