An Epidemic Inside of a Pandemic: How COVID-19 has impacted the Ongoing Opioid Crisis

Nearly three-quarters of a million people have died due to the opioid epidemic from 1999 to 2018 (1). This crisis has affected individuals throughout the entire economic and geographic spectrum in the United States. Scores of families and individuals have suffered. Furthermore, the number of deaths as a result of fentanyl (an illegal and more dangerously potent opioid than prescribed ones) has shown that the potential of this epidemic could be catastrophic. In recent years, nonetheless, there has been some progress in the number of deaths attributable to prescribed opioids. This is a result of an increase in the number of clinical drug tests taken, allowing for more individuals to be treated. However, studies have shown that the ongoing coronavirus disease 2019 (COVID-19) pandemic has led to a substantial decrease in the number of drug tests. What’s more, these smaller numbers of drug tests have seen an increase in incidence of dangerous drug combinations taken by individuals that do get tested.

The Center for Disease Control and Prevention (CDC) recommended states to impose stay-at-home orders beginning in the middle of March as well as asked hospitals and clinics to delay all non-emergency and medical prevention services that could be done virtually (2). A direct consequence of this was a significant decline in the number of drug tests conducted either by businesses or health facilities to indicate usage of prescribed opioids or non-usage of illicit ones.

According to a report by the Well Being Trust Fund in tandem with the American Academy of Family Physicians (3), the need to find employment is crucial for the health of individuals initially displaced by the pandemic. Workers in areas such as the retail space, service workers, hospitality, transportation, and small businesses have lost nearly all sources of income and have been relying on unemployment benefits and stimulus payments in order to survive. These stresses - in addition to feeding one’s family and making rent or mortgage payments - have added significantly to the mental psyche of so many individuals in the United States. Furthermore, those that lose their jobs lose their employment-based insurance and wait for emergencies before seeking direct medical care. The consequence to all of these factors is the increased likelihood of drug overdoses, medication abuse, and even death. Even restrictions with regard to social distancing has been shown to misuse of substances due to extended periods of isolation. A study in the Journal of Population Health Management has confirmed not only the increase in use of illicit drugs since the start of the COVID-19 pandemic but also illustrated the increase in usage of a combination of drugs including fentanyl and other illicit and harmful substances.

Authors of a study in partnership with the American Academy of Family Physicians state, "Now, perhaps more than ever, given the increased stressors associated with the pandemic, we must maintain extra vigilance and not lose ground in our continued efforts to combat our nation's drug abuse crisis."

It is quite clear that the increased factors associated with the COVID-19 pandemic has further accentuated the need to combat the opioid epidemic. Further efforts appear to be necessary to combat the opioid crisis, and it is imperative that patients continue to receive tests for these drugs and for clinicians to continue to educate them about much safer and healthier alternatives to deal with the added stresses inflicted during this pandemic. It is the hope that as the healthcare sector continues to evolve during this crisis, so does the treatment and care of those directly dealing with the drug abuse epidemic.

Centers for Disease Control and Prevention. Opioid overdose. https://www.cdc.gov/drugoverdose/data/index.html
Centers for Disease Control and Prevention. Framework for healthcare systems providing non-COVID-19 clinical care during the COVID-19 pandemic. https://www.cdc.gov/coronavirus/2019-ncov/hcp/framework-non-COVID-care.html
Petterson, Steve et al. “Projected Deaths of Despair During the Coronavirus Recession,” Well Being Trust. May 8, 2020. WellBeingTrust.org.