A Crisis Within A Crisis: How COVID-19 Is Making The Opioid Epidemic Worse

COVID-19 has pushed many national emergencies into the background. One of the major issues that has taken a backseat in the midst of pandemic chaos is the opioid epidemic. While it doesn’t have the same fear inducing numbers as the pandemic, in 2018, 47,600 people died from opioid related overdoses.  With the coronavirus dominating our collective resources, headlines and energy, it is difficult to quantify exactly how much the virus is worsening the opioid epidemic, but media in regions all across America are reporting increasing opioid related fatalities. Fentanyl and cocaine cut with fentanyl are responsible for much of the overdoses.

Take Dupage County in Illinois just West of Chicago.  Dupage County has reported a sharp spike in overdose deaths this past May. “In the past three weeks, we have had 20 overdose deaths, mainly due to opioids,” said Richard Jorgensen, MD, the DuPage County coroner. 

This trend can be seen in areas across the country.  Why is this happening?

There are a few potential reasons.  First, it is possible that there is a new, deadlier drug combination circulating.  Fentanyl and drugs cut with fentanyl is often consumed unknowingly and is incredibly deadly. 

Second, while the emergence of the widespread usage of telehealth in lieu of in person check-ups has increased access for some, lack of internet and/or computers has made it more difficult to receive treatment for others. The American Medical Association has issued a report that details what actions states can take to help those battling with opioid addiction during the COVID-19 crisis.  Some of these steps include the following:

• Governors must adopt the new SAMHSA and DEA rules and guidance in-full for the duration of the national emergency—this includes flexibility for evaluation and prescribing requirements using telemedicine;
• States must enact as part of their own Emergency Orders and other actions a complete removal of prior authorization, step therapy and other administrative barriers for medications used to treat opioid use disorder;
• States must remove existing barriers for patients with pain to obtain necessary medications. This includes removing arbitrary dose, quantity and refill restrictions on controlled substances; and
• States must enact, implement and support harm reduction strategies, including removing barriers to sterile needle and syringe services programs.

For more information, you can read the full report here. 

Social distancing, isolation and stress have also increased the onset of mental health disorders and precipitated relapses among many who suffer from substance abuse, and can make current usage heavier in those currently struggling with addiction.  “As you may have seen, Friday night to Saturday night our county saw 28 nonfatal overdoses—this is a high number for our county,” said Anahi Ortiz, MD, referencing Franklin County, Ohio. “COVID-19 has showed us the vulnerabilities and deficiencies in our addiction services—in addition, it has increased the mental health needs of this population.”

As mentioned, the current reigning chaos makes it difficult to fully understand the scope of the problem and its eventual impact.  Increases in suicide, substance abuse, non-COVID-19 deaths from an overburdened and failing private medical system, people who died from COVID-19 at home and never made it to a hospital, the opioid epidemic–the impact of all of these will be something we are left to attempt to quantify and understand in the aftermath of the pandemic.  We do, however, have concrete and actionable items that states can take in order to mitigate the effect of COVID-19 on those already suffering from another deadly public health crisis.

To read more about how COVID-19 is worsening the opioid epidemic, click here.

Yours in Strength,

The Take Back Control Team