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When an Epidemic and Pandemic Collide: Solutions Exist and We Must Act Now

The intersection of COVID-19 and the opioid epidemic put the American healthcare system in a challenging position. Cases surge throughout the country, forcing hospitals to focus on the immediate public health threat of COVID-19 rather than other ongoing public health concerns. Despite declining media coverage of the opioid epidemic, studies show an increase in substance use since late March of 2020 indicating a worsening of the epidemic. The American Medical Association attributes social distancing, a dramatic increase in unemployment, and widespread economic deterioration to the overall increase in feelings of isolation and anxiety, which are common triggers of substance use disorders. Beyond that, COVID-19 presents a unique set of challenges for those in recovery; treatment centers, and outpatient services operate differently if at all due to social distancing guidelines. 

Another major cultural shift results from the lack of a unified response to COVID-19 from the US federal government; American citizens continue to lose their jobs. Preliminary research shows that unemployment is one of the largest contributors to the increase in substance use disorders during COVID-19. Daniel Buccino of the Johns Hopkins Broadway Center for Addiction writes, “At first, some of our patients were resilient and resourceful in staying drug-free. As time went on, it started getting harder for them” (Winer 2020). 

Unemployment has increased dramatically due to COVID-19, but the issue has been tied to opioid use before COVID-19. Research conducted in 2017 by economists at the National Bureau of Economic Research found that “As the county unemployment rate increases by one percentage point, the opioid death rate per 100,000 rises by 0.19 (3.6%) and the opioid overdose ED visit rate per 100,000 increases by 0.95 (7.0%)” (Hollingsworth, Ruhm and Simon 2017). Macroeconomic shock affects opioid use in “normal” times making the COVID-19 pandemic a perfect storm as it brings economic downturn and mass unemployment coupled with isolation and uncertainty. Coupled with a lack of access to care due to the stress on the health system from the immediate threat of the virus, those in recovery from a substance use disorder find themselves in an exceptionally challenging position. 

The solution is twofold. First, healthcare providers need to innovate in order to reach struggling patients. Solutions like Aspenti’s mobile health unit allow healthcare professionals to reach the most vulnerable population without putting themselves or their patients at risk. Second, economic relief provided by the federal government and an expansion of unemployment benefits are crucial resources for the health of the population in these challenging times. Solutions to the pandemic and opioid epidemic are complex and intersected, but until the economic recession due to COVID-19 subsides, it is more difficult than ever for those with a history of substance use to improve their situation. 

Hollingsworth, A., Ruhmn, C., and Simon, K. (2017). MACROECONOMIC CONDITIONS AND OPIOID ABUSE. National Bureau of Economic Research. https://www.nber.org/papers/w23192.pdf

Devivo, A. (2020). Aspenti Health™ launches a Mobile Unit for Urine Drug Testing Collections. https://aspenti.com/aspenti-health-launches-a-mobile-unit-for-urine-drug-testing-collections/

Robezieks, A. (2020). COVID-19 may be worsening opioid crisis, but states can take action. https://www.ama-assn.org/delivering-care/opioids/covid-19-may-be-worsening-opioid-crisis-states-can-take-action

Weiner, S. (2020). COVID-19 and the opioid crisis: When a pandemic and an epidemic collide. https://www.aamc.org/news-insights/covid-19-and-opioid-crisis-when-pandemic-and-epidemic-collide

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