A Brief Overview of the Opioid Epidemic during COVID-19

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From the initial research done during the COVID-19 pandemic, it is clear that opioid deaths have been increasing rapidly in recent months. As people socially distance and lose touch with their support groups, opioid abuse becomes a greater danger. Between March and May 2020, a 25% increase in drug-related deaths occurred in Ontario (2). Notably, there was an increase in overdose deaths among men, jumping from 69.7% to 78% after the pandemic struck (2). A recent American study found that Emergency Medical Service trips for confirmed opioid overdoses increased by 17% after the lockdown (3). Additionally, there was a 50% increase in suspected opioid deaths during EMS visits (3). Multiple American studies have found a clear relationship between the pandemic and opioid abuse (6,7). These numbers paint a dangerous picture. Not only is the opioid issue worsening under the strains of the COVID-19 pandemic, but past progress is also being undone. Since the lockdown began in March, there have been major reductions in social support programs and an overall decrease in illicit drug supplies (5). Researchers argue that the combination of pandemic-associated economic pressures, social isolation, and lack of regimented healthcare and treatment access is creating a new wave in the unending opioid crisis (3). With the suspension of treatment plans, it has become statistically more likely for an overdose to occur (4). Patients affected by the cessation of Opioid Agonist Therapy (OAT) programs, which treat individuals with opioid use disorder, are also more likely to begin self-medicating with street drugs (5). With such an urgent problem, the federal government is under even greater pressure to create quick and effective intervention plans. Opioid treatment experts have begun exploring proposed interventions and initiatives that may benefit patients during the pandemic. For example, the importance of telehealth, or online healthcare, is growing for two major reasons. Firstly, the pandemic’s strain on access to healthcare professionals can be somewhat alleviated by telehealth (5). Secondly, there is a growing number of patients experiencing symptoms of isolation, particularly as comorbidities to opioid addiction (5). As the number of people requiring mental health assistance grows, telehealth can provide them with efficient access to care and treatment. However, there is still a massive need for in-person care during the lockdown (4,5). Particularly, in cases of substance abuse, the need for direct, personal support is critical (5). Hence, the need for open treatment clinics is ongoing, and clinics should remain open with COVID-19 protocols. As the pandemic continues to ravage the public health sector, the extent of its impact on the opioid epidemic will become more and more apparent. However, much more research is needed in the field before the situation can be completely understood. The degree to which the two crises intersect is still unclear. More research must be done on pain management and OAT prescribing patterns during the pandemic. Because of the massive scale and complexity of these colliding crises, the full extent of the impact of COVID-19 on the battle against the opioid epidemic will be unknown for many years.

References

  1. Tyndell, M. Safer Opioid Distribution in Response to the COVID-19 Pandemic. Intl Journal of Drug Policy. 2020 Jul 27; 83:
  2. The Ontario Drug Policy Research Network, The Office of the Chief Coroner for Ontario, Public Health Ontario, Centre on Drug Policy Evaluation. Preliminary Patterns in Circumstances Surrounding Opioid-Related Deaths in Ontario during the COVID-19 Pandemic. Public Health Ontario: Nov 2020. 24p.
  3. Slavova S, Rock P, Bush H M, Quesinberry D, Walsh S. Signal of Increased Opioid Overdose during COVID-19 from Emergency Medical Services Data. Drug and Alcohol Dependence. 2020 Jul 1. 18p.
  4. Cousins G, Boland F, Courtney B, Barry J, Lyons S, Fahey T. Risk of mortality on and off methadone substitution treatment in primary care: a national cohort study. Addiction. 2016 Jan; 111(1):73-82.
  5. Sun Y, Bao Y, Kosten T, Strang J, Shie J, Lu L. Editorial: Challenges to Opioid Use Disorders During COVID‐19. Am J Addict. 2020 Apr 13.
  6. Wainwright JJ, et al. Analysis of drug test results before and after the US declaration of a national emergency concerning the COVID-19 outbreak. JAMA. 2020 Sept 18.
  7. Ochalek TA, et al. Nonfatal opioid overdoses at an urban emergency department during the COVID-19 pandemic. JAMA. 2020 Sept 18.
Ekta Mishra