In states like Ohio, the arrival of the coronavirus pandemic has meant many healthcare providers are now combating two epidemics at once.
“We were still in the opioid epidemic and now we got hit with the coronavirus epidemic,” said Dr. Tanvir Singh, medical director of recovery services at the University of Toledo Medical Center. “And now we’re trying to balance the two.”
Despite a 4% decline in mortality from 2017 to 2018, the number of drug overdose deaths reached nearly 70,000 in 2018, according to the Centers for Disease Control and Prevention, more than two-thirds of which involved opioids.
Ohio had the fifth-highest drug overdose mortality rate in the country in 2018 with 40 deaths for every 100,000 residents and was the state with the fourth-highest total number of overdose deaths, at more than 3,900.
For Singh and other addiction specialists, efforts to address one epidemic can put patients at increased risk for the other. As cities and states throughout the country ban many public gatherings, concerns over the pandemic have compelled addiction medicine providers to limit access to their facilities and temporarily halt in-person group therapy sessions and replace them with counseling over the phone or through videoconferencing.
Efforts to practice social distancing are raising concerns that it could help worsen the opioid epidemic. Isolation creates the type of environment that can put those with substance use disorder issues at higher risk to use more and those in recovery at higher risk for relapse.
“They’re already in isolation because of drugs and alcohol,” said Dr. Chris Johnston, chief medical officer at Pinnacle Treatment Centers. “One of the goals of treatment is to break down the isolation, and now we have an illness that’s going around where a big part of the treatment is to isolate.”
And the outbreak has exacerbated long-standing problems with access to treatment services that under normal circumstances provide support to a relatively small share of those in need.
Of the more than 21 million Americans estimated to have been in need for substance use treatment in 2018, approximately 3.7 million received access to such services over the previous 12 months, according to a 2018 U.S. Substance Abuse and Mental Health Services Administration report.
But the access challenges caused by the pandemic are forcing many treatment professionals to re-examine their normal processes for providing care. Some view the current outbreak as an opportunity to identify new ways of delivering services that they hope will lead to addressing some of the long-standing barriers that have prevented more people from receiving treatment.
“I think we’re learning a lot on how we can make our services have even lower barriers still,” said Dr. Jessica Taylor, assistant professor of medicine at Boston University School of Medicine and an attending physician at Boston Medical Center.