As we face new realities every day in order to mitigate the pandemic of COVID19, we discover new ways in which different segments of the population are affected by orders to quarantine and practice social distancing. We are also continuing to see the outcomes of the virus on certain segments of the population with particular health concerns. In the wake of the opioid epidemic, many Americans are struggling with substance use disorders and COVID19 poses unique threats to recovery.
Access to Treatment in Peril?
Some have pointed to the risk that methadone treatment poses in the current environment. There are an estimated more than 1,250 programs across the United States, which treat more than 350,000 people. These methadone programs often have strict rules, which require participants to show up at the program every day to get their dose of methadone. A single opioid treatment program may see thousands of patients a day, a scenario that could foster the spread of the Novel Coronavirus.
Under the current paradigm, those who aren't able to attend a clinic or treatment centers are unable to get their medications, casting an uncertain light on those who may contract the virus, need to care for an ill loved one, or are advised to quarantine themselves due to possible/confirmed exposure.
Advocates are calling for relaxing these rules or implementing other alternative measures that allow program participants to still have access to life-saving, addiction-targeted medication therapies, such as methadone and buprenorphine. Failure to do so, they claim, could result in a worsening of the opioid epidemic.
Currently, outpatient clinics and urgent care centers have ramped up the use of virtual visits and insurance companies are expanding coverage for these visits. Federal agencies are being called on to change policies regarding methadone distribution during a national state of emergency. The federal government allows clinicians to use virtual visits to evaluate patients, allow patients to take additional doses home, make it possible for surrogates to pick up doses when someone is ill, or deliver doses to anyone who is unable to come to the clinic.
COVID-19 Health Risks Associated with Substance Use
According to the US National Institute on Drug Abuse (an organization falling under the umbrella of the National Institute of Health), the Novel Coronavirus presents a special risk to those who use and/or abuse certain substances. The Institute warns: "Because it attacks the lungs, the coronavirus that causes COVID-19 could be an especially serious threat to those who smoke tobacco or marijuana or who vape. People with opioid use disorder (OUD) and methamphetamine use disorder may also be vulnerable due to those drugs' effects on respiratory and pulmonary health."
The NIH also warns that certain people who experience addiction issues may be more likely to experience homelessness or incarceration compared to the rest of the population. These environments present additional challenges for stopping the spread of disease and should remain an area of focus.