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COVID-19 May Worsen the Opioid Crisis

The rapid and unprecedented spread of the novel coronavirus has revealed massive gaps in our nation’s public health and support infrastructure, and some of the most vulnerable patients are those who are already fighting another epidemic: opioid addiction.

In spite of extensive interventions, enormous amounts of funding, and the rapid expansion and easy availability of overdose reversal drugs like naloxone, the number of deaths continues to rise.

Mandated shelter-in-place orders and shutdowns have disrupted access to medications such as methadone or buprenorphine for some people with opioid use disorder (OUD) because of strict government regulations about how and where they are dispensed.

That makes the OUD population more vulnerable to seeking drugs on the street or through other black market sources, which may put them in harm’s way during the coronavirus pandemic, according to an article by addiction medicine physicians Dr. Ximena A. Levander and Dr. Sarah E. Wakeman in health and medicine publication STAT.

Government agencies could follow the lead of physician groups and outpatient clinics who easily converted to telemedicine and virtual visits by adopting more flexible policies for evaluating OUD patients.

Changes such as allowing patients to take additional doses home to minimize the frequency of visits, allowing a surrogate to pick up their medications if they become ill, or arranging for home delivery of their medicines could make an immediate and positive difference, the doctors wrote.

Leading up to mandated stay-at-home orders, many federal, state and local officials urged people to prepare by stocking up on essentials like food and prescriptions. OUD patients can’t do that with controlled substances like methadone, which makes them more susceptible to relapse, the authors said.

In order to protect the gains that have been made in recent years to slow the growth of opioid abuse, and in the interest of public health, established protocols might need to be temporarily modified in this unusual era of extended closures.

Proactive actions right now could have lasting positive effects for populations that struggle with OUD when they face new, unexpected and long-term health threats from coronavirus, they said.