Research Is Needed to Address the Intersections of Substance Use and COVID-19

Nora D. Volkow, M.D.

The challenges of life during the COVID-19 pandemic are greatly magnified for those with chronic illnesses, who may have less access to needed care and support. This is especially true when those health conditions make them more susceptible to contracting or becoming seriously ill from COVID-19. People with substance use disorders or who are struggling to recover fall squarely in this category and research is urgently needed on the intersections of COVID-19 and substance use and related health issues. Such research could not only benefit some of the most vulnerable groups, but valuably inform efforts to address the pandemic more generally.

People with substance use disorders are potentially facing challenges on many fronts. Those who use opioids, for instance, could be at increased risk for COVID-19 or its worst complications and consequences, both due to opioids’ effects on respiration and as a result of various social consequences of opioid addiction. The need to obtain opioids as well as, in some cases, lack of stable housing or imprisonment may place these individuals at greater risk of contracting COVID-19. On the other hand, physical distancing is making it harder for people with opioid and other substance use disorders to access treatment, harm reduction, and recovery supports (such as 12-step groups) that may be a crucial social lifeline. This also reduces the chances for overdoses to be reversed by bystanders with naloxone. People with substance use disorders may also avoid or delay visiting a hospital in fear of the stigma attached to their addiction.

Unfortunately, while the nation shifts its attention to the pandemic, there is a risk of losing sight of our efforts at curbing drug-related mortality. As healthcare systems around the country become overloaded and inconsistencies in testing and reporting persist, it is hard to know how severe the impact on people with opioid use disorder and other vulnerable populations will be. The Office of National Drug Control Policy reported an average 20% increase in overdoses in the first four months of 2020 in six states that had relatively high-quality data, compared to the same months the previous year. It is crucial that researchers and healthcare systems gather and share data on overdoses and relapses as they relate to the pandemic so that preventive measures can be designed and deployed.

Dr. Nora Volkow is the Director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health.

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