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What Did The Opioid Epidemic Say To The Covid-19 Pandemic

By Dr. John Rosa

“Thanks, man, I was starting to lose traction, but you’re a great dis-traction and I’m killing it again!”

It’s not a joke and it certainly isn’t funny. But, unfortunately, it’s a fact. This has been my greatest concern since the pandemic took center stage back in February. As reported recently at Quartz (qz.com) by geopolitical reporter, Annalisa Merrelli, in an article entitled, Covid-19 is undoing a decade of progress on the opioid epidemic, “experts are worried the progress made so far on tackling the opioid crisis may be jeopardized.” https://qz.com/1889798/covid-19-is-making-the-opioid-crisis-much-worse/

The COVID-19 pandemic is without question the perfect storm that is allowing the opioid epidemic to spread freely again and take the lives of so many without even being noticed. The isolation, social distancing, uncertainties, and job losses, combined with decreasing support systems, are all well-known risk factors for increasing drug use. For people who have been in recovery, the pandemic provides the perfect excuse and environment in which to relapse.

Job Loss And Loss Of Insurance Coverage

Social distancing and isolation aren’t the only reasons that contribute to relapse. Consider the number of patients who find themselves suddenly without insurance who lost coverage through loss of work. It takes time to enroll in Medicaid, which results in loss of continuity of treatment, and ultimately increases the risk of relapse and overdose. And of course, the hardest hit areas economically are the rural and poorer communities where opioid abuse is always higher risk.

Opioid Addiction Research Comes To A Halt

In addition, losing ground in this effort is going to have long-term effects since much research has come to a halt because of the pandemic – especially clinical research. With so many COVID-19 patients to take care of hospitals simply don’t have sufficient to continue their work on opioid addiction research. And, where patients were being studied in prisons, doctors no longer have access due to prisons being closed to external visitors.

Fatal Overdoses Hard To Confirm Under COVID-19 Shadow

In the aforementioned Quartz article, it is stated that medical professionals around the country have seen increases in fatal overdoses. Though according to the director of the National Institute on Drug Abuse, “it’s hard to quantify by how much, because not only does the official data lag behind incidents, but its collection relies on autopsies to confirm overdose as the cause of death. With coroners and pathologists overwhelmed by Covid-19, performing such checks has been impossible in many cases, which will likely result inaccurate data for 2020.” https://qz.com/1889798/covid-19-is-making-the-opioid-crisis-much-worse/

One Crisis Overshadowing Another Is No Joke

The daily deaths throughout the U.S. from COVID-19 is just under 1,000 – around 941. The pre-pandemic daily death toll from OUD (opioid use disorder) was 150. Clearly unimpressive from some perspectives. However, from the perspective of someone who has seen the damage inflicted on family members, colleagues and friends due to opioids, who are not included in the damage or death reports, I think that statistic could be much higher.

Losing a child, a husband, a father or wife, a sister, a mother, or a friend to opioid overdose causes irreparable damage and heartache to those left behind. Some of those loved ones feel like they should have or could have done something to prevent the death. In the case of COVID-19, the killer is an invisible virus. No one knows where it is, who is potentially carrying it. In other words, there’s little notion of having a sense of control involved. Short of following safety protocols that include wearing a mask, staying safely socially distanced and washing hands there’s really nothing much one can do.

The thought that one might have been able to prevent a loved one’s death to drug overdose is equally out of anyone’s control except the person who is addicted. Addiction is as unpredictable as COVID-19 and deaths from both are equally tragic.

I find it even more tragic how the appearance of one crisis can so quickly decimate the progress that’s been so hard-won on another crisis. I have faith though that despite all appearances there will be positive outcomes learned from both of these diseases wreaking havoc on our country and the world at large.

The Explosive Combination Of Opioids, Isolation And COVID-19

Isolation has historically been used as a form of torture around the world. We humans need interaction with other humans. We need the warmth of connections, family, friends, colleagues. So when I think about people who have become addicted to opioids that sooner or later isolate themselves from either a life they want or a life they remember, it is another form of torture that is as devastating as the drug itself.

Drug Abuse Is A Mechanism Of Escape

If someone became addicted because a doctor prescribed opioids instead of treatment or if someone tried it at a party to get high and fell into the trap of using, the dependency usually serves the same mechanism of escape. People with a difficult life like the feeling of not caring about that difficult life. People with a great life who get caught up in using become isolated as they continue to cause friction and distance from the ones they love which in turn demands more use.

Psychology tells us that people begin abusing drugs often as a result of being bored and having too much time on their hands. Furthermore, it is known that as abuse progresses into addiction, boredom becomes even more of a factor because the drug actually rewires the brain to receive more gratification from the opioid than from normal activities.

Isolation Without Routines

Normally, there is some routine in place that keeps most people from abusing drugs at all hours of the day. However, when work, school and social activity come to a halt, people struggling with addiction have to face more cravings while also having fewer options for combating them.

Depression and anxiety also increase with isolation. Being isolated makes it more likely for a person to estrange themselves from friends and family.

Along Comes COVID-19

COVID has made those susceptible to use opioids much more likely to do so. I look at the opioid crisis as a pile of burning wood that has been sending smoke signals to our country demanding help.

The wood is the susceptible population.

The drying of the wood is the long standing cover up and greed of pharmaceutical companies. The gun powder on the wood pile is the overprescribing by doctors.

The gasoline poured over the pile is heroin and fentanyl

– and here comes COVID-19 walking by and takes that last drag on a cigarette before flicking it towards the pile.

Kaboom!

The explosion has happened. Opioid users are now more isolated than ever, more vulnerable than ever, more terrified than ever, more tortured than ever. We have a bigger problem than ever on our hands as this global pandemic disrupts all our lives in one way or another. The opioid epidemic was already spiraling out of control and now it’s going to be even more challenging to pick up the pieces.

Increased Opioid Misuse Due To Abandoned Safety Measures

There are millions of people that are dependent on opioid medications and in most areas of the country, there are rules for doctors to follow that help their patients get the medications they need for their own personal use. In addition, these rules were instituted in order to make sure the patients receiving the drugs are not selling them instead of using them for their own pain control needs.

Safety Rule number one is: If it’s the first time a doctor is prescribing a narcotic to a patient, it must be during a face-to-face encounter. Rule number two is: there must be follow-up visits for urine testing to make sure the patients are taking the meds and not diverting them. This also shows the doctor if there are other substances that would raise an alarm.

These two safety measures were helpful in preventing the rampant misuse of opioids. However, the DEA declared that during the COVID emergency doctors can prescribe controlled substances by telemedicine for a new patient and without continued tracking of existing patients by urine tests.

It isn’t difficult to imagine the possibilities of misuse without these safety measures. Another issue is that there are a lot of rural areas where people do not have access to telemedicine and their doctor’s office is closed.

Unfortunately, we have already begun to see the results of having these two safety measures abandoned. In cases where drug dependency is strong enough pills are being purchased on the street. Eventually, that becomes too expensive for many and the switch to less expensive heroin and fentanyl Is inevitable.

The telemedicine initiative was clearly necessary in light of the COVID emergency. However, in many instances it simply created another problem that leads to overdose deaths and misuse.

Opioid Deaths Increasing Across The Country As Pandemic Continues

By Dr. John Rosa

It’s been 3 months since the U.S. went into shelter-in-place mode due to the global COVID-19 pandemic. My immediate concern was how those in recovery from opioid use would fare without being able to have face-to-face substance-abuse treatment. And, now, the numbers are beginning to surface.

According to a report from the American Medical Association, they are greatly concerned “by an increasing number of reports from national, state and local media suggesting increases in opioid-related mortality – particularly from illicitly manufactured fentanyl and fentanyl analogs. At least 30 states have reported increases in opioid-related mortality…” https://www.ama-assn.org/system/files/2020-06/issue-brief-increases-in-opioid-related-overdose.pdf

Another recent article out of Martinsburg, WV, reports that overdose deaths in the tri-state area are outpacing COVID-19 related deaths. In Erie County New York, health authorities report that there has not been an increase in opioid use locally since the pandemic, but because of social isolation, more people are using alone, making it less likely someone is around to help them in the event they overdose. Jacksonville, Florida has seen a 20% increase in overdose calls from February to March.

The national public health group, Well Being Trust, suggests as many as 75,000 people could die during the pandemic due to drug overdose. According to CNN, “The group is sounding the alarm that the growing unemployment crisis, economic downturns and stress caused by isolation and lack of a definitive end date for the pandemic could significantly increase so-called “deaths of despair” unless local, state and federal authorities take action.” https://www.cnn.com/2020/05/08/health/coronavirus-deaths-of-despair/index.html

Integrative Medicine and Chiropractic clinics have been open and available to treat people in pain throughout the pandemic. However, in the past two weeks, in addition to COVID-19, a new epidemic has burst onto the scene that is sure to have serious consequences for those already struggling with addiction, mental and emotional health issues. It is the systemic virus of racism, inequality and injustice which has not only contributed to the use and abuse of opioids but is visible in all aspects of healthcare. Drug addiction, isolation and social injustice are massive contributors to chronic stress feeding many ails as we face today. Triple epidemics have surfaced simultaneously. It seems clear that a seismic change in the way we address the problems in this country is necessary.

Not Everyone Will Be Able To Zoom Through The Pandemic Without Relapsing

Some people with substance abuse challenges may be able to use the pandemic as motivation to steer clear of drugs and stay clean. Some may be inspired by attending Zoom meetings while others simply will not be able to endure the overabundance of unstructured time, not being able to attend recovery meetings in person and the feelings of anxiety caused by COVID19.

The Appalachian region, a 205,000-square-mile-region encompassing the Appalachian Mountains, stretching from southern New York state to northern Mississippi is known for an inordinately large number of opioid overdoses and deaths. Since the pandemic began, according to a cnn.com article, “substance abuse experts, doctors and state officials have seen a rise in relapses.” https://www.cnn.com/2020/05/14/health/opioids-addiction-appalachia-coronavirus-trnd/index.html

One person who used the pandemic as motivation to change was quoted in the article as saying, “The fact that I have young children now and I would put them above anything, even my addiction. I know that for a fact.. I would go through the sickness just to be sure that my kids were safe and not getting sick and potentially dying.” https://www.cnn.com/2020/05/14/health/opioids-addiction-appalachia-coronavirus-trnd/index.html

People with substance abuse disorders are not only at risk of relapsing, their health is compromised due to damage that’s been caused by opioid abuse, and so are also at heightened risk of dying from the virus. Drug use weakens the immune system and makes users more prone to infections and infectious diseases. Opioid use also appears to result in a rapid progression of any disease. Typically opioid use has been related to respiratory issues, pulmonary infections and viral infections, all of which are conditions caused by COVID19.

If you have a loved one who is addicted to drugs, please reach out as often as you can to help them get through this challenging time. Explore the use of digital platforms to have virtual visits if possible. This is not an easy time for anyone, and it is particularly difficult for anyone addicted to opioids, alcohol and drugs of any kind.

The Loneliness Of Addiction Magnified During COVID19 Pandemic

By Dr. John Rosa

As the COVID19 pandemic continues with no ending point in sight, getting help for drug addiction is more important than ever. Unfortunately help for addicts is not readily available with the closure of clinics for medication assisted treatments and well as alternatives for chronic pain management. And social distancing requirements make it even more difficult on addicts

This lack of help and human interaction for people in recovery from drug addiction is creating the perfect environment for relapse. At least those who suffer from Alcohol Use Disorder (AUD) still have access to alcohol since liquor stores have been deemed essential businesses in most states. In addition there is very limited medical treatment for AUD and keeping people out of hospitals is important. This is one important reason why liquor stores have been deemed essential. There are more than 15 million people in the U.S. who have AUD and it’s imperative they have access to their substance of choice.

Without an equivalent method of help for drug addiction, the rate of relapse and overdoses will put an even greater demand on hospitals that are already overburdened with COVID19 patients.

The Rat Park Experiment Proves How Loneliness Fuels Addiction

Drug addiction is a disease. It is a disease caused by loneliness, fear and uncertainty. To help anyone who may be unfamiliar with how loneliness fuels addiction, I am posting the results of a famous experiment called The Rat Park Experiment as posted on. Psychcentral.com.

“One of the most infamous drug experiments that was proliferated during the “War on Drugs” era in the United States was the rat experiment. Rats were placed in a cage containing a feeder bottle of water laced with cocaine and, unsurprisingly, they consumed the cocaine in enormous quantities until they died. This experiment supposedly displayed why even just trying an illicit substance could get you hooked, but it didn’t satisfy Bruce Alexander, a researcher at Simon Fraser University.”

“He recreated the experiment and tweaked one important variable: the cage. In the original experiment, the rats were in a small cage by themselves with no company, no space, and no exercise toys to play with. In Bruce’s new experiment, he constructed Rat Park, filled with everything a rat could desire from tunnels and turn wheels to other rats to play with. This time around, none of the rats got hooked on the drug laced water, which this time was a morphine drip. Alexander’s main point was that it wasn’t necessarily the drug that created addicts, but the cage they were trapped in that drove them to become addicts. When a rat had plenty of things to do, space to be free, and other rats to socialize with, it was far less likely to develop a crippling addiction.”

https://psychcentral.com/blog/why-addicts-are-often-lonely-people/

Efforts Must Be Made To Keep Addicts Safe From Withdrawal, Relapse And Overdose

I imagine by now regular folks who are not addicted to drugs or alcohol are beginning to feel the pressure of social isolation. Some of these people may decide to have a drink. Some may even experiment with drugs. This challenging time is helping many people understand how easy it is to fall prey to addiction during times of uncertainty, fear and loneliness. If you have a loved one who is addicted to drugs, please reach out as often as you can to help them get through this challenging time. Explore the use of digital platforms to have virtual visits if possible. This is not an easy time for anyone and it is particularly difficult for anyone addicted to opioids, alcohol and drugs of any kind.

The COVID-19 Pandemic Is Making The Opioid Addiction Epidemic Worse

By Dr. John Rosa

Isolation and loneliness have an overwhelming effect on people who are addicted to drugs and other substances.

It has been shown that many people who feel more socially isolated are the ones who are more susceptible to mental health and substance abuse issues. And, it has been noted that addiction to drugs and alcohol may not just be an effect of isolation but also one of the causes of it. Anxiety and isolation will often be the cause of relapse for many who suffer and it may be a calling to those who have never used to start now.

When a pandemic that requires people to self-isolate crashes headlong into an ongoing epidemic that is fueled by loneliness and isolation, things are going to get increasingly harmful. And that is exactly what is happening as the COVID-19 pandemic crosses paths with the opioid epidemic.

Alternative Therapy

With alternative methods of treating chronic pain, including chiropractic, physical therapy, massage and acupuncture being limited or completely unavailable due to COVID-19, people that have controlled symptoms with no or little medication have nowhere to turn. On top of that, add an overburdened medical system, with every nurse, doctor and other medical professional being called upon to help in this crisis, those who are addicted may be afraid to go to the hospital or urgent care for fear of becoming infected with the virus. There has, however, been in increase in tele-health visits, which is taking pressure off of the healthcare system with in-person encounters. But now a new problem has come up. Due to the “stay-at-home” orders in most states, the doctors are more inclined to prescribe pain killers rather than refer patients for any other kind of treatment.

Catch-22

It’s a definite catch-22 no matter how you look at it. In the pandemic social isolation is going to save lives. In the opioid epidemic social isolation is likely to cause a new addiction, relapse or perhaps even death. I know we have our hands full, but we must find a way to help this very vulnerable segment of our society in the midst of one of our most challenging times.

The Effect Of COVID19 Pandemic On The Opioid Epidemic

By Dr. John Rosa

We’re in the midst of a global pandemic.

The way a nation takes care of all of its citizens is a reflection of that nation’s evolution as human beings. So far, here in the U.S. we don’t get a great score as a global pandemic adds to a score of other challenges.

We, as a nation have been slogging through an opioid epidemic since the early 1990s that was brought on by the very people who are supposed to be most concerned about the health and well-being of their fellow humans. Efforts to stop the blatant over prescribing of addictive drugs has been slow and in some medical specialties not at all. Even today, if you go to the doctor or even the dentist for a simple ache or pain, the first thing most do is reach for their prescription pad to give you pain killers. The point is, we could be doing a lot more.

Now, here we are in the midst of a virulent global pandemic. And, the big deal about this is that every single person is at risk. This is a reality that cannot be ignored. No one can be judged as being weak or an addict if they get the Coronavirus. Unlike the people who became addicted to a drug that the medical establishment knew was highly addictive.

Social Isolation More Difficult For Those In Recovery

Most of us humans are by nature social creatures. During the social distancing and self-isolation required during the COVID19 pandemic, many people will be able to handle the lack of socializing for a while. We have technology that allows us to visit with our friends and loved ones. However, while most of us prepare to hunker down at home and self-isolate with our favorite foods and healthy supplies of toilet paper, there is a segment of the population that will have a very difficult time with social isolation.

People who are addicted to opioids, alcohol and other drugs and have been attending 12-Step programs will no longer be able to meet and talk about their challenges. For these people, isolation actually feeds addiction. Patients that rely on Chiropractic, physical therapy and acupuncture for pain control are finding it hard to find clinics that haven’t shut their doors. Relapses are already being reported at a higher rate in just the last few weeks.

A Global Pandemic On Top Of An Opioid Epidemic

We are in a strange, historic time and critically important time. Who knows how this situation is going to evolve? Lives will continue to be lost as a result of both COVID19 and drug overdoses. It is thought that the COVID19 virus will eventually stop spreading, as viruses do. Though we don’t know how long it will take for it to run its course. However, the opioid epidemic will still be with us and unfortunately the likelihood is that it could be more virulent than ever.

I pray for the safety and well-being of everyone during these unprecedented times. My heart goes out to all those who have fallen due to COVID19 and to their families. I pray for the safety of all those on the front lines who serve in the hospitals, the police and other public servants, supermarkets and other essential services personnel. I thank you for your courageous service.

And I pray for all of those who continue to suffer the pain of addiction. Please stay well and safe.

65,000 Toddlers A Year Exposed To Drugs And Many Die As A Result

By Dr. John Rosa

Prescription drugs can affect more than those who have them prescribed.

Very young children, I’m talking about toddlers, are being irreversibly harmed and/or are dying at an alarming rate due to the fact that they are getting access to drugs intended for their parents or grandparents.

In a recent Mercola article entitled “Pediatric Drug Deaths On The Rise,” it was said that, “The Journal of Pediatrics reviewed patient records from the National Poison Data System of the American Association of Poison Control Centers.” In that review the records showed “that 453,559 children aged 5 or younger were admitted to a health care facility following exposure to a potentially toxic dose of a pharmaceutical drug between 2001 and 2008.”

According to the article, “Forty-three percent of all children admitted to the hospital after accidentally ingesting medication ended up in the intensive care unit, and prescription (opposed to over-the-counter) medications were responsible for 71% of serious injuries, with opioids, sedative-hypnotics and cardiovascular drugs topping the list of drugs causing serious harm.”

Think About the Consequences

The percentage of people over 60 that are on several medications is alarming in itself but when you think about how many of them care for their grandchildren you can imagine my concern. The labeled, days-of-the-week pill boxes are given to the majority of these people and what scares me is that it looks like a child’s toy with snapping plastic compartments with pretty colored objects inside.

Be Extra Cautious

If you are the parent or grandparent of young children, please be extra careful with your medications. Make sure you keep your medications safely stored away from where any child could get them. That means, somewhere other than the night stand. In addition, be sure to keep the Poison Help number in your phone, and make sure your babysitter or caregiver has it. In the U.S., the Poison Help number is 800-222-1222. If you suspect your child has taken a prescription or OTC medication, even if he or she is not yet exhibiting symptoms, call the Poison Help line immediately.

The Opioid Epidemic Won’t Go Away If We Ignore It

By Dr. John Rosa

Chances are the opioid epidemic has wreaked havoc in your home or community.

If it has hit close to home do you feel helpless in the face of this devastating epidemic? We humans tend to stick our heads in the sand when the going gets rough, hoping that whatever problem we are avoiding will disappear.

The opioid epidemic is not going to go away no matter how we try to ignore it. Those who have been left in its wake are the ones who are most likely to take some kind of action. But, we all have a responsibility to do something to help our children and loved ones avoid or turn away from the devastation of opioid abuse in order to save their lives. But how? Where do we begin?

Talking Might Help

Talking about possible solutions might be a good starting place. Discussing other methods for dealing with pain could be another. Both of these topics, as well as many others help people who have been adversely affected by the opioid crisis feel as if they are doing something. And that feels better than doing nothing.

Community Outreach

What can your community do to create greater interest in helping to solve the problem?

We need to get to the children. We need to get into the schools and speak about the crisis to the children. We have to inspire the kids to stay away from drugs and to help their friends who may have already started on the path to destruction.

Make Sure You Aren’t Contributing To The Problem

As parents we must make sure our medicine cabinets are cleared of old pain pills and other drugs that kids may be tempted to experiment with. We have to talk about this uncomfortable topic and be vigilant in looking for signs of drug use in our kids. Making kids angry is far better than watching them die. So, don’t be afraid to talk about drug use with them.

Nothing can compensate for the loss of a child or other loved one. This epidemic affects all ages, socioeconomic classes, races and religions. Opioid Use Disorder is rampant throughout the country and among high functioning professionals.

The Same Thing Happened 100 Years Ago

Back in the 1890’s, Bayer, the aspirin maker marketed heroin in the same way opioids have been marketed in the current opioid epidemic. “Bayer targeted physicians, which led to hundreds of favorable clinical papers, “a form of advertising that would be reprinted in myriad newspapers and magazines. The Boston Medical and Surgical Journal gushed: “Heroin possesses many advantages. It’s not hypnotic and there’s no danger of acquiring a habit.””

Sounds very familiar. The sad truth is that there are many co-conspirators who are not facing the burden of responsibility for the current epidemic. I’m talking about the physicians as well as the regulators who failed to do their duty and protect the public.

Let’s Keep Talking

If we talk about it enough, maybe the regulators will get the message and do their job instead of lining their pockets while so many innocent people die. If you, or someone you love is dependent or addicted to opioid drugs, please seek help before it’s too late. If you would like to learn more about the Opioid Crisis as it relates to awareness, prevention and treatment or schedule a corporate or organization seminar contact us at DrJohnRosa.com. Here you will learn how to connect you, your company or organization with the leading experts on the crisis and how to help your community stay safe.