People with substance use disorder (SUD) are advised to take extra precautions during the coronavirus pandemic. Health officials warn that those struggling with an addiction --- particularly opioid and methamphetamine use disorders -- and those who smoke or vape nicotine or marijuana may be more vulnerable than others to the coronavirus that causes COVID-19 and to developing more severe symptoms. COVID-19 attacks the respiratory tract and can lead to serious complications, such as pneumonia and respiratory failure.
In the United States, it is estimated that 20 million people suffer from a substance use disorder. While more research needs to be conducted, the virus’ effect on a person’s lungs and weakened immune systems for individuals suffering from an addiction has prompted experts to warn of greater risk of complications. Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA) noted that “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.”
Dr. Mark Gold, 17th Distinguished Alumni Professor, University of Florida and Chairman of the Scientific Advisory Board for Addiction Policy Forum explains: “Individuals who smoke or vape are a particular concern, as vaping can cause lung damage and therefore they may be more vulnerable to COVID-19. However, the stresses associated with SUDs, the effects of opioids and methamphetamine on the pulmonary and cardiac systems and the weakening of the immune systems associated with SUDs may similarly put an individual at greater risk of complications from COVID-19.” All of these risks are occurring at a time when the traditional routes for opioid overdose rescue, intervention, and referral to treatment are shut off as the health delivery system focuses on the COVID emergency.
In addition to the disease of addiction, people with SUDs face other risks that could place them at greater risk for the coronavirus and, therefore, COVID-19. These include living in densely populated areas, untreated medical diseases that increase COVID risk, housing insecurity, decreased access to health care and greater likelihood for incarceration.
Jessica Hulsey, founder of Addiction Policy Forum, shares: “There continues to be an overall lack of access to care related to the crisis and stigma associated with substance use disorders. Stigma exposes some of the persistent feelings that many have about those with SUDs that can deter a person from seeking treatment or help, which may be exacerbated during this time of fear, anxiety, and social isolation. In addition, the uncertainty and stress associated with this national emergency can lead people who use substances to use more, people who have been treated to relapse, and Americans seem to be consuming more alcohol and other substances as coping mechanisms for stress and anxiety.”
“Use of methamphetamine, cocaine, and synthetic opioids like fentanyl are continuing to increase. While heroin availability has decreased in some large cities, fentanyl has not decreased at all. Relapses, slips, naloxone availability, and overdoses are a major concern at this time when access to EMTs, Emergency Rooms, Academic and General Hospitals are reduced due to COVID 19. Occasional substance users are drinking and using more drugs, patients with OUDs are wondering whether they need to take their MATs, patients in stable remissions are slipping as face-to-face support and recovery programs have moved online. Anxiety, loneliness, social isolation, lack of support, nihilism, depression, and despair multiply these effects,” further explains Dr. Mark Gold.
“People with substance use disorders should take precautions to minimize the risk of contracting coronavirus, such as regular hand washing, social distancing, and wearing a mask. And it is critical for people struggling with addiction to reach out safely for help. Family and friends of those suffering with a substance use disorder should also check on their loved ones regularly to ensure they stay connected and feel supported during these uncertain times,” shares Jessica Hulsey, Founder of Addiction Policy Forum.
There are precautions recommended by trusted sources that you can take to help keep you healthy. Avoid close contact with people who are sick, and take preventive actions:
Wash your hands often with soap and water for at least 20 seconds, especially after using the bathroom, blowing your nose, coughing, or sneezing, or having been in a public place.
If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
To the extent possible, avoid touching high-touch surfaces in public places–elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
Wash your hands after touching surfaces in public places.
Avoid touching your face, nose, eyes, etc.
Wear a mask or scarf - this will help prevent the spread of the virus but may not necessarily protect you from catching it so following other precautions remains important. It also
Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones).
Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
If you live in a multi-generational household, try to pay special attention to protect those above 60.
Avoid non-essential travel. Check with the authorities in your area or state. If you were planning on going outside the US, the CDC recommends that travelers avoid all non-essential international travel.
If you need to go out, it's best to check the CDC's guidance about protecting yourself and others. If you are a cancer patient, survivor, or caregiver, talk to your cancer care team about whether there are any additional precautions needed.
Guidance for people in recovery:
Social distancing and stay-at-home requirements may cause changes to recovery support, including going to see your addiction health care provider, 12 step meetings and other key programs. A wide array of online support, as well as meetings is available to fill this critical gap if you have computer or telephone digital access during this time. Addiction Policy Forum makes available a list of online support options and smartphone apps you can start utilizing today.
Taking and refilling medications for psychiatric and addictive illnesses is important. Stay connected to your healthcare and addiction provider, call them and continue your medications as prescribed. Ask about virtual options for appointments.
Guidance for people with an active substance use disorder:
For those struggling with a substance use disorder, do not share your supplies, including injecting supplies, pipes, vapes, bongs, straws or glasses.
Despite social distancing requirements, do not use opioids alone especially if injecting fentanyl or heroin. If you do find yourself alone, call or video chat a friend or family member and have them call 9-1-1 if you become unresponsive. Stock up on naloxone to have on hand where you are staying and ensure loved ones have access as well.
For individuals who Naloxone stockpile or store extra supplies and substances, consider engaging friends or family on a plan to ensure safe use.
For those getting take- home opioids or virtual MAT prescriptions, don’t sell or give them to others, and don’t take more of your MAT than prescribed.
The COVID-19 situation can also be the time to start a treatment and recovery plan. Call a local addiction treatment provider you know and trust or text Addiction Policy Forum helpline at 833-301-HELP to begin your journey today, especially if you are struggling with vaping, marijuana, opioids or stimulants like methamphetamines.