Crowds gather on the Capitol steps to commemorate opioids, loved ones lost to substance abuse. (Capital Star photo by Cassie Miller).

Brian King, Andrea Richworth, Luci Patel

Since First COVID-19 Case Diagnosed in US on January 20, 2020, news of infection rates, deaths and financial hardship due to pandemics are part of our daily lives.

However, there is a gap in knowledge about how COVID-19 impacted the pre-pandemic public health crisis: the opioid epidemic. Prior to 2020, 128 Americans died daily from opioid overdoses. That tendency accelerates during the pandemic, according to the Centers for Disease Control and Prevention.

We’re a team of health and environmental geography researchers .. When social distancing began in March 2020, addiction treatment experts were concerned that shutdown could lead to an increase in opioid overdose and mortality rates. To our latest research The Journal of Drug Issues examines these trends by examining an opioid overdose in Pennsylvania before and after the statewide home stay order.

Our results suggest that this public health response to COVID-19 had unintended consequences for opioid use and abuse.

History of the Opioid Epidemics

Opioid abuse has been a major health concern in the United States for over 20 years. It mainly affects rural areas and the Caucasian population. However, the recent shift in related drugs from prescription opioids to illegally manufactured drugs such as fentanyl is primarily affecting race and ethnic groups.

From 1999 to 2013, drug abuse mortality increased, particularly between the ages of 45 and 54. First decline in life expectancy in decades for white non-Hispanic Americans.

There was a modest population of Reduced Mortality from Prescription Opioid Overdoses from 2017 to 2019, but the COVID-19 pandemic has undone many of those advances. As one of our public health partners told us, “We made progress until COVID-19 hit.”

How will Pennsylvania lawmakers deal with the opioid crisis with new emergency response guidelines?

We believe this is an urgent need for research on the relationship between COVID-19 policy response and patterns of opioid use and abuse.

Increased opioid use during pandemics

Pennsylvania is one of the states hardest hit by the opioid epidemic. It had a highest drug overdose death rate in 2018, 65%, for a total of 2,866 deaths, including opioids.

The state stay at home order, which came into force on April 1, 2020, requires residents to stay at home as much as possible, practice social distancing and wear a mask outside of the home. I did. All schools have moved to distance learning and most businesses have had to work remotely or close. Only important services were allowed to continue operating directly.

Over the next few months, general public cooperation on these missions contributed to this. Measurable decrease in coronavirus infection rate. We evaluated the data from to see how these obligations affect people’s opioid use as well. Pennsylvania Overdose Information Network Changes in monthly opioid-related overdose incidents around April 1, 2020. We also examined changes by gender, age, race, drug class, and naloxone dose administered. (Naloxone is a medicine that is commonly used to reverse the effects of an overdose.)

Analysis of both fatal and non-fatal cases of opioid-related overdose from January 2019 to July 2020 was carried out between whites and blacks and in some age groups, particularly 30-39 and 4. After the 1st of the month 40-49 groups. This means that prior to the COVID-19 pandemic, overdosing was accelerated in some of the opioid-affected populations. However, there was also an uneven increase in other groups such as blacks.

There was a statistically significant increase in overdose of heroin, fentanyl, fentanyl analogues, or other synthetic opioids, pharmaceutical opioids, and carfentanil. This is in line with previous research on the major classes of opioids that contribute to drug overdose and increased mortality. The results also confirm that synthetic opioids like heroin and fentanyl are currently the greatest threat to the epidemic.

When a pandemic and an epidemic collide

Significant changes in opioid overdose were seen during the COVID-19 pandemic, but the results don’t mention some of the drivers. In order to better understand this, we have been surveying healthcare providers since December 2020.

Key factors they emphasize as contributing to increased opioid use include financial difficulties due to pandemics, social isolation, and interruptions in personal treatment and support services.

The number of opioid deaths in Pennsylvania has increased during the COVID-19 pandemic, officials said.

From March to April 2020, Pennsylvania’s unemployment rate rose from 5% to about 16%, as a result of 725,000 unemployment benefits filed in April. Some people turned to drugs, including opioids, because the closure of their jobs made it difficult to finance housing, food, and other needs and the lack of personal support.

One of our public health partners suggested that people in the early stages of treatment or recovery from an opioid addiction might be particularly prone to recurrence. “You have financial problems because you may be working in a closed industry … [and] Add to that the problem of addiction, and now I hate going to meetings and can’t make connections. (Our public health informants remain anonymous with permission from a Pennsylvania State University human study.)

Addiction treatment counselors, especially those with past or present opioid use problems or mental health problems, said, “It is not good to be alone with your own thoughts, that is, when everyone is kind. If I was trapped… Depression and anxiety struck. “

Another counselor also pointed out depression, anxiety, and isolation from increased opioid abuse. The pandemic “got everything out of control,” they said. “Overdose, everything, everything.”

One question is whether states like Pennsylvania will continue to support telemedicine in the future. Moving from personal services to telemedicine services Increased access to treatment For some people, such as rural and elderly people, this poses a challenge. One provider stated, “It is really difficult. [rural] To use telemedicine services due to limited internet and broadband connections. In other words, the flexible form of addiction treatment may work for some people but not for others.

The purpose of our research is not to criticize efforts to contain the spread of COVID-19. Without the mandatory Pennsylvania home order, both infection and mortality would have worsened. However, our research shows that such measures have unintended consequences for addicts. Holistic Approach to Public Health May politicians work to address both COVID-19 and America’s addiction crisis.

Brian King is a professor of geography at Pennsylvania State University. Andrea Rishworth is a postdoctoral fellow in geography at McMaster University. Ruchi Patel has a PhD. A student of geography at Pennsylvania State University. You wrote this working interview, The place it first appeared.

The rise in deaths from opioid overdoses during pandemics reinforces the need for a holistic approach to public health issues. Opinion

Source link The rise in deaths from opioid overdoses during pandemics reinforces the need for a holistic approach to public health issues. Opinion

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