Deaths resulting from drug overdoses in the U.S. increased by a shocking 30% over a one-year period of the COVID pandemic. The most significant mortality numbers involved fentanyl and other “synthetic” opiates. There was also a 46% increase in deaths from psychostimulants (mainly methamphetamine) and a 38% increase in cocaine overdose deaths. These many drug overdose deaths tied to the COVID pandemic for a couple of reasons.

Mirroring these alarming statistics is the increased risk that someone with a substance use disorder (SUD) diagnosis will contract COVID. A study by the National Institute on Drug Abuse (NIDA), using electronic health records from 7.5 million patients, found that patients with a recent diagnosis of SUD were nine times more likely to contract COVID. For those with an opioid use disorder, the increased risk was 10-fold. 

If an SUD patient does contract COVID, the outcomes are also significantly worse than for a non-SUD patient (death from 6.6% to 9.6% and hospitalization from 30% to 41%). 

Of course, the pandemic shut-downs were a major factor in these relationships. Access to medication and peer groups decreased, and the added stresses from social distancing pushed more people into illegal drug use. And reversing drug overdoses with Naloxone (Narcan) is much less likely if a patient is job-less, homeless, or not socially involved with others. 

Government programs and rules were modified to try to take these factors into account. For example, a requirement for methadone treatment had been that a patient present to the methadone clinic on a daily basis. The rules were relaxed to allow some patients to bring home methadone. And prescriptions for another drug — buprenorphine – were allowed during telemedicine visits. NIDA is now studying how the changes caused by the pandemic have impacted drug abuse and treatment.         

Dr. Nora Volkow, NIDA Director, pointed out that prioritizing research into drug abuse has been difficult. Many promising approaches have been developed, but are not effectively implemented. A major problem, she points out, is that those with drug abuse problems are stigmatized, and the health care system tends to discriminate against them. She noted that “we need to work together to address and get rid of stigma because it interferes with the outcomes of the patients and long term it’s actually much more costly.”