Unless you’ve been living under a rock, you’re probably aware of the COVID-19 pandemic. It’s all over the news, social media, and is dominating most conversations we have. But what isn’t being talked about is how specific populations may be affected by the virus, particularly those struggling with substance abuse. This country’s drug epidemic has been the talk of the nation for the last few years, with tons of time and money poured into solving it. But what’s happening to those people now, and what will happen as this virus progresses?
There isn’t a blanket answer to this question, mostly because we don’t know. We’re entering uncharted territory, at least for this country, where this set of factors doesn’t have a precedent. But we’re learning what COVID-19 is and how it works, and we already know about drug addiction and its effects on a population. This makes us able to predict what will likely occur when these two factors combine. Suffice to say; it isn’t pretty.
Like most coronaviruses, COVID-19 attacks the respiratory system of its victim. Those who die from the virus do so because of respiratory failure. The lungs become so compromised that they cannot function properly, requiring intubation and ventilation. A patient’s survival becomes dependent on oxygen and whether their lungs can eventually recover. One thing we’ve learned is that those with underlying conditions that affect their respiratory and cardiovascular systems are particularly at risk, as these systems are responsible for the absorption of oxygen and circulation of oxygen-rich blood throughout the body.
We also know from secondhand experience that once a geographic area is hard-hit by the virus, its medical systems become overwhelmed. Whether it’s not enough beds, workers, or equipment, hospitals have had a notoriously difficult time housing and treating all the patients. This has led to makeshift, temporary hospitals being constructed in a matter of days, and people being called out of retirement to volunteer their time to help victims, often at the risk of their own lives. In other countries, medical professionals have been placed in horrendous situations, where they must decide which patient gets the last ventilator.
When we look at people who struggle with addiction, a few things stand out. First is their already increased risk of infectious disease. Substance abuse is a risky lifestyle by nature, and drug users are often taking substances of unknown origin and makeup. Since we know that COVID-19 can survive outside of the body on inorganic materials for hours and even days, this means the infection can occur from handling drug packaging and consuming drugs. These drugs are often smuggled from other countries and go through many hands, so it’s anyone’s guess if they’re contaminated. Then there’s the sharing of drugs and drug paraphernalia. In addiction judgment frequently falls by the wayside as the person becomes increasingly compelled to use drugs at all costs. This is why things like needle sharing exist, despite the fact that it may seem illogical to anyone else. HIV and Hepatitis can run rampant among drug users. There’s no reason to assume that COVID-19 wouldn’t follow this same path, especially when you add in the ease of transmission through sharing smoking devices, joints, or other paraphernalia.
Currently, those who might wish to seek treatment during this time are in quite a quandary. Treatment centers were not set up to withstand a viral assault like COVID-19 because their model is the virtual antithesis of social distancing. People live in a near communal setting at inpatient facilities, and outpatient programs mainly consist of “group” where many patients gathered together for group therapy. And those involved in Medication Assisted Treatment, or MAT, still have to go to clinics daily in most cases to receive their daily dose. While various governing authorities have made some provisions, there is no real direction for these programs besides increased sanitation and allowing patients to take home up to two weeks’ worth of medications if they’re ill. These factors add to the list of how substance abuse increases one’s risk of exposure to the virus.
Finally, there’s the fact that drug abuse compromises a person’s immune system and ability to fight infections. This can occur in a couple of ways. Most drug users aren’t generally healthy and can often be malnourished. Smoking any substance will jeopardize lung function, which we know increases the risk of mortality for those who have the virus. And when we’re talking about opioids, America’s most popular drug, it gets even worse. These drugs have a profound and direct impact on the respiratory system, reducing lung function up to the point of death, much like COVID-19.
Essentially, the addict’s body is already fighting one war against toxins, and introducing a deadly virus is a recipe for disaster. Substance abuse and COVID-19 share a lot of the same underlying health conditions, which independently increase the risk of mortality in each. When these issues are combined, the overall mortality risk would be exponentially larger. Since pneumonia can be caused by opiate abuse, one who then contracted the virus would be at higher risk of mortality from it, as well as increased risk of overdose death from the opioids. And drugs like meth and cocaine can cause heart problems, which would then place one in a higher risk category should they contract the virus. Given this, it only makes sense that one would consider substance abuse to be one of the underlying conditions, which makes COVID-19 more deadly.
As you can see, this doesn’t portend well for those struggling with substance abuse. A pandemic like COVID-19 can and will expose the weaknesses in our major systems, such as healthcare. While many may think that this is the worst possible time to seek treatment, it could be more dangerous not to. According to the CDC, people with preexisting mental health conditions should continue with their treatment and be aware of new or worsening symptoms. Given the outlook above, it may also be safe to consider substance abuse as one of the “underlying conditions” that increase one’s risk during these trying times, making treatment potentially lifesaving in more ways than one.
