Before COVID-19 hit American soil, there wasn’t much curiosity about how the growing epidemic might collide with another well-established epidemic that has raged uncontrollably for nearly two decades. Perhaps the novelty of the corona virus and the political atmosphere that developed around it has monopolized the attention of many Americans and distracted them from what was once the most striking public health emergency of the millennium. Enough time has now passed to collect and study the data from the first few months of the effects of COVID-19. This is how we can piece together the current landscape of “another” most notable health crisis in America.
In April, the National Institute on Drug Abuse issued one of the first warnings about how this virus can affect people with substance use disorders. This article highlighted the increased risk of having drugs in the hands of individuals, particularly when it comes to susceptibility to contracting the virus and difficulty recovering from it. Other authorities repeated these predictions on the matter and made suggestions on how to find safe treatment during the pandemic. It didn’t take long for these predictions to begin to manifest, and the national media took minimal note of some alarming reports of overdose deaths exploding in many communities. But now the bigger picture is clear. From March 19 to May 19, 2020, there was a national increase in overdose deaths of 17.59%. It is not difficult to see that this is a massive increase in an already enormous problem for a struggling nation.
When the need for substance abuse treatment services has been greatest, availability has been sorely lacking. Rehab across America is primarily to blame for the state of our nation’s drug problem, but it is not entirely to blame. In order for people to be supported by rehab, detox and outpatient counselors, they need to show up. When COVID-19 first broke out, many people in treatment stood up and left, and it’s easy to see why. The amount of confusion and mixed signals about what was safe and what was not caused many to think and act for themselves. This meant getting out of a community environment and returning to their families. For those who had not finished treatment, it was often associated with relapse.
Aside from those who left treatment and had relapsed, there was an even larger group in long-term recovery who relapsed due to the psychosocial pressures of the COVID-19 pandemic. Many others who had no history of addiction were driven to substance abuse under increasing stress and need. It is still unclear how much addiction has increased overall. The only way to get close to quantifying the incidence of substance use disorders is through small sample surveys or by counting the number of people who have turned to licensed treatment services. This doesn’t give the full picture of how many people struggle with addiction.
The inequality between the need for services and their underutilization has created a disturbing paradox: How are we going to keep America’s rehab centers open when no one is using them? This is especially problematic when we consider how badly they are needed once the virus is in check, if that day comes at all. Even if it doesn’t, in the near future people will regularly use services that they have avoided. And when they are all closed, there is nowhere for people to get help.
Treatment centers have suffered massive hits. From January through April 2020, 83% of responsive treatment programs expressed financial losses averaging over $ 21,000 each from insurance revenue. This is mainly due to a lack of customers. In addition, many treatment centers have had to invest in technology to provide telemedicine services at over $ 6,000 to 73% of the responding treatment centers. And nearly 40% of responding centers each spent over $ 3,000 on personal protective equipment to improve safety and comply with rapidly evolving guidelines. But perhaps the biggest achievement for the country’s rehab system was the $ 40,000 that lost nearly half of every responding program because it was unable to hold major fundraising drives. So many rehabs are nonprofits that exist to serve people, but they need income to survive.
These costs add up. With less disposable income, they can pay fewer staff, so they have to lay off something and reduce working hours. This leads to a smaller workforce and reduced patient capacity. Lower capacities mean lower revenues and the cycle continues. Add overtime pay for the few employees who work and can work in these high risk environments and it is clear that this problem is quickly turning into a crisis in itself.
The obvious solution is to raise funds for America’s treatment programs and give them the financial relief needed to get through this difficult time. But that’s easier said than done, and the average person has little to no control over this type of funding. But what can be done in the meantime is very simple. Those who work in the treatment field can continue to provide the commitment and quality service that people need if they are to have a chance at recovery in today’s climate. We can continue to adapt and be on the cutting edge of services by using telemedicine and other advances. Insurers are making unprecedented exceptions to allow people to access services. So be sure to find out about options and do some research.
For those who may not work in the treatment field but know or love someone struggling with addiction, you can help too. Myths and false data abound in the recovery community. Perhaps the most dangerous is the mantra that someone cannot be helped until they are “ready”. The fact is that every day people die of drug addiction before they were ever “ready” to get help. But it doesn’t have to be that way. Intervention saves lives and only exists for that reason. When someone is struggling with addiction, don’t watch and wait. Step up before it’s too late and get the life-saving treatment services that need us almost as much as we need them.
– Joseph Kertis, guest author
Feature: Michael Longmire at Unsplash, Creative Commons
First: GoaShape at Unsplash, Creative Commons
Second: Ian at Unsplash, Creative Commons
About the author
Joseph Kertis is a seasoned medical professional turned journalist. His drug abuse and addiction recovery experience provides a unique glimpse into one of our nation’s most challenging epidemics. He uses this knowledge in his writing to convey an expert point of view that spreads awareness through education.