The Pandemic within the Pandemic

Overdose Deaths Rise Sharply During the COVID-19 Pandemic, Compounding the Already Significant Challenges of SUD and Health Equity

2020 was a difficult year.  As we pivoted to life under quarantine, many people lost access to the support they relied on to stay healthy – including services for those in recovery from substance use disorder (SUD).  This created “a perfect storm” of rising use, fewer support services, and isolation. Unfortunately, 2021 may continue to bring significant challenges in these areas.

Recent studies indicate a sharp rise in the number of overdose deaths during the pandemic.  For example, in December 2020 the CDC reported substantial increases in drug overdose deaths across the United States, primarily driven by rapid increases in overdose deaths involving synthetic opioids excluding methadone, likely illicitly manufactured fentanyl.  In 2020, we witnessed the highest number of overdose deaths ever recorded in a 12-month period, and the largest increase since at least 1999.  Other research shows that the problem isn’t going away: 13% of Americans reported starting or increasing substance use as a way of coping with stress because of COVID.

The impact of the COVID-19 pandemic will reverberate far and wide for those battling SUD.  Given the disturbing trends, what can and should we do differently to give those with SUD a better chance at successful treatment and recovery?  At CHESS, we are working to expand evidence-based solutions to address the SUD crisis that is impacting all of us.  Here are three key areas we are beginning to shine additional light on:

Rural Communities.

Even without the COVID-19 pandemic, individuals in rural communities struggle to access SUD treatment and services to support their recovery.  This can have dire consequences: for example, a recent study in Ohio found that people who lived more than a mile away from a treatment provider were less likely to stay in treatment for opioid use disorder.[i]  Less treatment often translates into more fatal overdoses.  In Rio Arriba County – a rural county on the New Mexico/Colorado border – the opioid mortality rate is six times the national average and more than four times New Mexico’s average.[ii]

Leveraging a virtual peer support network, such as we have within our Connections App, is a key component for extending the reach of SUD programs into rural areas.  By providing those in recovery with active discussion groups, virtual meetings, and on-demand cognitive behavioral programs, we can enhance the safety net that people in rural communities need.

Social Determinants of Health.

The difficult road to recovery is exacerbated when individuals have additional barriers that impede their progress.  Issues like food insecurity, access to safe housing, and job continuity all add to the stressors that can trigger relapse.

At CHESS, we often find that governments and community support programs struggle to “talk to each other.”  Making sure that government agencies and public programs can refer to each other is a key to success.   Connecting across the continuum is essential – and we can facilitate that by making sure that SUD providers can refer to community-based agencies, such as for food and housing support.

Health Inequities.

Black, Indigenous, and People of Color (BIPOC)  with substance use disorder may be particularly at risk for poor outcomes.[iii]  We see through studies, for example, that white Americans are 35 times more likely to have buprenorphine visit than Black Americans.[iv]  In addition to developing strategies to combat racial inequities, we must also look within and across communities and populations, including LGBTQ+, adolescents, among Veterans, and examine outcomes based on gender.

CHESS Health is the leading provider of technology supporting the addiction management and recovery lifecycle.  We are driven by a higher calling to uphold the dignity of individuals in recovery and address the crisis caused by SUD.  We collaborate with health plans, state/local governments and others in the public sector, and providers to connect care across the continuum to achieve higher abstinence rates, reduce the risk of relapse, and lower the cost of care.