Anybody that reads this blog will be familiar with the information that people with substance use disorders (SUD) have been particularly vulnerable during the Covid-19 pandemic. I have also found many articles pointing out that people living with HIV (PLWH) are also part of the groups hardest hit by this pandemic. The study that I am using as research for today’s article was published in the journal AIDS and Behavior, and the researchers looked at people with HIV who also have previously struggled with substance use disorder, which is what we deal with on this blog all the time. I think it is important that we do not shy away from the prevalence of viral infections in the substance use disorder community, as it relates to both IV drug users and those who may have encountered HIV in any other way. Every great recovery center, rehab clinic, and treatment facility in the country should be doing some sort of outreach and/or testing for viruses including HIV, Hepatitis C, and Tuberculosis. As a blog that is read by people involved in treatment of alcoholism and addiction, it is also important for us to talk about these issues as they relate to people with Substance Use Disorder who may also be affected by them. Certainly, we should also say that anyone using drugs, mainly drugs like Heroin or Fentanyl with hypodermic needle use included, should know the risks and how to protect themselves and others when it comes to infectious diseases that are already endemic to our communities. The facility that I work with is called Florida Springs Wellness and Recovery Center in Panama City, Florida, and it is one of the best drug and alcohol rehabs in Florida or anywhere in the world.
Before and During the Pandemic
The researchers wanted to look at drug use and HIV self-care before the pandemic and compare those results to what people were facing during the pandemic. This area of self-care and HIV management also included the ability of people with HIV to see doctors and get to medical appointments. I was interested in this part of the study because I know how much telemedicine has changed what our great clinicians are doing at Florida Springs, and I was interested if the researchers had anything to say about telehealth. Telehealth is the use of video conferencing and other technologies to connect medical personnel with patients, and it has been a key component of providing mental health services to people during the Covid-19 pandemic.
From the study, “PLWH and SUD have increased illicit substance use and contact with other substance-using individuals and decreased their confidence to stay sober and attend recovery meetings. The proportion of people missing their HIV medications also increased, and confidence to attend HIV follow-up appointments decreased.” They do note that telehealth helped with some regular appointments, but did not fix this problem entirely during Covid-19. I imagine that for some addicts and alcoholics with HIV, going back to hard drug use and drinking is one of the first signs that a person may soon get off of their medication.
So, this is scary. Not only do these results mirror my own feelings about what has gone on during the pandemic with people who struggle with addiction, it shows that other people in need of medical care were dropping out of treatment regimens and relapsing into drug use during the pandemic. The pandemic often led to an increase in depression and feelings of helplessness amongst people with SUD, and people with HIV who also struggle with drugs may have been in the toughest spot of all, as access to important and expensive medicine can quickly be cut off once a patient starts missing medical appointments. The researchers also note that people with SUD and HIV were seeing more people who were also using drugs, and who also may have been higher risks for spreading Covid-19. This is in line with something we have talked about repeatedly. During a pandemic and lockdown, people with substance use disorder are forced to risk getting the virus and spreading it because they are not actively engaging in an effective treatment program and must obtain drugs. I imagine similar things can happen with HIV treatment, and this research seems to speak to that, although I am not an expert.
What Do We Do About It?
I am not an expert on HIV. I am more of an expert on what has gone wrong with addiction and alcoholism treatment. We must stop criminalizing and stigmatizing disease, and I imagine that stigmatization concerns are just as true for HIV and AIDs treatment. We must get large numbers of people into drug and alcohol treatment that works for them, including medication assisted treatment (methadone and suboxone) and rehabs, halfway houses, and other initiatives that show promise. HIV experts must speak on this issue from their vantage point, but from the SUD side; I do not think we will be more prepared for another pandemic unless we make quick strides towards dealing with the current opioid/meth/alcohol crisis in this country. The best drug and alcohol rehab is in Panama City Florida, and the great people at Florida Springs Wellness and Recovery Center might be able to help you or your loved one today if you reach out to them at the phone number above.
By T.A. Cannon (Contact me at TACannonWriting@gmail.com)
“Potential Influences of the COVID-19 Pandemic on Drug Use and HIV Care Among People Living with HIV and Substance Use Disorders: Experience from a Pilot mHealth Intervention”, Karli R. Hochstatter et al. Feb. 2021, AIDS and Behavior.