When Epidemics Collide Hidden Risks for Healthcare System

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An editorial from a group of doctors that was just published sheds light on some hidden risks for the health care system and specifically the substance abuse recovery industry. If you have found this page because you want more information on the best drug rehabs in Florida, Alabama, or anywhere in the United States, go to the programs page for more information. The article that I am referring to, published at Annals.org recently, brings up new problems that the health system faces during Covid-19 which have not made any headlines. I have recently written about the spike in overdoses during Covid-19, and I have written multiple articles recently about risks faced by rural people with substance use disorder during Covid-19, but the authors have identified multiple major risks to the entire recovery industry right now. They call for immediate action to avoid major losses to mental health care capacity and to avoid losing previous gains made in the fight against the ongoing opioid epidemic.

From the editorial:

“COVID-19 could cause infection in persons with opioid use disorder, increase opioid overdose rates, reverse system-level gains in expanding access to medication for opioid use disorder, halt critical research, and prevent exacting of legal reparations against opioid manufacturers. The authors call for urgent action to counteract these risks.”

I have written about the issue of people with substance use disorder contracting Covid-19. The reasons that people who use drugs are at greater risk include exposure to non-family members when buying drugs from a drug dealer and other drug-seeking behaviors as a result of only having a small supply of drugs on hand at any given time. I have also touched on the issue of access to opioid use disorder medications, as I wrote an article discussing methadone clinics closing and being overregulated, especially during this pandemic. The first new issue that the authors brought up in this editorial is the halting of critical research. My first thought was that the research that is being halted is being replaced by Covid-19 research, and that seems to be correct from reading the rest of the editorial. A remarkably interesting concern is the prevention of exacting legal reparations against opioid manufacturers, such as Purdue Pharma, whom I wrote about one month ago. 

Some of the changes being immediately called for by the authors are extremely intelligent ideas. The authors want all methadone facilities to immediately give stable patients large take home supplies, and I fully agree with that. It is also clear that some methadone facilities have begun that process. They also want all buprenorphine or Suboxone, providers to switch to telemedicine wherever possible. That is a very smart way to fix the problem of doctors being required to see patients every month when they prescribe buprenorphine, but the federal regulators have, as of now, not made any changes to the regulations on buprenorphine providers. 

This next section seemed especially on a point based on what I have been seeing, 

“We recommend several additional steps to ensure access to buprenorphine in preparation for shifts in prescribers’ work duties or sick leave due to COVID-19 and potential treatment disruptions as patients move in and out of hospitals. The federal government should temporarily remove limits on the number of patients an individual prescriber may treat concurrently.”

Providers of buprenorphine have historically had ridiculously long waiting lists. Sometimes a patient who needs buprenorphine will be put on a waiting list for over a year. The best drug rehabs in Florida and elsewhere are always under heavy regulation from the federal and state levels. This specific problem arises because the regulators have limited the number of patients each doctor can have concurrently. There is no good medical reason for these regulations that can possibly outweigh the growing need of patients. The authors correctly assess that those regulations should be lifted during Covid-19, but in my opinion, many of these regulations were wrongheaded from the beginning, and many Americans have died because of the stupid regulations that are imposed on opiate use disorder treatment providers. If we can fix some of those long-standing problems during Covid-19, that can help with some of the increased risks that people with substance use disorder are facing during this fraught time. As always, if you are looking for treatment options for you or a loved one, visit our programs page for more information about the best drug rehab in Florida, Florida Springs Wellness and Recovery Center in Panama City, Florida.

By T.A. Cannon (Contact me at TACannonWriting@gmail.com)

 

References 

Becker WC, Fiellin DA. When Epidemics Collide: Coronavirus Disease 2019 (COVID-19) and the Opioid Crisis. Annals of internal medicine. 2020;173(1):59-60. doi:10.7326/M20-1210