Substance Use Blog Series: The Opioid Crisis and COVID-19
Today’s post is about the opioid crisis and COVID-19. We have written a number of posts about the opioid crisis already. Here you can find an article providing a general overview, here you can read about agonist therapy, treatment programs, and preventing overdose deaths here and here. Because of these existing posts we are going to focus specifically on the intersection between COVID and the opioid crisis today.
An epidemic during a pandemic
The effects of COVID-19 are currently visible and clear to all of us, but BC was facing an epidemic long before COVID hit, and it has claimed far more lives.
The arrival of COVID-19 has exacerbated the opioid epidemic, resulting in higher death tolls than ever before. In June, BC recorded its worst number of opioid-related deaths (183). In June 2019, the number was 76. The number of opioid-related deaths this summer alone has far exceeded the total of 284 deaths in BC due to COVID-19.
These numbers have risen at least in part due to COVID-19 specific factors. For example, the Canadian-US border closure disrupted drug supply chains. As a result, there has been an increase in drug toxicity and fentanyl concentrations. Social distancing and self-isolation also contributed to reduced access to services such as supervised consumption facilities and health care, especially near the beginning of lockdown (The Lancet). The healthcare community has since adapted in many ways and many supports are still available, which we will describe later in this post.
This video provides more of an overview of the opioid crisis in the context of COVID. It refers to to all of Canada, and I summarize some of its points below:
- Several factors associated with COVID-19 have acted as triggers for those struggling with opioid use. These include: social isolation, health, home, community, and income concerns.
- It is likely that factors of stress, boredom, and unstructured time are adding to opioid use.
- Last week we wrote about Alcohol and COVID-19, and a study run by the CSSA made these ties, although specific to alcohol. Even so, these are all factors that are known to trigger relapse for those in recovery so may affect opioid users as well.
- Lack of community hinders support systems that can be vital to those in recovery.
- Loss of income can trigger relapse.
- Lack of housing security / homelessness can expose people to places with no physical distancing. Being unable to follow public health measures impacts mental health, which may lead to more relapses.
- The regulations for social distancing are put in place to protect the health of our general community, but for individuals who are unable to social distance because of their housing situation, judgment from the general public in response to the restrictions can lead to increased marginalization.
Mitigating risk of two public health emergencies
Some other risks lie at the intersection between these two emergencies that we have not discussed yet, and we will outline them here.
Respiratory failure is already a risk when using opioids, so if someone were to get COVID and use opioids, their risk of death during an overdose increases, as COVID further compromises the respiratory system.
Using opioids can also increase the risk of infection due to weakened immune system (British Columbia Centre on Substance Use).
Transform Drugs provides suggestions for harm reduction strategies if using during COVID that can be accessed here. Some of these tips include avoiding sharing injecting equipment or foil, and practicing proper cleaning of supplies.
Resources
As we discussed above, one aspect of COVID that is negatively affecting those in recovery is the lack of community that comes with social isolation, and decreased access to healthcare during the beginning of COVID. We want to take time to share resources that are still running.
Fentanyl testing kits
Because fentanyl levels are increasing in drug supplies, it is vitally important to have your drugs tested before using. This Delta location provides free fentanyl testing kits.
We have made past posts providing resources for different types of treatment, and these resources are still running. They are linked at the top of this blog post. We also want to mention community supports that you may have already heard of, and inform you of how/whether they have changed and how you can access them. Some have adapted their services, but they are still available.
Narcotics Anonymous
Narcotics anonymous (NA) groups are still running mainly via zoom and can be found according to location here. Since they are on zoom, you are also free to attend meetings in other locations if the ones near you do not work time-wise.
You can apply filters specific to your community if you wish. NA is based on the AA (Alcoholics Anonymous) model and utilizes the 12 step program. The steps were originally developed within a Christian context and refer to surrendering ultimate control to God, but the program works with any external entity and its language is adaptable to fit any expression of spirituality, if that is a part of your identity.
SMART Recovery
Some people prefer not to include any form of spirituality in their recovery, and a useful community support for these folks is SMART recovery. SMART recovery groups teach evidence-based skills for coping with addiction and are entirely secular. These groups are also still running via zoom, and the little house society in Surrey (among others) is meeting in person again. You can find other SMART recovery groups here. There are other options for substance use groups which we will go into in a future post, but NA and SMART recovery are some of the most popular.
In some ways, virtual settings have decreased barriers to access. For example, for those who are concerned about seeing people they know at NA meetings near them, they are now freer to attend meetings in other cities or even provinces and countries to feel an increased sense of anonymity.
Help navigating resources
As always, if you are looking for support with opioid use, our Substance Use Counselling services are available.
You may also want to navigate resources that are not specific to substance use. This is particularly important to mention within this topic because of how factors like housing, income, restricted community supports and marginalization are affecting opioid users within the context of COVID.
If you are looking for help navigating these resources, the Peer Navigator team can help. They specialize in narrowing down overwhelming situations through goal setting and system navigation. While they are located on Commercial drive in Vancouver, virtual and phone support is available to residents of Delta: You can call them at 236–317–3396, or email at peer.navigator@cmha.bc.ca.
