Substance use disorders and COVID-19

COVID-19 is getting all the headlines, but substance use and substance use disorders are still one of the leading killers in the United States. Alcohol continues to be the third leading cause of death for preventable fatalities accounting from somewhere between 70,000 to 88,000 deaths per year in the US. According to the most recent estimates, between 60,000 to 70,000 deaths a year are due to drug overdoses. While most drug related deaths are associated with opioids, stimulants, such as meth are increasingly involved – especially in rural areas.

Some models based on COVID-19 infections suggest the virus might account for 100,000 or more deaths in the USA even with drastic mitigation during the pandemic. At the same time, alcohol and other drugs will be accounting for more deaths annually. We may not know the total fatalities from the pandemic, but we do have years of data on the toll that substance use disorders have taken on the American public.

In light of the pandemic, many with addiction concerns may be reticent to present for an evaluation or intake for treatment. The reality is that having a substance use disorder might be more likely to result in death than the risk of contracting the virus. Getting treatment for substance use disorders would appear to be the wise choice.

The other side of this coin is the fact that persons who have been infected with COVID-19 pose a danger to staff and other patients. The challenge for treatment programs will be the capability of doing testing for COVID-19 at the time an individual presents for intake or evaluation. This will be a critical factor in protecting staff and other patients. Given that many infected people appear to be asymptomatic, this might also be a benefit to the persons evaluated and people in their social network in alerting them to get tested and take precautions.

The prudent option for funders would be to cover COVID-19 testing costs as a standard part of treatment for substance use disorders and other behavioral health conditions. Current evidence suggests that the virus is likely to be around for a protracted period. Logic would dictate that routine testing for the virus should be a standard until such a time as an effective vaccine is widely implemented.