COVID's impact on substance abuse

The substance abuse epidemic is relentless, lethal and pitiless, as evidenced by the six Long Islanders who died this month after police say they overdosed from what they suspect was fentanyl-laced cocaine. This tragedy brushes aside arbitrary definitions of status, ethnicity, or hometown.

And it’s about to get worse.

The Centers for Disease Control and Prevention reports drug overdose deaths rose nearly 30% in 2020, with more than 93,000 Americans dying, the highest annual toll since the opioid epidemic began in the 1990s.

The reason is clear. While absolutely necessary to confront and defeat COVID-19, pandemic lockdowns left those already vulnerable at a breaking point. Isolated, substance abuse became their solution. Some empathetic families and friends justified that destructive behavior as self-medicating therapy. When vaccines became available and infections began to wane, there was a burst of social gathering; families reunited and travel beckoned.

So, too, did multiple variants of COVID as the unvaccinated fueled an increase in infections. Now, the delta variant may impose new social isolation. For those susceptible to substance abuse, it is a forbidding challenge; much like a prisoner in solitary offered his freedom, a return to confinement is doubly devastating.

This emerging crisis comes as both Long Island counties will receive funds from the settlement of a national lawsuit with pharmaceutical companies involved with opioids. Nassau is expected to receive nearly $87 million and Suffolk as much as $106 million, reflecting how hard-hit these suburban populations have been.

In Suffolk, a task force has been convened by County Executive Steve Bellone to consider how best to proceed. County health professionals, law enforcement officials, and county legislators will seek to determine the best course of action. What they will find is what many health professionals already know: Dollars alone will not defeat this menace.

We need a broad-based community approach to combating this crisis. We must build partnerships with our community organizations, local businesses, houses of worships, and schools — and incorporate strategies to identify and engage people in need.

Educational teams can work directly with pharmacists to help end the stigma around medications like buprenorphine. Although it is a vital, lifesaving medication for people with opioid use disorder, one in five pharmacies deny access to the drug due to draconian federal regulations governing its use for fear of diversion. Those that do stock it are allowed to dispense only a finite quota each month. An influx of patients in a community can quickly exhaust that supply. It is time we remove all barriers to effectively overcoming this crisis, and this should be a cornerstone of that effort.

In addition, consider underwriting a data-driven approach to tracking relevant demographics of those impacted by the opioid crisis. Such data will help create more appropriate responses in our communities. Invest in mobile teams of health care professionals who can flood communities to fight this menace. Include "train the trainer" programs where addiction experts train other health care professionals, business leaders, clergy, and community organizers on how to identify and mitigate risks of addiction.

Recovery is possible. With the help of our community partners, local government, and holistic approaches to treatment, we can effectively address this opioid crisis. As science continues to evolve, and our community partners are provided with new and powerful resources, we can work to end the stigma around addiction and get through this stronger and healthier than we were before.

This guest essay reflects the views of Dr. Rohan Singh, an addiction medicine internist at Wellbridge Addiction Treatment and Research Center in Calverton.