Implications Of Covid-19 For Individuals With Substance Abuse

As people across the United States and around the globe contend with coronavirus disease (Covid-19), the research community is also alert to the possibility that this virus could hit some populations with SUDs (substance use disorders), particularly hard. Because Covid-19 attacks the lungs, it could be an especially serious threat to those who vape and smoke tobacco or marijuana.

People with substance use disorder are vulnerable due to the adverse effects of these drugs on respiratory and pulmonary health [1]. Furthermore, these individuals are more likely to experience incarceration or homelessness than those in the general population. These circumstances pose challenges regarding the transmission of the Covid-19 virus. All these possibilities should be a primary focus of active surveillance as researchers work to understand this health threat.

People who use high doses of opioids or who have OUD face unique challenges to their respiratory and pulmonary health [2]. Since opioids act in the brain to slow breathing, their regular use not only puts the patient at risk of fatal overdose, it may also lead to hypoxemia [3] (harmful decrease in oxygen in the blood). Lack of oxygen can be damaging to the body organs, especially the brain. While brain cells are able to withstand short periods of inadequate oxygen supply, they can suffer damage when hypoxemia persists. Chronic respiratory diseases are already known to increase mortality risk due to overdose among people taking opioids, and thus diminished lung capacity, and upper respiratory tract infection from Covid-19 could similarly endanger this population. People with substance use disorder are at a higher risk of developing respiratory infections due to the adverse effects of these drugs on respiratory and pulmonary health. Furthermore, these individuals are more likely to experience incarceration or homelessness than those in the general population. These circumstances pose challenges regarding the transmission of the Covid-19 virus. All these possibilities should be a primary focus of active surveillance as researchers work to understand this health threat

Covid-19 and Opioid Use Disorder (OUD)

People who use high doses of opioids or who have OUD face unique challenges to their respiratory and pulmonary health [2]. Since opioids act in the brain to slow breathing, their regular use not only puts the patient at risk of fatal overdose, it may also lead to hypoxemia [3] (harmful decrease in oxygen in the blood). Lack of oxygen can be damaging to the body organs, especially the brain. While brain cells are able to withstand short periods of inadequate oxygen supply, they can suffer damage when hypoxemia persists. Chronic respiratory diseases are already known to increase mortality risk due to overdose among people taking opioids, and thus diminished lung capacity, and upper respiratory tract infection from Covid-19 could similarly endanger this population.

People with substance use disorder are at a higher risk of developing respiratory infections due to the adverse effects of these drugs on respiratory and pulmonary health. Furthermore, these individuals are more likely to experience incarceration or homelessness than those in the general population. These circumstances pose challenges regarding the transmission of the Covid-19 virus. All these possibilities should be a primary focus of active surveillance as researchers work to understand this health threat.

A history of opioid use may also put people at risk. Opioids constrict the blood vessels and contribute to pulmonary hypertension and pulmonary damage in people who use it [4]. When treating those with COVID-19, clinicians, and other health care providers should be prepared to evaluate the possible side effects of opioid use.

Other risks for people with opioid use disorders include a higher likelihood of incarceration, decreased access to health care, and housing insecurity. Limited access to hospitals and clinics place people with substance abuse at higher risk for many illnesses, including Covid-19. Homelessness or incarceration can also expose susceptible people to certain environments where they are in contact with people who might be at higher risk for infections. The prospect of public health measures and self-quarantine may also disrupt access to medications, syringe services, and other medical support needed by people with OUD.

Takeaway

People with substance abuse, particularly opioid use disorder, are at a greater risk for developing infections – including Covid-19. Opioid acts in the nervous system and can slow down the breathing – leading to a short supply of blood to the brain. This may prove fatal and can cause severe respiratory complications such as pneumonia, respiratory distress, and death.

As researchers strive to confront the health challenges of opioid and other drug abuse disorders – and now the rising of Covid-19 infection – WHO encourages clinicians to be prepared to obtain data on the risks for COVID-19 and evaluate the possible side effects of opioid use.

References

  1. https://americanaddictioncenters.org/health-complications-addiction/respiratory-system
  2. https://erj.ersjournals.com/content/50/5/1701153
  3. https://www.drugabuse.gov/publications/drugfacts/prescription-opioids
  4. https://www.ncbi.nlm.nih.gov/pubmed/29508628

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