How did COVID change addiction treatment?

January 5, 2022

Originally published by Verywell Health – January 5, 2022


Throughout the course of the pandemic, substance abuse in the United States has been on the rise.

According to the Centers for Disease Control and Prevention (CDC), there were more than 94,000 fatal overdoses in January 2021, a nearly 31% increase from January 2020.1 And between January and October 2020, the number of visits made by patients who experienced opioid overdoses increased by 9.7%.

Overdoses have specifically hit harm reduction and substance use clinics hard. Like many health centers, Venice Family Clinic, a nonprofit organization serving more than 45,000 people in poverty living in Los Angeles, had to adapt its services in order to keep COVID-19 from spreading.

Gilmore Chung, MD, director of addiction services at Venice Family Clinic, moved support group meetings for people with opioid use disorders online. However, physical isolation became an issue.

“It’s not good for anyone but that is especially true of people with a substance use disorder. They are always told to go get help, usually at a 12-step meeting,” Chung told Verywell. “The more separation between people, the less chance of healing through support groups.”

This sentiment was shared by Dale Parker, MA, LPC, program director at Sandstone Care, who works with youth. “Young people were disengaged and they were having trouble making connections through the screen,” Parker told Verywell.

But Chung, Parker, and other organizations learned to adapt to the new changes presented by COVID.

“We don’t have much space for people to hang out but we still have outreach workers that go out every day of the week, visiting encampments, assisting people on the street, checking in on them, seeing how they’re doing, delivering supplies, exchanging needles,” Chung said.

Verywell asked these experts to weigh in on whether some of these changes to care that emerged during the pandemic will last.

Narcan access increased

Unprecedented surges in opioid overdoses led many harm reduction groups to promote using Naloxone, also known as Narcan, a life-saving medication that can reverse an overdose caused by opioids, including heroin, fentanyl, and prescription medications.

The medication can return restore a person’s breathing to a normal state within two to three minutes. Narcan is administered as a nasal spray and is safe and effective to use

Due to the rising rate of overdoses, Chung predicts there will be increased and continued use of Narcan in the new year. For example, agencies in Wisconsin, including local public health departments, tribal health clinics, and syringe access programs participating in the Narcan Direct Program increased from 72 to 100 from 2020 to 2021.

“In terms of our efforts to prevent overdoses, we provide Narcan at no charge to anyone who needs it,” Chung said. “Venice Family Clinic also has nine street medicine teams that go out every week to reach out to people on the street.”

Chung said that the clinic will continue to provide Narcan and respectful care.

“To be able to prevent an overdose or to be able to treat somebody, that’s great,” Chung said. “Thing is, you [have to make] sure that everybody knows that the door is always open to them.”

What experts hope to see more of

To prevent overdoses, SAMHSA administered grants to states and territories based on the highest overdose rates and treatment needs from fiscal years 2018 through 2021.4

In 2021, SAMHSA awarded $123 million to connect people with substance use disorders to culturally appropriate and evidence-based treatment and support.1

These funds aim to:

  • Increase access to medication-assisted treatments
  • Reduce unmet treatment need
  • Reduce opioid overdose deaths through the provision of prevention, treatment, and recovery services

However, while funds can propel overdose prevention efforts forward and are expected to continue in 2022, funding alone is insufficient, according to Chung and Parker.

“All of this stuff costs money so there needs to be a reallocation,” Parker said.

Parker hopes to see a redirected investment in medication awareness and practitioner referrals. “There’s a lot of people that will go to the doctor that maybe don’t know where to go for therapy, so increasing public awareness of therapy through their primary care physician [is important],” he explained.

Coupled with increasing access to life-saving medications and treatments, Chung hopes to see a greater emphasis on addressing the root causes of addiction, such as poverty and housing, to prevent people from relapsing and reverting back to substances to cope with stressors.

Individuals experiencing homelessness were nine times more likely to die from an overdose compared to those who had stable housing.5 81% of overdose deaths were caused by opioids among those experiencing homelessness, 20% higher than the national average of 61%.5

“When you see someone making improvements and getting their lives back and someone who has been sleeping in a car and now is working and back in touch with family, you realize we actually can make a difference. [You realize] how many doors we can open by not writing this population off and recognizing them as people who are hurting in some way and are self-medicating when they are using,” Chung said. “You do definitely see these bright lights.”