Opioid Epidemic and COVID-19 Pandemic: Deepening Disparities

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This JAMA Network article warns of the “synergistic effects” of the COVID-19 pandemic and the opioid epidemic and how those effects will exacerbate existing health disparities. Some social determinants of health and factors that play a role in those (e.g., racism, discrimination, poverty, lack of access to quality healthcare) contribute to both increased risk of substance use and overdose, and to preexisting chronic conditions that increase risk of poor COVID-19 outcomes.

This National Academies workshop series discusses how social determinants of health have disproportionately increased risk of exposure to COVID-19 and contributed to higher numbers of COVID-19 cases, hospitalizations, and deaths for racial/ethnic minorities (as shown in CDC data).

The series also discusses gaps in access to mental health and substance use treatment experienced by racial/ethnic minorities, as well as the growing need for treatment services during COVID-19. Since the onset of the COVID-19 pandemic, Black, Hispanic, Native/Indigenous and multiracial people have reported higher prevalence of increased substance use, symptoms of anxiety or depressive disorder, traumatic stress, and suicidal ideation (as shown in CDC data). Meanwhile, a recent report shows that the COVID-19 pandemic has caused reduced capacity for mental and behavioral health facilities, as well as shortages of and strains on healthcare workers, further limiting access to treatment and care for racial/ethnic minorities.

Prepandemic AHRQ data (3.43 MB) show that overdose deaths involving synthetic opioids were contributing heavily to the opioid epidemic (pp. 178-180), and the rates of those overdose deaths were increasing fastest for Blacks and Hispanics (pp. 178-179). Findings from this study show that African Americans with substance use disorder (SUD), especially those with opioid use disorder, have the highest risk of COVID-19 infection, hospitalization, and death compared with those with SUD in other racial/ethnic groups. 

[Read more in Opioid Epidemic and COVID-19 Pandemic: Dual Crises.]