What Will Happen to Drug Treatment During a Pandemic?

We’re in uncharted waters right now. With the novel coronavirus, COVID-19, spreading rapidly through America there are a lot of situations that we just don’t know how to handle. And treatment for substance abuse is one of them.

America is in the middle of a drug epidemic and consumes more drugs than anywhere. Opioids are our national drug of choice, and there’s been a huge push to expand and improve treatment over the last decade. It hasn’t been an easy battle, and we’re far from declaring a victory.

We’ve been able to study how COVID-19 affects other countries, but one thing that’s lacking is information on how this pandemic will affect a large population of drug users such as what exists in America. Because of this, no one knows what to do with this treatment industry we’ve been building and what to do with its patients.

Drug and Alcohol Rehabilitation consists of face to face interaction, either in a group setting or with a counselor. Treatment facilities are often inpatient, meaning many people living together in close quarters. This lends itself terribly to the spread of disease, particularly among a population whose body is already compromised from drug use.

Those who rely on MAT medications such as Methadone or Suboxone for opioid dependence have their own challenges. Due to laws which restrict these medications, they’re often only dispensed by daily dose and only at clinics. This means potentially thousands of people going to a single clinic each day and waiting in line, only to gather in a waiting room and be doled out their meds. Again, it’s a recipe for disaster.

Guidelines issued by authorities often contradict and don’t take into account these situations. Some guidelines have been issued SAMSHA regarding MAT clinics and how they can potentially give up to 14 days’ worth of medications if someone is ill. But these are guidelines, not laws or directives and state laws may prohibit this. It also does little for prevention given that people can spread the virus easily without exhibiting symptoms. Nothing has been issued regarding COVID-19 and treatment facilities, or than instructions for proper sanitation.

No one’s saying what people who are in treatment already should do. Should they stay and potentially be at increased risk? It’s difficult, given that leaving treatment before it’s complete greatly increases chances of relapse. Should treatment centers still be operating? One could assume that because no one’s said to close them down, it’s been decided they’re safe. But it’s also possible that no one’s even gotten to this problem yet or knows what to do.

Those who need treatment but haven’t entered yet are in a similar dilemma. Should they even go? Which is the lesser of two evils? Perhaps the only thing we know is that substance abuse is a killer, possibly more so than COVID-19. Until orders are issued otherwise, anything that increases your survival overall will likely help you withstand this pandemic. Healthcare is an essential service.