The COVID-19 pandemic has state governments scrambling to manage both the health crisis and budget shortfalls caused by the economic downturn. In some states, that has led to budget cuts in many areas, including funds to fight the opioid epidemic. Treatment professionals worry that funding cuts to treatment programs and the pandemic shutdown could cause patients to drop out of treatment, potentially increasing addiction and mortality rates. Many Opioid Use Disorder (OUD) patients in recovery and treatment programs share those concerns.
The COVID-19 Pandemic Initially Made OUD Treatment Access More Difficult
Early in the pandemic shutdown, drug treatment advocates worried that the intense focus on the pandemic could inadvertently worsen the opioid epidemic.
“People of course are paying attention to COVID-19. I am too, but the opioid crisis was still a major thing in and of its own, and it wasn’t showing much sign of abating anyway,” said Rob Valuck, executive director of the Colorado Consortium for Prescription Drug Use Prevention. “We have to keep one eye on each.”
Dr. J. Craig Allen, medical director of Rushford, part of the Hartford HealthCare Behavioral Health Network noted:
First, in the best of times, stress and anxiety amplify risk for relapse. The pandemic’s impact on schedules, worries about health, family, friends and finances, and access to social media put those with risky use or in recovery in a challenging place.
Lastly, a decrease in access to legitimate supplies of opioid pain medications – either because they cannot access their medical provider or a shortage of drugs in high demand for COVID-19 care – can lead people to use alternatives from non-medical sources.
National Public Radio reported that the pandemic could put recovery at risk because “some inpatient and outpatient programs are not accepting or admitting new patients because they aren’t yet prepared to operate under the physical distancing rules.”
State Budget Cuts Could Raise Barriers to Treatment
The economic downturn has ravaged state budgets, resulting in substantial budget cuts to drug treatment and awareness programs. For example:
- Colorado recently “stripped at least $26 million for substance-abuse prevention, awareness and treatment from next year’s state budget.”
- Georgia could cut its annual $4 million appropriation to local addiction recovery centers as part of the state 11% across-the-board budget cuts.
- New York State cut payments to local government to fund private, non-profit drug and alcohol treatment providers by 31% – effective immediately.
- Oregon is considering a $69 million reduction in funding behavioral health treatment for people with mental illnesses and substance abuse disorders.
Treatment providers are already battered by rising costs and lower revenues caused by social distancing and the extra costs for sanitizing activities required to protect patients and staff from COVID-19. Administrators are worried about keeping their doors open. A June survey of behavioral health care organizations found that 71% “have had to cancel, reschedule, or turn away patients in the past 3 months,” and 44% “think they can only survive 6 months or less in the current financial environment.”
OUD patients in treatment and recovery are also struggling. Data suggests that the US could set a new record for overdose deaths this year, with the increase driven by anxiety about the pandemic, unemployment, the difficulty of navigating sobriety in social isolation, and lack of access to treatment. There’s evidence that the pandemic is triggering opioid relapses in Appalachia, already one of the regions most affected by the opioid crisis.
Some Regulatory Changes May Increase the Amount of Drugs Stored at Home
Federal regulators have relaxed some requirements in an effort to allow patients to continue with existing treatment protocols.
For example, the Substance Abuse & Mental Health Services Administration (SAMHSA) relaxed some requirements and allowed states to request blanket exceptions to allow stable patients in opioid treatment programs (OTP) to receive 28 days of take-home doses of OTP medication. Non-stable patients may receive up to 14 days of medications.
The US Department of Justice and the Drug Enforcement Agency announced on March 16, that physicians would be allowed to prescribe buprenorphine, a Schedule III controlled substance under the federal Controlled Substances Act, via telemedicine technology rather than an in-person examination.
This Office of National Drug Control Policy COVID-19 fact sheet lists other regulatory changes made to assist patients and providers.
Educate Patients on Safe Storage and Disposal of Opioids and Other Medications
These temporary changes could result in more controlled medications being kept at home. When patients receive medication-assisted treatment (MAT) on-site at a clinic, the facility is responsible for the safe storage and disposal of any unused/expired doses. That is not something the patients needed to consider before. Now patients may be storing the medications in their own homes for weeks at a time.
The drugs could be shared with or stolen by friends and family members. Improper disposal in the trash or flushing medications endangers communities and the environment. Treatment providers should address these issues when writing prescriptions. Studies have shown that patient education about opioids can help reduce misuse and encourage safe disposal of unused/unwanted medications.
Many communities have postponed their drug take-back day events due to the pandemic, but patients still need safe, affordable, DEA-compliant drug disposal options. Sharps Compliance can help.
Our TakeAway Medication Recovery Systems are an affordable, DEA-compliant option for safe disposal of most medications:
- Non-controlled prescription drugs, such as allergy medications and antibiotics
- Over-the-counter pharmaceuticals like analgesics and sleep aids
- Controlled medications – Schedules II-V only (no Schedule I)
The postage-paid containers are returned to Sharps compliance for safe, secure disposal and destruction.
Our MedSafe drug collection kiosks offer a comprehensive medication collection and disposal solution that complies with DEA requirements. MedSafe kiosks help ultimate users safely, and at no cost, dispose of both non-controlled and controlled (Schedules II-V only) pharmaceuticals without waiting for a community drug take-back event.