UofSC Psychiatry Resident || @TheHeadDocMD || MyStreetHealth Content Creator

Sub-city Pandemic

As news networks closely track the number of COVID-related infections and deaths, addiction and the opioid epidemic are taking a backseat in the media's attention. Now more than ever, we as a nation must focus our attention on addiction because of the serious mental health repercussions related to the COVID-19 pandemic that negatively affects those with substance use disorders (SUDs). The shelter-in-place orders across the country are forcing many of us into seclusion, which may contribute to elevated levels of stress in some instances. The tension could lead some to choose unhealthy coping mechanisms that can sometimes have health-related consequences. When those who abuse substances temporarily emerge from their homes, they may be at a more significant risk of illness or death from the virus. Why aren't news outlets drawing more attention to this sub-pandemic?
COVID-19 pandemic is undoubtedly associated with worse addiction outcomes; however, we won't know the actual toll on illness and loss of life for some time. One thing is sure, the shelter-in-place orders across the country are contributing to social isolation and stress, which are significant predictors for the risk of addiction and substance abuse. The research shows that increased exposure to stress contributes to increases in initiation and escalation in the amount of alcohol, opiates, and psychostimulant use. Where I live in the crowded area of Koreatown, Los Angeles, I was surprised weeks ago to see psychedelic light shows (which are commonly associated with party drugs) in the windows of neighboring apartments. Also, I noticed while on essential grocery runs that there seems to be an influx of drive-by drug pick-ups at the local homeless encampment. So, with shelter-in-place orders just beginning to fall off across the country, those citizens that relapsed during these difficult times will may require the support and recognition of community members to achieve sobriety. 
Substance abuse and drug overdoses are on the rise. Current statistics are providing us a glimpse into the devastating power of a pandemic. The University of Southern California found that alcohol sales increased by 55% from last March. Alcohol misuse can contribute to binge alcohol use, alcohol poisoning, and alcohol withdrawal. All of which can have deadly results. In states across the country, reports of drug-related deaths are on the rise, and these are just what is reported. In Minneapolis, there has been an 8% increase in overdoses when compared to last year, which is the highest on record in the previous decade in reports published by the police department. Other states are showing similar trends without enough news coverage. Sharing this information with the public would increase awareness and start a dialog about the risk of contracting the virus. 
This is because the infection takes hold of the body by way of the lungs, which are particularly susceptible to drug-using populations especially those with SUD. Those who smoke tobacco, cannabis, or vape often won't consider themselves within the SUD category, but those in China with smoking-related lung disease showed a 4% higher case-fatality-rate. This statistic didn't account for those with opioid use disorder (OUD) or methamphetamine use disorder (MUD). The drugs contribute to decreased lung function by opioids suppressive effects on the respiratory center of the brainstem, causing breathing to slow or methamphetamine's constrictive action on blood vessels. Both drugs reduce blood's oxygen-carrying capacity. Often times, those with SUDs are self-medicating the symptoms of the gross negligence they face from the social injustice of adverse childhood experiences (ACEs).
Supportive innovation and structure in our days are what is necessary. Recently, there has been coverage of the sub-pandemic that lurks under the statistics of COVID-19 tracking frenzy. The attention has led to increased awareness of the supportive networks that were available before the pandemic like Alcoholics and Narcotics Anonymous. While new innovative ways that bridge zoom and cellphone applications provide instant connection when triggers lead to cravings. I find structure in my days around some normalcy, by finding time for myself through mindfulness and meditation. Despite times of social distancing, we all need to come together and support one another. We need to demand that the media draw more attention to mental health. Because while we track the numbers of COVID-related deaths, a better measure of life is the number of good mental health days.

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