The coronavirus outbreak could worsen America’s substance use crisis. USC addiction expert Adam Leventhal explains why it matters to all of us.

(Originally posted at Trojan Family Magazine.)

By Eric Lindberg

Adam Leventhal

Odds are about 50-50 that you know someone who’s been addicted to drugs, at least if you’re in the U.S. And now may be a particularly tough time for that friend or family member.

The COVID-19 pandemic has driven up anxiety due to lost jobs, economic uncertainty and growing demands at work and home. Today, more people are turning to drugs and alcohol to cope, research shows. That troubles health officials, who have seen suspected drug overdose deaths spike in 20 states since the pandemic began.

It’s especially troubling to Adam Leventhal, founding director of the USC Institute for Addiction Science. Leventhal has dedicated his career to understanding and preventing substance use and addiction. The professor of preventive medicine and psychology at the Keck School of Medicine of USC and USC Norris Comprehensive Cancer Center recently spoke with USC Trojan Family about why COVID-19 sets off alarm bells for people who fight addiction as a public health issue.

Data Suggest the Pandemic is Worsening Substance Use Problems

A national study by the Centers for Disease Control and Prevention asked people if they are using more substances to cope with the emotions of the pandemic. A significant proportion said yes. At USC, we have been surveying more than 10,000 teens and young adults across Southern California about their substance use, mental health, use of social media and other timely issues. We see similar concerns about increased substance use because of the pandemic.

Although we don’t have rock-solid evidence yet, everything is indicating that, on average, both younger and older Americans may be drinking more than they used to. We can speculate about why that might be: boredom, trying to calm nerves or relieve stress, or coping with depression — which alcohol is not very good at doing.

It’s concerning, particularly if people who already have an alcohol use disorder might be getting worse. The many negative consequences of that alcohol use could grow, especially the longer the pandemic goes on — if, in fact, the pandemic is the cause of increases in drinking in the U.S. On top of the pandemic, many stressful events have happened in society over the past 6 months or so, such as racial injustices and concerns about the 2020 election. Alcohol-related consequences like depression, difficulty fulfilling job or family roles, and the risk of many alcohol-related diseases are something health professionals and policymakers need to keep an eye on moving forward.

COVID-19 May Put Addiction Treatment Out of Reach for Some

People are losing their jobs and running out of money. And those with a substance use disorder are more likely to be socioeconomically disadvantaged. Some people with addictions are chronically unemployed. These folks are probably being hit hard by the economic impact of the pandemic. Economic issues and possible changes to the health care coverage system may affect the ability of people with addictions to obtain or keep health insurance, which clearly affects access to treatment.

Programs like Alcoholics Anonymous and Narcotics Anonymous have had a broad reach in terms of supporting people with substance use issues for decades. Can these ongoing 12-step meetings still be regularly held in the pandemic, and what are the safety protocols? People are trying to come up with workarounds and hold virtual meetings. They’re trying their best. But it’s not difficult to speculate that, on average, it’s harder to access meetings or other forms of addiction treatment.

There is some positive news, though: Some policy changes have made it easier to get medications for addiction problems through telehealth visits. Since the pandemic, people don’t need to visit a doctor in person to receive a prescription for buprenorphine, which is an effective treatment for opioid addiction. Federal rules are also being relaxed to make it easier to get reimbursed through Medicare and Medicaid for telehealth visits for substance use disorders.

It would be great if this pandemic ends up increasing access to treatment, especially for the people who have a hard time getting to their health care provider. Here in Los Angeles, it can take more than 2 hours and four bus transfers just to cross the city to see a provider. That alone is quite an obstacle.

Finding the Data Behind Addiction and COVID-19

Another good thing is that we’re seeing some new federal funding available for research on addiction and COVID-19. The National Institute on Drug Abuse has made special funds available for rapid research projects. At the USC Institute for Addiction Science, we are having roundtable discussions on addiction and COVID-19, and our researchers are studying the intersection of these two crises.

One of our studies is looking at Nielsen sales data to explore changes in alcohol and tobacco use during the pandemic. We’re also studying social distancing and how many young adults weren’t following the proper guidelines from May through August. We have found that people who use certain substances or are more politically conservative are more likely to host or attend parties with 10 or more people, which could increase the spread of the coronavirus in the community.

We’re also examining whether people who use substances like tobacco and could have damaged lungs are more vulnerable to contracting the coronavirus. Another project is exploring emergency room admissions that are addiction related, and initial data suggest those visits are going down. One possible reason for this trend is that people who need emergency services for addiction are not going to the hospital because they are afraid of being exposed to the virus. That’s a concern if people are still having acute addiction crises but aren’t getting emergency treatment.

Hospitals, including those in the Keck Medicine of USC system, have very stringent procedures to help protect all patients from exposure to the coronavirus. We need to get the word out about these safety procedures in hospitals, along with the dangers of going without treatment for addiction or any other acute health problem.

What You Can Do to Face Addiction

On a personal level, if you’re drinking a little more or using a little more marijuana than normal and you’re wondering if you should be concerned, a good first step is to start monitoring your substance use levels. Try to make a goal to reduce the number of days each week you drink or not surpass a certain number of drinks each day you drink. This exercise is useful regardless of how it turns out. If you meet your goal, that’s great, you’ve reduced your use.

If you don’t, that suggests you could potentially have one of the symptoms of a substance use disorder, which is an inability to control the amount of the substance you use. That might suggest you do need help. The American Society of Addiction Medicine’s website has some great resources for dealing with substance use issues during the pandemic.

Across the country and around the world, addiction costs a tremendous amount of money and causes so much death and loss. If you think about all the different addictions and their health effects, including tobacco- and alcohol-related diseases and opioid overdoses, addiction is clearly the leading cause of preventable death and disability.

As a society, we need use our resources, time and attention on the most detrimental problems we face. This means prioritizing the fight against the ongoing addiction epidemic, which was at crisis levels before the pandemic and is liable to be worse once the world overcomes COVID-19. It will be much harder to address later if we’re seeing even more people dying from tobacco-related cancers, more broken families with loved ones dying of overdoses, more people dying from complications of drinking, and all the other ways that addiction affects our society and health system. The extent to which we can try to stay ahead of any exacerbation of the ongoing addiction epidemic is certain to benefit us down the road.

Editor’s note: This interview has been lightly edited for clarity and flow.

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