Crisis Within a Crisis: How COVID-19 Is Driving the Opioid Epidemic

While the current national health conversation has largely centered on the COVID-19 pandemic, which has resulted in more than 200,000 deaths in the U.S. alone and more than a million worldwide according to recent World Health Organization (WHO) data, another ongoing and deadly battle has been looming in the background: the opioid crisis.

The misuse of and addiction to opioids, including prescription pain relievers, heroin and synthetic opioids such as fentanyl, started becoming widespread in the U.S. in the late 1990s and found its way to the top of the national health radar in 2017 when President Donald Trump officially declared it a public health emergency.

Although the nation’s focus may have shifted to the coronavirus pandemic in recent months, the opioid crisis not only remains a challenge, but also may have worsened due to COVID-19. That’s according to speakers during a webinar co-hosted by the American Property Casualty Insurance Association (APCIA) and the U.S. Chamber of Commerce.

“The impact that COVID-19 has had on the opioid addiction crisis in the U.S. has been staggering,” said APCIA President and CEO David Sampson.

Because opioid use affects respiratory and pulmonary health, those using opioids and other substances are also more susceptible to COVID-19.

Drug overdose deaths in the U.S. rose 4.6% in 2019 to 70,980, including 50,042 involving opioids, according to data from the Centers for Disease Control and Prevention (CDC). What’s more, many U.S. states are now reporting a significant rise in drug fatalities for 2020 as COVID-19 has created new obstacles contributing to increased opioid use, abuse and risk of relapse for those in recovery, Sampson said.

“For those battling addiction, quarantine and social distancing have resulted in disruptions of treatment and recovery services and limited access to mental health services and peer support,” he said. “Additionally, interrupted routines, loss of work, housing and prolonged stress.”

David Sampson

Because opioid use affects respiratory and pulmonary health, those using opioids and other substances are also more susceptible to COVID-19, compounding these two crises, Sampson said.

More Than a Health Issue

With this in mind, speakers added that private/public partnerships will be instrumental in fighting the opioid addiction emergency going forward.

“Yes, it’s personal and yes, it’s emotional, but it also impacts business,” said Suzanne Clark, president of the U.S. Chamber of Commerce. “It impacts entire communities. It impacts your workforce. It impacts the economy. And so they’re reasons for business leaders to be at the table and to be part of the solution.”

James Carroll, director of the U.S. Office of National Drug Control Policy, agreed, applauding insurance companies that have stepped up to provide reimbursement for addiction treatment services. Carroll said the current administration has been working to fund these services that are provided through small businesses, hospitals and specialty treatment facilities.

“During COVID-19, unfortunately, the numbers are going the wrong way.”

“The COVID-19 pandemic has affected everyone, but it has especially affected those in or seeking treatment and long-term recovery [for addiction],” he said. “We know that many are unable to access medication, counseling, recovery support services or mutual aid and response. This administration has mobilized the entire federal government to confront this problem.”

Carroll serves as the principal advisor to the President of the United States on drug policies and works to coordinate activities between 16 federal government agencies and departments on behalf of the administration’s effort to reduce the supply and demand of illicit substances.

James Carroll

“We have to be relentless to erase the stigma and address [the opioid crisis’] impact,” he said.

It’s an impact that has been far-reaching, not only serving as a public health issue but also an issue of social and economic well-being, according to the National Institute on Drug Abuse. This is why insurers like The Hartford have moved to combat the effects of this crisis.

“During COVID-19, unfortunately, the numbers are going the wrong way,” said The Hartford Chairman and CEO Christopher Swift. “So, we have to double down our efforts.”

As a large workers’ compensation provider, The Hartford is working to fight the opioid crisis by providing access to education and programs to reduce opioid use nationwide. This effort, Swift said, will require federal, state and local governments to explore options for increased partnerships with the private sector.

Surveys show 47% of small businesses and employers do offer employee assistance programs, but that means 53% don’t.

“I think it’s a fairly well-known fact…that with a three-to-five day dose of powerful opioids, you could create an addiction problem over a long period of time,” he said. “It’s a workforce issue. It costs us money.”

The CDC estimates that the total economic burden of prescription opioid misuse in the U.S. is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment and criminal justice involvement.

“I think this is more than a health issue,” Swift said. “It’s a workplace productivity issue. We’ve done surveys of small business owners where we have a deep understanding that 56% of them say that they are impacted or believe they will be impacted by opioids in the future.”

Christopher Swift

With this in mind, Swift called upon employers to review their employee benefit plans and ensure they contain addiction support services that meet employee needs.

“I think business leaders through their HR department could really look hard at their benefit programs and say, “Is it doing everything we can or should do for our employees and their beneficiaries during this period of time?'” he said. “Again, in a lot of our surveys, 47% of small businesses and employers do offer employee assistance programs, but that means 53% don’t.”

As one example, Swift said, The Hartford added prescription digital therapeutics for substance use and opioid use disorder to its benefits package over the past year and began offering a mobile app, as well as a telephonic medical concierge service, that provides real-time support for employees to get the help they need.

“We need more companies like The Hartford coming forward and saying, ‘We care about this issue, and we’re going to put our money where our mouth is and commit to erasing the stigma,'” said Courtney Hunter, vice president of state policy for Shatterproof, a national nonprofit organization dedicated to transforming addiction treatments, ending stigma and supporting communities.

“During COVID-19, unfortunately, the numbers are going the wrong way.”

Change for the Better

Particularly in light of COVID-19, Hunter and Swift both agreed that it’s more important than ever for business leaders to have an increased communication strategy that makes it safe and comfortable to talk about addiction and mental health.

“Language is incredibly important,” Hunter said. “Utilizing the right language and making sure that it’s advancing our policies and our actions around what the healthcare community is saying, which is that addiction is a disease. It is not a moral failing, and we need not have shame.”

This has been made easier by advancements in telemedicine and increased use of technology within the health sector, speakers said.

“One silver lining to this terrible pandemic is that it has driven a rapid transition to virtual platforms across the treatment and recovery support sectors, as well as the broader recovery community,” Carroll said.

Swift predicts that telemedicine will become more widespread as a complement to in-person medical services in the future.

“I don’t think it’s going to replace the traditional approach,” he said. “I think it will augment it and ultimately give people more comfort and confidence.”

Telemedicine will become more widespread as a complement to in-person medical services in the future.

Most of all, despite the combined impact of the ongoing opioid epidemic as well as the COVID-19 crisis, Swift and Hunter both emphasized the importance of not losing hope.

“No one in the world thought we would ever live through a pandemic, at least I didn’t, and we got set back,” Swift said. “Just because we got set back doesn’t mean we give up and run away.”

Courtney Hunter

Swift said that instead, it’s time to double down and continue to fight for those with substance use disorders. Clark agreed.\

“Just like the pandemic, there is light at the end of the tunnel,” she said. “…we know that when companies do well, they can do good. It’s a great joy for me in my job to get to meet companies that are doing so well and then turning around and doing so much good. I think the private sector really does lead the way on so many of society’s challenges.”

But with the COVID-19 pandemic and the opioid crisis each exacerbating the other in some ways, is it possible to remain hopeful?

“I hear stories of hope every day,” Hunter said. “I work with so many families and people that have lost and continue to advocate and work in this field and change things for the better. So absolutely, we can do it. There’s hope.”