When a Pandemic and an Epidemic Collide by LISA HOWLEY Anxiety. Stress. Isolation. Grief. For far too long, these words have been used to developing effective treatments for both COVID-19 describe the consequences of the epidemic of substance and SUD. The Association of American Medical use disorders that has devastated communities across Colleges, which represents the academic medicine the country. Now, as the COVID-19 pandemic piles community, is committed to supporting all of our on the uncertainty for individuals, families, and members’ efforts to improve the lives of patients and communities, it is also threatening the progress of the health of our nation. people with a substance use disorder (SUD) and putting As an educational psychologist, I have the honor others at risk of developing one. of supporting our constituents Although we don’t yet know in their efforts to practice the full picture of the pandemic’s medicine, teach, and conduct impact on the opioid epidemic, research. During this pandemic, we do know that in 2018 the I have not only seen the toll it number of people suffering from is taking, but I have also seen a substance use disorder topped firsthand their commitment 20 million and just 11 percent to patient care. The academic of those in need of treatment medicine community has and were able to receive it. Since the continues to step up despite the pandemic began, more than 40 challenges they are facing and states have reported increases those who teach doctors and the in substance-related deaths, next generation of scientists and particularly those related to clinicians are finding innovative illicitly manufactured fentanyl, ways to respond to the epidemic methamphetamine, cocaine, and of addiction amid the pandemic Lisa Howley heroin. of COVID-19. People are hesitant to seek Although all of our members medical treatment, including are teaching content related to Since the pandemic for SUD, for fear of catching addiction, we recently awarded began, more than 40 COVID-19. And for many grants to nine diverse institutions months during the early days of states have reported in particular— Arizona State the pandemic, while cities and University, Penn State College increases in substancestates were enforcing lockdowns, of Medicine, Stony Brook related deaths. those treatment facilities may not University, The Robert Larner, have even been open. But no two M.D. College of Medicine at experiences are identical. For the University of Vermont, some with SUD, social distancing may have helped The University of Florida College of Medicine, The keep them away from dangerous substances or harmful University of Texas at Austin Dell Medical School, influences. But for others, the loneliness of isolation University of Alabama at Birmingham, Vanderbilt could make their situations much worse. The pandemic University Medical Center, and the Zucker School of may be unprecedented, but the consequences of an Medicine at Hofstra/Northwell—to develop tools and economic downturn have been seen before. resources to help advance teaching and learning in At the frontlines of both the COVID-19 pandemic areas such as pain management and addiction. and the substance use epidemic are academic medical The pandemic has caused these teams to rethink, centers, comprised of medical schools and teaching realign, and reset their goals, each in different ways. hospitals that are caring for patients while also But one of the unanticipated benefits is that these teaching health care professionals and researching and educational innovations, born of the unprecedented RIPON FORUM October 2020
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