CURRENT EVENTS
A CRISIS WITHIN A CRISIS THE OPIOD EPIDEMIC AND THE COVID-19 PANDEMIC By
Sanjana Rao Anna Argulian
The COVID-19 pandemic has devastated the United States, killing approximately 225,000 people over the last 10 months. However, over the two decades before COVID-19 reached American shores, a more insidious epidemic has been ravaging the country. In 2018, it was estimated that 128 people died of an opioid overdose every day, leading to an overall total of 450,000 opioid related overdoses from 1999 to 2018. Among those who survived, chronic opioid abuse has been shown to inflict critical damage to their pulmonary and respiratory health, placing them at high risk of developing severe symptoms should they contract COVID-19. Moreover, many such individuals are already at risk from a socioeconomic standpoint, as a large majority are either homeless or incarcerated. The opioid crisis in the USA has not disappeared under the onslaught of COVID-19. On the contrary, affected individuals are now more vulnerable than ever. Opioids refer to a class of drugs that bind to opioid receptors, blocking pain signals from the brain and stimulating the release of dopamine, resulting in feelings of euphoria. Users find themselves craving the drug, as it strongly reinforces the wish to repeat the experience. Commonly abused opioids include Hydrocodone (VicodinÂŽ), Oxycodone, Fentanyl, Morphine, Codeine, and Heroin, some of which are prescribed as pain medication. Substance Use Disor-
der (SUD), or more specifically, Opioid Use Disorder (OUD), is highly prevalent in the United States, with an estimated 2 million suffering from it and more than 10 million people misusing or abusing opioids. OUD has been associated with a long list of adverse effects, including chronic kidney, liver, and lung diseases, as well as cardiovascular diseases, type 2 diabetes, obesity, and cancer. Chronic opioid misuse is associated with disordered breathing, which can result in hypoxia, or low oxygen levels in the brain. Similarly, studies show that up to 10% of patients who take opioids over long periods develop hypoxemia, which is an oxyhemoglobin saturation of lower than 90%. Low oxygen levels can lead to permanent brain damage and can severely damage the workings of several organs, including the lungs and heart. A recent study among Medicare patients suffering from arthritis that compared the effects of opioid prescriptions with NSAIDs and COX-2 inhibitors found that opioid therapy was correlated with a 77% increased risk of cardiovascular events. COVID-19 has been demonstrated to have (according to data from the Chinese Center for Disease Control and Prevention) a fatality rate of triple the normal fatality rate in patients with chronic respiratory disease. Further data from the CDC indicates that patients with comorbidities are at a higher risk of hospitalization with COVID-19, as well as fatal complications. Moreover,
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