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Understanding Impacts of COVID-19 on Substance Use Disorder and Treatment

In the midst of an ongoing nationwide opioid crisis, the global COVID-19 pandemic has significantly impacted people with substance use disorders – and particularly opioid use disorders. Social distancing requirements, shelter-in-place orders and the many unknowns about this coronavirus have created challenges for ensuring access to prevention and treatment services.

“The COVID-19 pandemic created additional challenges for people with substance use disorders and those at risk of developing problems, but treatment providers, policymakers and researchers have been working to find new ways for people to get the help they need during this time,” said Hillary Samples, a faculty member of the Center for Health Services Research at the Rutgers Institute for Health, Health Care Policy and Aging Research and an assistant professor at the Rutgers School of Public Health.

What concerns did COVID-19 present for people with substance use disorders?
COVID-19 immediately presented concerns about accessing treatment for substance use disorders. Depending on the nature and severity of the problem, treatment may require frequent in-person visits. For example, some medication treatments for opioid use disorder are administered daily, raising the risk of virus exposure and transmission.

Efforts were made to rapidly and substantially transform treatment practices to reduce community spread of COVID-19, but concerns about the balance of risks and benefits remain – not only for people who were in treatment before the pandemic, but also people who may have developed problems with substance use during this time. While data often lag, particularly for illicit drugs, there are early indications that substance use has increased.

What is being done to help people with substance use disorders?
Treatment for substance use disorders is highly regulated. In response to the pandemic, the federal government, in partnership with states like New Jersey, broadly increased the availability of health care by providing temporary flexibility to ease program requirements and expand options like telemedicine. In addition, specific policy exemptions relaxed regulations for medications for opioid use disorder to reduce in-person visits without limiting access to new or ongoing treatment.

Going forward, we need to better understand the impacts of both COVID-19 and the changes made by policymakers and treatment providers on people with substance use disorders.

What is the research community doing to understand the impacts?
The research community is working to better understand the outcomes of both the challenges presented by COVID-19 and the changes in treatment access and delivery. Knowing more about what changes have been effective can help drive lasting advances in policies and practices that improve substance use treatment access and quality.