EPIDEMIC MEETS PANDEMIC
THE IMPACT OF CORONAVIRUS ON THE OPIOID EPIDEMIC
AND HIGH SCHOOL DRUG EDUCATION PROGRAMS
Post by BRITTANY LADSON
One of the least noticed effects of the COVID-19 pandemic is not the disease itself but its devastating effect on other medical problems. One of the biggest of these is what’s happening with the crisis with opioid misuse. "The interaction between COVID-19, the fear of COVID-19, and substance use and addiction are pretty much the worst combination I have seen in my career without question," according to Dr. Thomas Britton, CEO of the Gateway Foundation, a network of drug treatment centers in Chicago, who spoke to ABC News. The stay-at-home orders and social distancing are having disproportionate effects on those already suffering from substance misuse—with terrible consequences. In Chicago, CBS News reports overdose fatalities are up 50 per cent over last year. News headlines such as “Cries for Help: Drug Overdoses are Soaring” “Opioid Overdoses are Skyrocketing,” and “U.S. Drug Overdose Deaths Resurge” are becoming increasingly common around the country. Opiate overdose deaths have literally become a symptom for COVID-19.
Before COVID-19 was introduced to the world, those experiencing opiate misuse disorder could attend narcotics anonymous meetings, receive treatment at methadone clinics, and receive in-person social support from friends and family. Although these resources have not been equally accessible across all socioeconomic backgrounds, their impact in many lives has been extraordinarily vital. With the introduction of social restrictions, people in recovery are put in risk of relapse or overdose. Physical distancing hinders community support, reduced income or job loss can introduce new stress in lives, and difficulty accessing treatments such as naloxone, buprenorphine, and methadone can lead to withdrawal.
Another effect of the pandemic is school shutdowns, which have halted high school opiate education programs. Even before the complications of coronavirus, an average of 70,000 people died from opiate related deaths in the United States every year, but educational and Naloxone distribution programs can reduce the total number of opioid overdoses up to 55% within those communities.
This is where my work comes in. To address the growing opioid epidemic, six 3rd year medical students at Michigan State and I developed an opiate awareness educational program for high school students across Michigan, then tested its efficacy. High school students in Michigan already learn about the dangers of cigarettes and alcohol through the required Drug Abuse Resistance Education (DARE) program but weren’t receiving systematic knowledge about opioid abuse.
Above: Christian Rohl, Terry Cregg (high school teacher at East Lansing High School), Brittany Ladson and Saaranga Sasitharan, students who ran the opiate awareness programs. Credit: Brittany Ladson
Our program fills this gap with an interactive combination of thought-provoking videos, energetic group discussions, and a unique lecture-styled material delivery. We began by holding educational programs for nearly 300 students at East Lansing High School in Ingham County, Romeo High School in Macomb County, and Benjamin Carson High School in Wayne County. If high school students learn early about the seriousness of opiate misuse, would that impact their decisions to use opiates? This is exactly what we sought to discover.
Topics discussed during the program included identification of opiates, overdose, societal impact, national financial burden, and Narcan administration (an overdose reversal medication). When we gave students a chance to talk to one another in small groups about developing solutions to these problems, we were astounded to see how engaged and creative they were. Some even thought of ideas that never crossed our minds. One group of students thought to create an electronic pill box that would only open when it was the exact date and time of a patient’s next narcotic dose, thus stopping patients from taking too much and preventing potential addiction.
It helped that we were so close in age to the high school students, allowing us to keep their eyes on us and their ears and minds open. Every classroom we talked to was eager and receptive to the information we shared with them. One student was prescribed Dilaudid after injuring his anterior cruciate ligament (ACL), one of the major ligaments in the knee. This is an incredibly strong and addictive painkiller, completely out of proportion to his actual needs. Fortunately the boy’s father, an emergency room physician, found out about it and intervened with his son’s doctor, threatening to bring him to the state board to have his medical license stripped for life. Most children, of course, don’t have a physician parent who could understand and intervene, leaving them vulnerable to overprescription of painkillers without knowing the gravity of the prescription.
To learn what impact our program had on students, we tested them once before we began it and once afterward, asking such questions as “Which drugs are considered opiates?,” “Where do users get access to opioids?,” and “Is it possible to stop someone that is overdosing?.” After months of working with students, our tests showed more correct responses after the program and an increase in the overall confidence in students’ understanding of opiates. Given these positive results, we intend to continue our opiate education program in high schools all across the state and even include education on the vaping epidemic we are currently entering as a nation. We also hope to make this education mandatory in every high school across the state and to see the longitudinal effects of implementing this program.
The continuing impact of the pandemic means primary education across the country will look dramatically different next school year. Students will be spending less time in the building and there will be countless guidelines on how to encourage social distancing among students and staff. It will also be more challenging to have guests come into schools and teach an opiate educational program. If education on opiate misuse disorder in the youth is derailed, what does that mean for those vulnerable to developing addiction and those actively going through its effects? We hope to train high school teachers on how to deliver an effective opiate education program so its implementation can continue regardless of any regulations schools are faced to endure in the aftermath of coronavirus.
The opioid epidemic is facing a global pandemic. Coronavirus has changed healthcare and health promotion in ways no one thought would be necessary but has shown us all how to be resilient. Multiple health crises mean comprehensive solutions. Through the implementation of virtual narcotics anonymous meetings, telemedicine consultations, and phone therapy sessions, there continues to be ways to reach long lasting recovery.
If you or someone you know is struggling with opiate misuse disorder and need resources for support, listed are virtual services available during the coronavirus pandemic.
Substance Abuse and Mental Health Services Administration:
How to support a friend or family member:
BRITTANY LADSON is a 3rd year medical student at Michigan State University College of Osteopathic Medicine. She starts her rotations at Sparrow Hospital in Lansing, MI this August and hopes to pursue a residency in emergency medicine so she can combine her interest in opiate addiction medicine with other fields of medicine. She is also vice president of operations for MSU Sci Comm. Read her Instagram feed at https://www.instagram.com/mymilestomedicine/
Kitty meets goat. Creative Commons
Cartoon by Dave Adam Zyglis. Crative Commons
Photo courtesy Brittany Ladson
Photo courtesy Brittany Ladson