Pandemic (from Greek πᾶν, pan, “all” and δῆμος, demos, “people”) is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of people
An epidemic (from Greek ἐπί epi “upon or above” and δῆμος demos “people”) is the rapid spread of disease to a large number of people in a given population within a short period of time
Declaring that COVID-19 has uprooted almost every single facet of our daily lives would belabour the obvious. Elections are dominated by finger pointing over the lives lost from the virus. We can no longer eat meals at our favorite restaurants without a Plexiglas screen. Every social gathering requires careful and deliberate planning, so that lives are not lost from a simple BBQ. Even the scaredness of weddings and funerals is marred by distance protocols and masks. However, although our attention is turned towards our pandemic, our epidemics have not disappeared. The chaos wrought by COVID-19 has only exacerbated the deadly Opioid Epidemic that has been killing Canadians for decades.
Despite a decline in 2019 of opioid-related deaths in Toronto, incidents of opioid overdose in 2020 immediately spiked following the onset of the pandemic, rapidly exceeding the prior year’s cases (1). In BC, it has been estimated that more people have been impacted by the surge of opioid cases, through the persisting addiction or death from overdose of a loved one, then by COVID-19 itself (2). The acceleration has shown no sign of letting up and may be worsened when further restrictions are put in place to blunt a second wave.
Support services that normally limit the potential for overdose deaths have been forced to scale back to comply with social distancing restrictions. For individuals with opioid use disorders, the metamorphosed stations can be alienating (2). The sight of social workers decked out in PPE and stringent restrictions governing the stations does little to mitigate the stigma already inherent with drug abuse (2). First responders such as paramedics and police have already had their resources significantly stretched, and so the ability to respond swiftly and effectively to an overdose crisis has been crippled. Supply lines have also been dealt a significant blow, meaning lower quality and laced street drugs like heroin are becoming more of a norm for consumption, when traditional opioids have been exhausted (2). Social restriction guidelines strike at the core of the attempts of individuals to wean themselves off their addiction or at least practice in a way that ensures harm reduction. Increasing evidence suggests that the lack of social connection and support is perhaps an important driver in deciding who becomes addicted to opioids and who does not(3). COVID-19s sudden decimation of social gatherings and events thus destroys one of the most important steps used by individuals to make the first steps toward sobriety or at least safe-use.
Although the temporary diversion of Public Health resources to the COVID-19, and the temporary social distancing restrictions might have lead to the short term surge in opioid cases, there is no guarantee that these issues will resolve with the close of the pandemic. The financial consequences that have brutalized the service industries have taken their toll and will almost certainly generate an environment suited to sustaining opioid abuse. Throughout the world, economics have been utterly devastated, and years of effort to reduce poverty and social inequalities have been largely reversed. The World Bank estimates these in absolute poverty will rise by almost 100 million(4). Canada being a wealthy nation, will probably avoid much of the disaster that will soon befall the third world. Yet the disadvantaged in our nation will bear a significant brunt of the long-term costs of COVID, as the reduced demand for goods and services persists and eventually translates into reduced employment for the service industries that form the backbone of our economy. The Canadian Human rights commission recently prepared a statement declaring that the impact of COVID-19 upon economic prospects is very much disproportionate (5). The Indigenous peoples of Canada, who already experience higher levels of poverty and opioid use disorders, will undoubtedly suffer from COVID19 exacerbating the overcrowding, isolation, and lack of basic health facilities that unfortunately characterize many of their communities (5). These in precarious housing situations now not only have to worry about reduced incomes, but also a lack of public spaces that they could relocate to in the event of losing their living quarters (5). Though the rise in poverty will not be as calamitous as in the developing world, Canadians will still have much to lose.
Opioids can become an appealing option for these trapped in the destitute environment of poverty. Seeking any sign of relief from their torturous, stressful, and tumultuous conditions, many individuals will turn to the dopamine rush offered by narcotics (6). Billions are already being provided by the federal government as a bulwark against calamity. Borrowing more could potentially be unsustainable and lead to crippling interest rates and debt in the future that may cripple the long-term growth of the nation for years to come. However, the federal government can and should allocate resources towards dealing with this second hydra’s head of public health, lest it emerge even more empowered upon concluding the pandemic. Safe injection spots must be maintained, and social work bolstered to provide support to recovering individuals. Expanding access to a safe supply of drugs would be better then individuals using the contaminated street products, and when monitored, can help prevent the chance of excess and overdose (1). Although cases have begun to surge again, the nation will be more able to deal with the pandemic effectively and proactively, having learnt from the lessons from the past. What we are not ready for is a nation crippled by an opioid epidemic that was ignored only to become an uncontrollable beast.
1. Jeffords S. Opioid crisis worsens during pandemic as services for drug users scale back. [Online] National Post. National Post; Available from: https://nationalpost.com/pmn/news-pmn/canada-news-pmn/opioid-crisis-worsens-during-pandemic-as-services-for-drug-users-scale-back [Accessed: 11thOctober2020]
2. Hernadez J. Overdose crisis affecting more British Columbians than COVID-19: survey | CBC News. [Online] CBCnews. CBC/Radio Canada; Available from: https://www.cbc.ca/news/canada/british-columbia/overdose-crisis-affecting-more-british-columbians-than-covid-19-survey-1.5721478 [Accessed: 11thOctober2020]
3. Weiss R. The Opposite of Addiction is Connection. [Online] Psychology Today . Available from: https://www.psychologytoday.com/ca/blog/love-and-sex-in-the-digital-age/201509/the-opposite-addiction-is-connection [Accessed: 11thOctober2020]
4. The pandemic is plunging millions back into extreme poverty. [Online] The Economist. The Economist Newspaper; Available from: https://www.economist.com/international/2020/09/26/the-pandemic-is-plunging-millions-back-into-extreme-poverty [Accessed: 11thOctober2020]
5. Landrye M-C. Statement – Inequality amplified by COVID-19 crisis. [Online] Statement – Inequality amplified by COVID-19 crisis | Canadian Human Rights Commission. Available from: https://www.chrc-ccdp.gc.ca/eng/content/statement-inequality-amplified-covid-19-crisis [Accessed: 11thOctober2020]
6. Dasgupta N, Beletsky L, Ciccarone D. Opioid crisis: no easy fix to its social and economic determinants. American journal of public health. 2018 Feb;108(2):182-6.