Coping with COVID-19 and Substance Use Disorder (SUD)

NIDA Director Dr. Nora Volkow discusses the challenges faced by those in recovery or struggling with addiction and NIH research dedicated to understanding SUD-related health risks during the COVID-19 pandemic.

Video length: 6:42

Transcript

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Anne Rancourt speaking:

Dr. Volkow, let’s start by talking about the risks of COVID. What do we know about possible increased risks of contracting COVID or getting a more severe case for people who are struggling with addiction or who are in recovery?

Dr. Nora Volkow speaking:

Well, it is a new pandemic, so we don’t have much data that has emerged that can actually give us the evidence of exactly what is it that happens. However, because of what we know of COVID, recognizing that certain comorbidities, particularly pulmonary and cardiac, are going to put you at greater risk, we can clearly actually predict that individuals with a substance use disorder are going to be at higher risk of adverse outcomes from COVID because they are much more likely to have these comorbidities, due to the effects of drug exposures, in pulmonary and respiratory diseases.

The other component too that relates to infection, the risk of infection, we know that if you are addicted to drugs and you don’t have a support system, and you are actually out there in the streets trying to get these drugs, you’re much more likely therefore to encounter conditions where you may get infected.

And we also know, on a third level, is that many of the drugs of abuse themselves indirectly or directly affect the physiology of our bodies. For example, if you are using opiates, that produces respiratory depression, and respiratory depression leads to lower oxygen content in the lungs, which, of course, makes you then much more vulnerable for any infection that is going to be targeting pulmonary function. These are three of the events, actually, from which we can predict that individuals with a substance use disorder are at greater risk.

Anne Rancourt speaking:

What are some of the challenges that people in recovery, specifically, might be facing now?

Dr. Nora Volkow speaking:

We are social creatures, we human beings, and we depend on social support in order to actually do many of the things and for a sense of wellbeing.

And this is also the case for individuals that are fighting drugs or are on recovery. The social supports are fundamental for providing a structure that will increase the likelihood that they will succeed. So as we in the COVID epidemic have had to observe social distancing, this makes it much harder for those that are trying to achieve recovery or are on recovery to stay on recovery when those social structural systems are no longer there.

Anne Rancourt speaking:

And, also, so challenging people who are now struggling with substance use, what do they need to know in terms of challenges that are out there and also what do their friends and family need to know and possibly that they could do to help?

Dr. Nora Volkow speaking:

Well, like anything that has such a tragic effect on our society, it leads us to come up with solutions. Some of those solutions actually, if taken advantage of, can significantly help outcomes. So if someone is addicted to drugs, and they see these services in the community closing down, it’s very important for them to realize that now there has been an expansion of access of telehealth applications that enable them to receive treatment or support, including social network support, through these applications. Some of them are for free.

Anne Rancourt speaking:

You’ve seen first-hand how stigma can take a toll on people who are struggling with addiction. What lessons learned have you seen from your work that we should keep in mind now during COVID?

Dr. Nora Volkow speaking:

I think it is very relevant that we all recognize our emotions when we are faced with someone. And be aware that we are operating under very stressful conditions and that we have to learn to be more tolerant to diversity as it relates, of course, in general to all different ways of looking at the world, but, importantly, as it relates to someone that may come or need help 

Be aware that that person actually may be in much greater need of help than someone else. And to also recognize in our own actions, whether, in fact, some of that rejection is, in fact, stigma, and being aware of our own way, the way that we deal with our issues, and overcome them. Because a person that is suffering from substance use disorder may not necessarily seek out for help. 

And so we sometimes need to be proactive and make that person feel comfortable, Being able to create that sense of trust in the person that is suffering from addiction so that they can seek out the help, is also very important.

Anne Rancourt speaking:

Here at NIH, scientific research is our business, of course. What research questions has COVID-19 prompted for you as a researcher? 

Dr. Nora Volkow speaking:

Well, there are many questions that this pandemic hitting the epidemic of the opioid crisis in the United States has posed to me in terms of research, starting from a better understanding about what this collision means to people out there suffering from addiction, their families and the healthcare system and justice settings that are dealing with it.

What are the realities people are facing and how diverse are they? And how are the communities addressing these challenges?

…so research at NIDA and certainly as a researcher in neuroscience, I’m obviously extremely interested, like many others, of the extent to which the virus may influence the brain and does it influence it in terms of does cross the blood-brain barrier or are its effects predominantly indirect through exacerbating immune responses that then affect how the brain functions.

Well, what happens in terms of brain development, if a mother who’s pregnant gets infected with COVID, how does the influence? Does the virus influence the brain? And are you going to be seeing it clinically, or will it be a silent infection? These are some of the examples of the questions that are extraordinarily important for us to investigate so that we can guide better the patients themselves but also the interventions and follow-up and monitoring of these patients.

Anne Rancourt speaking:

Absolutely. We’ve so much to learn. Dr. Volkow, thank you so much for joining me today. And thank you for watching. 

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