COVID-19 Creates New Challenges for Workers Suffering from Opioid Addiction

Construction workers are the most likely of all occupations to use cocaine and misuse prescription opioids, and significantly more likely to become addicted to opioids, such as prescription painkillers, than other workers in the general population. The fatal overdose rate among construction workers is six times higher than in the greater population.

Before the first COVID-19 case in the United States, the opioid crisis was taking the lives of 130 Americans a day, on average. NAHB has made a concerted effort to address the opioid issue impacting the home building industry.

Unfortunately, individuals with opioid use disorder (OUD) may be at increased risk for the most adverse consequences of COVID-19 because of the drugs’ effects on respiratory and pulmonary health. Substance use disorders weaken the immune system. Patients with COVID-19 have had mild to severe respiratory illness with symptoms of fever, cough and shortness of breath. Severe complications include pneumonia in both lungs, multi-organ failure and, in some cases, death.

Besides the threat of infection, people with OUD are vulnerable to the impacts of COVID-19 because of social distancing, self-isolation, quarantine and shelter-in-place orders. People recovering from addiction now face new challenges.

Necessary COVID-19 containment measures, such as physical distancing and closures of public spaces, are more than inconveniences to a person struggling with addiction; they make it harder for people with substance use disorders to seek help, keep up their treatment regimen or access social supports. For people who struggle with substance use disorders, social distancing messages seem directly at odds with harm reduction recommendations.

One of the main tenets of harm reduction is to avoid isolation. The void of direct access to social support networks, including going to meetings and being in face-to-face contact with supportive friends, is said to be a huge trigger for relapse. The prospect of self-quarantine and other public health measures may also disrupt access to medications and other support needed by people with OUD.

According to a report by ABC News, "With millions of Americans forced into weeks of extended isolation, several communities have reported a spike in drug overdose deaths, prompting health officials to raise concerns about the safety of those suffering from substance use disorders amid the COVID-19 pandemic."

Another concern is that restrictions on movement may lead those with substance use disorder to opt to purchase heroin or opioids from less trusted sources, raising the risk of overdosing on drugs that may be spiked or tainted.

On a positive note, one of the consequences of the social distancing requirements is that more virtual meeting or telehealth options are emerging. And harm reduction organizations are offering tip sheets for drug users on how to stay safe amid the pandemic. Tips address stocking up on supplies, practicing safer drug use, and keeping clean and practicing hygiene. In some states, clinics are providing options for patients, such as curbside and "doorstep" deliveries of methadone and buprenorphine, as suggestions for patients who are quarantined or isolated because of COVID-19.

More information on COVID-19 recovery resources can be found here:

• bmc.org/addiction/covid-19-recovery-resources
• drugabuse.gov/related-topics/covid-19-resources
• naadac.org/covid-19-resources
• vitalstrategies.org/drug-use-covid-resources/
• medicine.umich.edu/dept/psychiatry/programs/addiction-center/coronavirus-covid-19-addictionrecovery-resources
• opioidtaskforce.org/covid-19-resources/
• preventconstructionsuicide.com/COVID_19_Resources

For questions about NAHB resources on opioids, contact David Jaffe.