Combatting Substance Use in the Wake of COVID

By Dr. Indira Paharia

The COVID-19 pandemic has been a persistent threat to people’s lives across the globe. Its immediate and lingering effects are still being studied, both from a health perspective but also the many ways it has permeated and influenced our lives. Experts anticipate continued increases for all age groups across a number of mental health issues including substance use disorders (SUDs), depression, anxiety, and suicide.

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Since the onset of the COVID-19 pandemic, substance use for those with substance use disorder (SUD) has increased by 20%, and there have been significant increases in opioid-related deaths. In addition to increased relapse rates for those already diagnosed with SUD, the pandemic has been associated with a surge in first-time diagnoses of SUD among those with no prior history of misuse. Use of multiple substances is also common. More readily available and socially acceptable, individuals may turn to alcohol to decompress, reduce stress, and cope with challenges arising from COVID. The frequency of alcohol consumption for adults age 30 and over has increased year-over-year by 19%. Research shows that alcohol can exacerbate the risk of illicit drug use and co-occurring disorders, amplifying the need to address misuse early. 

The stigma surrounding SUD can serve as a barrier to prevention and treatment. Many accounts show that the medical community may struggle with supporting those facing SUDs, so overcoming that stigma is crucial to mitigate the current and future impact SUDs have on our nation. The first step for reducing stigma is to ensure all individuals in healthcare are educated and trained in how to interact with those battling abuse. Centene continues to invest in the development of comprehensive resources to increase the expertise and effectiveness of our care teams, deliver critical support to providers to aid them in identifying and referring care, and educate members with the goals of improved treatment and overall health outcomes. 

Because SUD flourishes in an atmosphere of secrecy and shame, increasing education and awareness, and promoting anti-stigma messages are essential to facilitate openness to treatment. The specific needs and nuanced experiences affecting certain populations must be acknowledged when providing treatment. While SUD can impact all individuals, rural populations and racial minorities may be differentially impacted due to the unique socio-economic challenges they face. For pregnant individuals, that can mean screening for SUD in a non-judgmental environment and delivering integrated prenatal care early in pregnancy to help improve outcomes. For families, reducing stigma around seeking help with parenting challenges and substance misuse can decrease long-term adverse effects to children in the household, and reduce the generational impact of SUD. By tailoring support to be sensitive to these distinctive populations, the likelihood of prevention and recovery is enhanced, and health disparities can be decreased. 

There is ample evidence to support the impact substance misuse has on mental health, as well as physical health. In adults, substance misuse and SUDs have been linked to an array of serious health conditions, including heart disease, stroke, diabetes, liver damage/disease, respiratory problems, and high blood pressure. Additionally, individuals who inject drugs are also at a higher risk for infectious diseases such as HIV and hepatitis C. According to nationwide hospital data, Americans with substance use disorders are at a higher risk of developing COVID-19, and more likely to experience virus-related outcomes, such as hospitalization and death. 

Research has demonstrated that there is a link between substance misuse, mental and physical health, and the total cost of care. An integrated approach to SUD treatment can lead to improved overall health, and lower costs for healthcare. At Centene, our evidence-based SUD program provides interventions across the prevention-to-recovery continuum through data-driven integrated care management and education, pharmacy policies, provider engagement and community resources to provide the best form of care and guidance. While addressing existingSUDs is imperative, preventing substance misuse and progression to SUD is foundational to a comprehensive solution. Centene’s SUD program utilizes data analysis to identify at-risk members for potential misuse enabling early intervention to prevent misuse and the negative impact on health. 

As our country continues to address the SUD epidemic that has been exacerbated by the COVID-19 pandemic, we have a responsibility to support individuals struggling with SUD. Centene remains committed in its vital role of collaborating with providers, helping its members achieve better whole health and quality of life, and fostering change for our nation to combat the rise of SUD. 

Dr. Indira Paharia, a licensed clinical psychologist and Chief Operating Officer, Behavioral Health, at Centene. In addition to her role with Centene, Dr. Paharia is a licensed clinical psychologist with specialized experience in behavioral health managed care, behavioral and physical health integration, and evidence-based programming for vulnerable populations. She currently serves on the board of the Association for Behavioral Health and Wellness. Dr. Paharia has served as a delegate at the World Health Assembly, the annual meeting of the World Health Organization and the United Nations and served as a federally appointed national advisor to SAMHSA for six years.

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