Isolation is the cornerstone of addiction. Not surprisingly, addiction is thriving under COVID-19 “Shelter at Home” policies.

In Shelby County for the month of April we have seen a jump in opioid overdoses by more than one third and a doubling in opioid overdose deaths compared to approximately the same time period last year. Municipalities across the country are reporting similar increased rates of opioid overdose.

These numbers do not surprise us at the Center for Addiction Science at the University of Tennessee Health Science Center. The recent spike in opioid overdose deaths correlates with an uptick we’ve observed in relapse rates among our own patients in our outpatient addiction medicine clinic.

Given the isolation and fear that people are experiencing, coupled with the unhealthy stress responses that occur as part of the disease of addiction, we expect over the next several months to see even higher incidences of overdose and other morbidities related to active addiction.

Shelby County overdose spike hits ‘unprecedented’ record

In light of the current crisis, we have particular concern about the potential for relapse in those who have been previously stable. This population is uniquely vulnerable to overdose and to death if relapse does happen, due to the increased sensitivity to opioids’ respiratory depressant effects that occurs with abstinence after previously heavy use.

Once a person achieves just a few days of sobriety, the tolerance to opioids can decrease dramatically. Amounts that were once easily tolerated may then prove to be fatal. This danger highlights the need for broader community availability of naloxone (Narcan) opioid overdose reversal kits, which can literally save an opioid overdose victim’s life with prompt administration of this intranasal or injectable opioid antagonist medication.

Moreover, while the opioid overdose statistics are troubling enough, opioids are not the only potential killer. Increased use and risk of relapse are not limited to opioids. Alcohol, methamphetamine, cocaine and benzodiazepine misuse are following the same trends. We believe it is important to always be mindful that addiction is a primary brain disease that is not substance specific.

We are living in trying times. However, we must not allow needed social distancing to lead to dangerous social isolation. The recovery community is keenly aware of the challenges created by COVID-19, and we are dedicated to making sure that resources remain available for those who need them.

Overdose help available through S.T.O.P.

Most treatment programs are still fully operational for anyone in need of treatment. For instance, UTHSC’s Center for Addiction Science has continued to fulfill our mission of caring for patients with addiction throughout the COVID-19 pandemic, with in-person or telemedicine options, and inability to pay need not be a barrier. All major insurances, including TennCare insurance plans, are accepted at our clinic. Treatment is available for any substance use disorder, including alcohol, stimulants, opioids, tobacco, or whatever the substance may be.

Keep in mind that Twelve Step fellowships are continuing to meet and are of incalculable value for combating the isolation of addiction. Most have been meeting virtually during the state of emergency, but several have continued to meet in-person, or are now reopening as community restrictions are eased. Meetings can be found on the Alcoholics and Narcotics Anonymous websites.

We recommend that people check to confirm that meeting times and locations haven’t changed due to the pandemic. Another resource is Tennessee REDLINE (800-889-9789), funded by the Tennessee Department of Mental Health and Substance Abuse Services. Tennessee REDLINE provides information on addiction and referral to appropriate treatment sources for Tennessee citizens at their request.

In this time of crisis it is particularly important to recognize addiction as a chronic disease that feeds on isolation. It is not a product of low moral character, insufficient willpower, or lack of intelligence. The addiction epidemic will not be solved by incarceration, ignorance, stigmatization, neglect, or willful blindness. We can, however, profoundly impact and mitigate suffering for individuals, families, and communities with compassion and proper treatment, and we humbly call on our community to support us in these efforts.

The UTHSC Center for Addiction Science is at 6401 Poplar, Suite 500, and can be reached at 901.866.8630.