COVID-19 has had a huge impact all over the world but we are still learning about the virus and how it effects different individuals. We know that a patient’s age has a major bearing on their likelihood of becoming seriously ill or dying from the virus, as do certain underlying health conditions. Experts now fear that opioid addiction and habits including smoking and even vaping can increase the risks of coronavirus.
It’s too early to predict exactly how the pandemic will affect the opioid addiction epidemic that exists in the UK and many other parts of the world. There have been some suggestions that supply chains of illicit drugs will be impacted, disrupting the availability of the drugs in some markets. Others have warned that issues associated with coronavirus including social isolation, anxiety, stress and an economic downturn could lead to a mental health crisis. This in turn could fuel increased drug use and other social issues.
We could see a rise in drug use and other problem behaviours
Professor Rory O’Connor from the University of Glasgow said that if we did not address these issues as a society, we risked seeing an explosion in anxiety, depression and other mental health conditions, as well as ‘problem behaviours’ including addiction to drugs, alcohol and gambling. This could also lead to knock-on effects such as breakdowns in relationships and an increase in homelessness.
For those who already have a history of opioid addiction, coronavirus could also pose a more significant physical threat. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) said that people who use drugs can be more at risk than others due to a number of different factors. Habitual drug users often have associated chronic illnesses or health conditions and this is particularly the case for those with an opioid addiction.
The EMCDDA said that the continent’s older users of heroin and other opioids could be particularly vulnerable due to existing health conditions linked to their drug use and lifestyles. They added the specific example that the “prevalence of chronic obstructive pulmonary diseases (COPD) and asthma are high among clients in drug treatment, and smoking of heroin or crack cocaine can be an aggravating factor”.
The centre also pointed out that addicts and substance abusers frequently gathered together to take drugs recreationally and often shared drugs or equipment. This could lead to an increased risk of spreading or contracting the virus, while the underlying health conditions could exacerbate the risks of more severe symptoms. Additionally, the stigma and marginalisation that accompanied opioid use could effectively put barriers in place that would affect the promotion of risk reduction efforts.
Opioid addiction and coronavirus
Heroin is one of the most addictive opioids and the most common opioid addiction definition classifies this addiction as both a disease and a brain disorder. Using the drug changes the structure of the brain over time, making it extremely difficult for the addict to resist their compulsion to use the drug, even when they know this will lead to negative consequences. Opioid addiction treatment medications play an important roll in many treatment programmes and any interruption to the supply of these medications can have a serious impact.
In a virtual presentation as part of the American Psychiatric Association (APA) Spring Highlights Meeting 2020, Nora D. Volkow, MD, Director of the National Institute on Drug Abuse (NIDA), said that those with substance abuse problems could be suffering from an interruption in care, including access to medication and meetings of peer support groups.
Is Covid-19 more harmful to vapers?
There are also growing concerns that may be alarming to smokers and people who are addicted to vaping nicotine. New York City Mayor Bill de Blasio recently declared that people who do smoke or vape could be more at risk of developing severe coronavirus symptoms.
“If you are a smoker or a vaper that does make you more vulnerable. If you are a smoker or a vaper this is a very good time to stop that habit and we will help you,” he said.
The science appears to be backing him up although, as with many things about this virus, the precise extent of the added risk is not yet clear.
Dr Michael Matthay, the associate director of critical care medicine at the University of California San Francisco (UCSF), said that it was ‘highly likely’ that both smoking and vaping could increase the risk and severity of pneumonia linked to the Vovid-19 virus. He said that this conclusion was based on previous studies of other pulmonary infections, but admitted that based the extent of any such risk was not yet known.
Is vaping addictive?
Nicotine is a highly addictive substance. E-liquids do not contain tobacco and they do not produce tar or carbon monoxide, which are two of the most damaging elements of cigarette smoke. Most e-liquids do contain nicotine however, making vaping addictive. If you were to ask the question, ‘Is vaping more addictive than smoking?’ the answer could be a little more complicated.
Different e-liquids can contain different levels of nicotine but there’s also the question of habit and psychological addiction alongside the purely physical release of dopamine.
Dr Rajy Abulhosn, medical review officer for Confirm BioSciences, told CNET that factors such as ease of use also played a part. He pointed out that a single Juul pod is roughly equivalent to a pack of 20 cigarettes, but added that the act of using the vaping system was much more convenient than removing and lighting an individual cigarette, especially when that might involve having to go to a designated smoking area outside.
Vaping can be a difficult habit to kick for all sorts of reasons but it could potentially increase the dangers of Covid-19, especially if used with THC oil (the psychoactive ingredient in cannabis).
At the Spring Highlights Meeting, Ms Volkow said: “Last year we saw new phenomena of vaping associated with long injury that result in a death in some of the patients. It’s now recognized that these cases of lung injury are associated with vaping of THC and when mixed with vitamin E that generate this reaction. This is a new technology and to our surprise when we believed that they were safe, that does not appear to be the case.”