Jan Fields here again. At the beginning of our OD2A Eval CoP webinar last week, I shared with you the fear I have of losing some of the gains we have made against the opioid epidemic due to the effects of the COVID-19 pandemic.
This fear began when I read an article in the Annals of Internal Medicine about the collision between these epidemics. Besides the threat of infection to persons with OUD, the authors of this article stated that there is serious risk that system-level gains in expanding access to medication for OUD, conducting critical research, and exacting legal reparations against opioid manufacturers will all reverse. Of particular significance to our work, I believe, are the recommendation they make to ensure uninterrupted access to the most effective medications for OUD treatment: methadone and buprenorphine.
My fear of losing ground was further stoked by this article in the Daily Beast. According to the article, there are increases in overdoses occurring all over the US since the COVID pandemic began. Some possible causes and implications for these increases are discussed in the article.
- Isolation and boredom can be a trigger. “The opposite of addiction is human connection, not sobriety…”
- The stimulus checks can be a facilitator. “All markets pay attention to these things. The illicit market is no different.”
- In the short term, the pandemic has led to an increase in prices of illicit drugs. This situation puts “a bigger strain on drug users experiencing poverty. That in turn could lead to an increase in criminal activity, as people seek money to buy drugs, and to a spike in the use of other drugs like methamphetamine, which is becoming more widely available.”
- In the long term, “once the supply chain reemerges, it could open the floodgates to more overdoses, as drugs will be more potent and come at a cheaper post-coronavirus price.”
The take-home for us as OD2A evaluators may be that we need to be more adaptive in the way we monitor and evaluate our program strategies and activities.
One resource that could be particularly useful for us is a new blog series on the Better Evaluation website that provides tips and techniques for monitoring and evaluation in these uncertain times. The first blog entry dovetails nicely with our first webinar since the topic of both is the management of evaluations.
Another resource is this illustrated collection of evaluator reflections on how COVID-19 impacts the field, pulled together by Chris Lysy over at Freshspectrum.com.
I would be interested to hear other thoughts on the possible effects and implications of experiencing two major epidemics at once.