Don't miss Dr. Volkow's session at the 2023 Annual Meeting:

The COVID-19 pandemic has claimed more than 1.1 million lives to date, and people with addictions are among those most vulnerable. Studies show that people with substance use disorders are at a higher risk of contracting COVID-19 and from becoming seriously ill from it. Meanwhile, drug overdoses accelerated to record levels during the pandemic. The sad confluence of both crises brought longstanding needs to the fore—many of which psychiatry can help address.

First, psychiatrists can recognize and address co-morbidities. Addiction goes hand-in-hand with other mental illnesses, and it makes medical, logistical and financial sense to tackle both. Prevention, too, is possible. I have written before about why we need to start talking about the crucial period before substance misuse or mild substance use disorders escalate, presenting greater damage to lives and relationships and making the road to recovery harder.

Critically, psychiatrists must recognize social factors that contribute to drug use and interfere with treatment adherence, such as racism, stigma, poverty and lack of access to healthcare—factors that existed before COVID-19, but became more glaringly apparent during the pandemic. My colleagues and I found that the risk of breakthrough COVID-19 infections was significantly higher in people with substance use disorders than in those without, and co-occurring diseases and lower socioeconomic status appeared to be largely responsible. In the face of these systemic challenges, psychiatrists can do their part by screening patients for substance use disorders and co-occurring conditions, delivering evidence-based treatment, and providing referrals, as needed, to help ensure continuity of care.

On a positive note, many treatment innovations occurred during the pandemic. These include expanded telehealth and increased flexibility for remote prescribing of buprenorphine and take-home dosing of methadone. Studies are ongoing to understand how these changes influenced patient outcomes and how these lessons can be applied to improve public health and psychiatric practice.

NIDA supports research in each of these areas with a focus on substance use disorders, their entwined psychiatric problems, and overcoming the various infrastructural barriers and stigma that have historically impeded our goals. I will go over the latest results at my talk and look forward to discussing psychiatry’s role in making headway against America’s addiction and overdose crises.