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SUD & COVID-19: A Resource for the Primary Care Setting

With the onset of the Covid-19 pandemic, we have seen an increase in use and worsening of outcomes in our patients struggling with substance abuse. A national study recently published in JAMA found that the overall frequency of alcohol consumption increased by 14% among adults over age 30, compared to the same time in 2019. Symptoms of depression and anxiety have become more prevalent with increase in isolation and lack of access to treatment like AA and other social supports; key components in managing substance use disorder. This lack of access to care increases our patients risk of relapse and death.

Patients with substance abuse problems are most often seen for the first time in a primary care setting.  Being able to address this population is especially important with the growing need secondary to the pandemic. Aside from an increase in substance abuse and mental health symptoms, you may notice worsening of their comorbid diseases like hypertension or diabetes due to lack of self-care or medication noncompliance.  This may be the first sign your patient is struggling.

Recognizing substance abuse is easy when your patient asks for the help.  It can be difficult to treat when your patient is in denial of their problem.  The use of screening tools is a simple way to gauge the severity of their use and willingness for change. It allows you to start the conversation and offer resources.  Sometimes less is more when it comes to treating this population. Eliminating, minimizing or monitoring use of habit-forming medication you may be prescribing is crucial. Long term treatment is standard of care and primary care providers must be aware of the resources available for their patients especially during these tumultuous times.

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