As reported by Reuters News Agency, a trial involving four large pharmacy chains was to begin last Monday as the Ohio counties of Lake and Trumbull seek to convince jurors of the pharmacy chains’ responsibility for flooding their communities with addictive pain pills and thus contributing to the current deadly U.S. opioid epidemic. To date, more than 3,300 cases have been brought primarily by state and local governments to hold the companies responsible for their role in this destructive public health problem.
These actions can be seen as merely a preview of the finger pointing that is sure to follow as we try to understand what has led us to a drug and alcohol epidemic-within-an-epidemic. A tragic development that has taken more than 93,000 lives from drug overdoses in 2020 alone. In a world where, according to an American Psychological Association poll, nearly one in four adults report drinking unhealthy amounts of alcohol to cope with their stress. Excessive alcohol consumption was already the leading cause of preventable death in the United States. According to the Centers for Disease Control and Prevention, it is responsible for more than 95,000 deaths a year.
Keep in mind, precise data on current drug or alcohol related deaths is hard to come by. It can take months for medical providers to provide toxicology reports for overdose incidents. As to alcohol, it is even more complicated. According to the Centers for Disease Control and Prevention, as of June 2020, 13% of Americans had reported starting or increasing some form of substance use as a way of coping.
As William Stoops, professor of Behavioral Science, Psychiatry and Psychology at the University of Kentucky Institute, explains in an American Medical Association report, “People are more stressed and isolated, so they make unhealthy decisions, including drinking more and taking drugs.”
As Dr. Elizabeth Bulat, an Addiction Medicine Specialist affiliated with Henry Ford West Bloomfield Hospital, recently explained in a Detroit News Opinion piece, substance abuse during the pandemic has also been an issue for seniors, though it impacts older adults differently. “Addiction in people over the age of 60 is skyrocketing,” she writes. According to the National Institute on Alcohol and Drug Abuse, alcohol and prescription drug abuse is up to 17% in this age group.
“Even before the COVID-19 pandemic hit in 2020, a growing number of older Americans were misusing alcohol and prescription drugs. Add social isolation to the mix, and fears about contracting a deadly virus, and substance use among seniors is at an all-time high,” says Bulat.
She further reports that substance use disorder among senior citizens is often overlooked, especially if they have medical or behavioral conditions such as depression or dementia that may be masking the signs of addiction. Polypharmacy, the practice of taking many medications at the same time, which is common in older adults, also increases the risk of overdose.
“People often think of addiction as a disease that strikes younger people, but it can happen to anyone at any time during their life,” she stresses. “During our senior years, a number of factors converge that increase the risk of substance abuse issues.”
Speaking of young people, the impact of the pandemic on our younger generations is maybe even more troubling. According to a study from the University of Surrey recently published in the journal Psychiatry Research, the pandemic has severely impacted the mental health of young people, generating increased levels of clinical depression.
Says Dr. Simon Evans, Lecturer in Neuroscience at the University of Surrey: “For many years there has been a rise in the number of young people experiencing problems with their mental health, and it is concerning to find that this has been significantly exacerbated due to COVID-19. Supporting the mental health of young people and ensuring they can access the support they need is vital to ensure their overall wellbeing … it is crucial that we take steps to protect their mental health.”
As one reader commented on last week’s column, discussion of the impact on substance abuse among young people was missing from my piece. Let me address it now.
According to a recent U.S. News report, a study published March 29 in JAMA Pediatrics highlights young people’s vulnerability to addiction, with adolescents (aged 12 to 17) seeming to be more inclined to develop addiction to substances faster than young adults (aged 18 to 25).
“Rates of past-year cannabis use disorder were greater among teens than young adults at all the time points since first use of the drug,” writes U.S. News. “For example, within 12 months since first cannabis use, nearly 11% of adolescents had the disorder, compared with just over 6% of young adults.”
According to Emily Einstein, chief of U.S. National Institute on Drug Abuse Science Policy Branch and co-author of the study, “Research has shown that brain development continues into a person’s 20s, and that age of drug initiation is a very important risk factor for developing addiction … Offering timely treatment and support to young people who need it must be a public health priority.”
As noted in a separate U.S. News report, substantive evidence exists that marijuana increases the risk of psychotic disorders such as schizophrenia. The report goes on to say that there is evidence of a toxic relationship between marijuana and depression. “A study published in the journal Addiction found that teenagers who suffered chronic depression were more likely to develop marijuana-use disorder later in life,” they write.
Not all experts concur, admitting that there remains a lot to learn about whether marijuana use may lead to mental health problems in young people. Medical organizations remain conflicted as to the nature of the relationship between marijuana and mental health. At the same time, the social stigma attached to addiction, seeing it as a moral failing on the part of the individual, continues to impede needed progress in addressing the problem.