Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day forty since
Speaker 1: coronavirus was declared a global pandemic. Our main story, opioid
Speaker 1: addiction had ravaged large parts of the country before coronavirus
Speaker 1: came along. Now those in recovery face a double whammy
Speaker 1: from the outbreak, increased vulnerability to the illness, and limits
Speaker 1: on addiction treatments that can only be done in person.
Speaker 1: But first, here's what happened today. Democrats and the Trump
Speaker 1: administration are racing to finish a deal for a nearly
Speaker 1: five hundred billion dollar interim coronavirus rescue package in time
Speaker 1: for Congress to approve it this week. The two signs
Speaker 1: have yet to hammer out many of the details. Democrats
Speaker 1: and Republicans disagree about a formula to distribute health care
Speaker 1: aid to states and which agency should oversee a stepped
Speaker 1: up testing program. According to people familiar with the discussions,
Speaker 1: the package would inject billions into the tapped out paycheck
Speaker 1: Protection program, which aims to help small businesses keep paying workers.
Speaker 1: The SBA program has already exhausted the three hundred and
Speaker 1: fifty billion dollars it was allotted. Just weeks ago. It
Speaker 1: also includes funding for hospitals, particularly in rural areas, and
Speaker 1: a testing program. Over the weekend, a handful of small
Speaker 1: protests against lockdown measures were met with support by President
Speaker 1: Donald Trump. That support goes against the guidance of his
Speaker 1: own administration's experts. Dr Anthony Fauci, the country's top infectious
Speaker 1: disease expert, said today that reopening WHO soon would damage
Speaker 1: the economy in the long run, not just public health.
Speaker 1: Faucia was asked on ABC's Good Morning America to respond
Speaker 1: to protesters who resisted stay at home orders with chants
Speaker 1: of fire. Fauci, Clearly, this is something that is hurting
Speaker 1: from the standpoint of economics, from the standpoint of things
Speaker 1: that have nothing to do with the virus. But unless
Speaker 1: we get the virus under control, the real recovery economically
Speaker 1: is not gonna happen. So what you do, if you
Speaker 1: jump the gun and go into a situation where you
Speaker 1: have a big speed spike, you're gonna set yourself back.
Speaker 1: It's gonna backfire. That's the problem. In Germany, which has
Speaker 1: been more successful than the US at limiting the outbreak spread,
Speaker 1: Chancellor Angela Merkel also warned that the country shouldn't move
Speaker 1: too quickly to ease up on social distancing measures. The
Speaker 1: Chancellor said that raises the risk of ending up with
Speaker 1: an even stricter national lockdown. In remarks on Monday, she
Speaker 1: said the country has made progress but not yet reached
Speaker 1: its target. Cases in Germany rose Monday by the smallest
Speaker 1: amount this month, and now for today's main story. Before
Speaker 1: COVID nineteen started spreading around the US, the country was
Speaker 1: already attempting to deal with another health crisis, opioid dependency.
Speaker 1: Although opioid treatment programs are considered essential public facilities and
Speaker 1: are allowed to stay open during statewide stay at home orders,
Speaker 1: experts are worried the coronavirus could exacerbate the opioid epidemic,
Speaker 1: possibly leading to more overdoses. Producer Jordan Gospure looked into
Speaker 1: how clinics and federal regulations are adapting to meet the
Speaker 1: knee of patients. For some patients with opioid use disorder,
Speaker 1: getting their daily dose of methadone, the prescription drug typically
Speaker 1: used to treat opioid dependency, is an essential part of
Speaker 1: their lives, but now standing in line or being in
Speaker 1: a crowded waiting room at an outpatient treatment program could
Speaker 1: increase the risk for COVID nineteen infection. Dr Sue Kim
Speaker 1: is the medical director of the Harm Reduction Coalition and
Speaker 1: an addiction medicine attending physician. We know that people who
Speaker 1: use drugs are often they could be at higher risk
Speaker 1: for acquiring this, or they might have conditions that predispose
Speaker 1: them to doing poorly if they do acquire covid um
Speaker 1: So it's it's a very difficult situation. Those with opioid
Speaker 1: use disorder are already more at risk of homelessness and
Speaker 1: incarceration than those the general population. Now they may be
Speaker 1: enabled to get necessary medications and treatments vital to the recovery.
Speaker 1: In the US, methodone can only be dispensed at highly
Speaker 1: regulated and monitored opioid treatment programs. There are nearly two
Speaker 1: thousand of these programs across the country that see thousands
Speaker 1: of patients. Many patients taking methodone or the prescription bupenorphine
Speaker 1: to treat their opioid use disorder aren't able to stay
Speaker 1: at home because of strict government regulations that limit the
Speaker 1: way these medications are prescribed and dispensed. Before the coronavirus pandemic,
Speaker 1: Some patients over time were able to take home a
Speaker 1: limited number of doses because they gained the trust of
Speaker 1: the clinic, but even the most trusted patient generally had
Speaker 1: to return to the clinic or pharmacy once a week
Speaker 1: for a supervised dose. The federal government temporarily relaxed restrictions
Speaker 1: in March for some patients to take home up to
Speaker 1: a month's worth of their daily methodone or bupanorphine doses,
Speaker 1: depending on their stability and treatment. Addiction advocates have along
Speaker 1: pushed for these changes, and research shows at making inti
Speaker 1: addiction medications more easily available cuts opioid overdoses in half. Still,
Speaker 1: even during a pandemic, Dr Kim says clinicians are leery
Speaker 1: about giving patients take hoome doses because they're afraid they'll
Speaker 1: be lost, stolen, sold early to an overdose. And these
Speaker 1: clinics are are each operating into you know, they might
Speaker 1: operate independently, but they are all overseen by particular state
Speaker 1: opioid treatment authority who dispenses the kind of the advice
Speaker 1: and the regulations. But it needs to trickle down to clinics,
Speaker 1: and clinics end up having to make a lot of
Speaker 1: decisions for their patients. It's incredibly complex. Opioid treatment facilities
Speaker 1: around the country have had to change the rehabilitation techniques
Speaker 1: in the face of the coronavirus pandemic. New patients can
Speaker 1: now be prescribed even orphine virtually or by phone, but
Speaker 1: for people recovering from opioid used disorder, the new guidelines
Speaker 1: have been inconsistent. There have been reports of some states
Speaker 1: requiring patients with take hoom do is to come into
Speaker 1: the clinic. Despite changes in federal guidelines. Other clinics are
Speaker 1: having problems tracking the medications substance of use them into
Speaker 1: Health services have finally issued some protocols in recent weeks.
Speaker 1: That's starting to make some difference in what towns and
Speaker 1: cities can do, but there's still a lot of confusion
Speaker 1: and a lot of fear. Even when a clinic is
Speaker 1: business as usual, those patients who pay cash for their
Speaker 1: medication are unable to afford more than their daily prescription.
Speaker 1: I recently spoke with Melissa Dunford, who started the Faces
Speaker 1: of Opioids Facebook group in sen for those who have
Speaker 1: been affected by the epidemic after a friend fatally overdosed
Speaker 1: she's heard stories from some of the members who have
Speaker 1: no recourse but to find the money or forego life
Speaker 1: saving treatment. What we're finding is one our cash patients
Speaker 1: are hosed or screwed over because they might not have
Speaker 1: money to pay for a thirty day supply and go
Speaker 1: home with it. So one woman was told, sorry, get
Speaker 1: the money, or you don't get your medicine and just
Speaker 1: set out the door. Experts warn that COVID nineteen will
Speaker 1: only worsen the opoid crisis. Workers at some opioid treatment
Speaker 1: facilities don't have enough face masks and gloves, so these
Speaker 1: programs are limiting their hours or shutting down completely. Online
Speaker 1: help groups are working to fill these gaps, but there's
Speaker 1: a risk that social isolation or an interruption to treatment
Speaker 1: may make it harder for some people to stay in recovery.
Speaker 1: Withdrawal sometimes mimics the symptoms of the coronavirus, so there's
Speaker 1: a fear that physicians evaluating patients with opioid use disorder
Speaker 1: will fail to identify cases of COVID nineteen. Staying at
Speaker 1: home may increase feelings of depression and anxiety, and patients
Speaker 1: who are at an increased risk of relapse and fatal overdose.
Speaker 1: If they live alone and overdose, no one will be
Speaker 1: there to administer no losin, the drug used to reverse
Speaker 1: opioid overdoses, Further complicating the problem, if black market drug
Speaker 1: supplies decrease, opioid dealers will be more likely to lace
Speaker 1: drugs with other dangerous substances like fentyl. Dr Kim says
Speaker 1: restrictions on movement may also prevent patients from buying drugs
Speaker 1: from the regular dealer, so out of desperation, will buy
Speaker 1: drugs from someone else. I've been concerned that a lot
Speaker 1: of my patients who were managing to get money for
Speaker 1: harrow and every day now don't have jobs. UM. So
Speaker 1: you know, everyone is UH in the addiction communities keenly
Speaker 1: aware of UM. Of how much we need to get
Speaker 1: these medications to people, and how life saving they are,
Speaker 1: and how we can need to be flexible and UM
Speaker 1: and accommodating so UM and give an orphan and method
Speaker 1: and are much safer, and we prefer people to beyond
Speaker 1: those treatments. Health providers in the US are working to
Speaker 1: make sure patients with opioid use disorder still have access
Speaker 1: to treatment, even from a distance. As the coronavirus sweeps
Speaker 1: across the country, closing businesses and forcing many people to
Speaker 1: stay at home. Telehealth treatments are more important than ever.
Speaker 1: Social isolation and an overburdened health system could undermine years
Speaker 1: of progress officials have made in addressing the opioid crisis.
Speaker 1: There are fear is that even once the coronavirus is over,
Speaker 1: it will continue to have profound effects on people with
Speaker 1: opioid use disorder. That was producer Jordan Gaspore. That's our
Speaker 1: show for today. For more on the outbreak from one
Speaker 1: and twenty bureaus around the world, visit Bloomberg dot com,
Speaker 1: slash coronavirus and one Small favor. If you appreciate the show,
Speaker 1: please leave us a review and a rating on Apple
Speaker 1: Podcasts or Spotify. It's the best way to help more
Speaker 1: listeners find our global reporting. The Prognosis Daily edition is
Speaker 1: hosted by Me Laura Carlson. The show was produced by
Speaker 1: Me Topher Foreheads, Jordan Gaspore, and Magnus Hendrickson. Today's main
Speaker 1: story was reported by Jordan gas Poore. Original music by
Speaker 1: Leo Sidran. Our editors are Francesco Levi and Rick Shine.
Speaker 1: Francesco Levi is Bloomberg's head of podcasts. Thanks for listening.