About this Research Topic
A recent report from the American Medical Association has stated that “as the COVID-19 pandemic grows, so does the nation’s opioid epidemic”. This is also echoed in the media and several publications which have highlighted how the social conditions created by the COVID-19 pandemic of unemployment, social isolation and despair, have enabled a sharp increase in substance abuse disorder (SUD) and overdose fatalities. This is concurrent with reduced funding for the outreach programs that have been critical in treating those with SUD who may also be hesitant to seek treatment due to the fear of contracting COVID-19. Another effect of COVID-19 is in the supply of these illicit substances. The United Nations Office on Drugs and Crime has stated that the COVID-19 pandemic is poised to alter illicit drug availability and use worldwide. With the closure of borders and lack of international air travel, drugs are being stockpiled and the normal supply chains and routes constricted. This has increased cost and also fueled the growth of local illicit substance production.
Against this backdrop of a disturbing collision between a pandemic and the opioid epidemic are a host of questions that need to be considered and addressed. Firstly, there is a need to understand the epidemiology and nature of the interaction between COVID-19 and illicit drug use in countries throughout the world. Although their interaction is beginning to be highlighted in the USA, it is neither well documented nor known if this is also happening worldwide. Secondly, we need to establish both clinical guidelines and public health policy for the treatment and control of pain and SUD during the COVID-19 epidemic. As both opioids and COVID-19 induce respiratory depression, careful treatment guidelines for both conditions are needed. Opioids are effective analgesics, but they can also induce a dysphoria, making the assessment and treatment of mental health important. Thirdly, both COVID-19 and opioids may have an impact on the same physiological functions within the human body. The most well-known are the respiratory and immune systems, but the effects of both opioids and COVID-19 on inflammation in the brain and the gastro-intestinal tract, and perhaps other unknown systems, are yet to be explored. At the level of intracellular trafficking and signaling, COVID-19 is known to hijack the angiotensin system. As both angiotensin and opioid receptors are members of the G-protein-coupled family of receptors that signal and traffic in a similar manner, the effect of COVID-19 on opioid receptor signaling and trafficking should also to be explored.
There is now evidence in the USA that, with the current economic and personal pressures of the COVID-19 epidemic, opioid abuse is increasing and this epidemic and pandemic are colliding. With that in mind how do we treat patients who need opioids when COVID-19 is present? This Research Topic has multiple angles to be investigated. From epidemiology to treatment to cellular interactions, the overarching goal is furthering our understanding of the medical use and misuse of opioids in the time of this global pandemic. We welcome all article types and expect submissions relating to, but not limited to, the following topics:
• The effect of the COVID-19 pandemic on the socioeconomic factors that contribute to substance abuse disorder.
• The effect of the COVID-19 pandemic on drug trafficking, use and abuse worldwide;
• The direct and indirect effects of different COVID-19 international public health policies and approaches on substance abuse disorder treatment during this pandemic.
• Public health guidance on vaccine use and availability for disadvantaged populations and groups such as those susceptible to substance abuse or other disorders.
• The relationship between opioid use and the response to a COVID-19 infection.
• The treatment of chronic pain or substance abuse disorder, particularly that of opioids, during the COVID-19 pandemic. Potential respiratory, immune, gut and brain interactions that should be considered in light of the effect of opioids and COVID-19 exposure.
• The treatment of chronic pain or substance abuse disorder if COVID-19 is present or likely to be present.
• The long term effect of COVID-19 on systems that may alter the analgesic or rewarding effects of opioids.
• The potential effects of COVID-19 on the intracellular trafficking and signaling of the opioids or other GPCRs.
Topic editor Wendy Walwyn founded WmScience,Topic Editor Kathryn DeFea founded PARMedics, Inc., and Topic Editor David Walwyn founded Reseva. All other Topic Editors declare no competing interests with regards to the Research Topic subject.
Keywords: COVID-19, opioids, substance abuse disorder, respiratory disorders, SARS-CoV-2
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