The Other Epidemic

But first, here's what happened today. Democrats and the Trump administration are racing to finish a deal for a nearly five hundred billion dollar interim coronavirus rescue package in time for Congress to approve it this week. The two signs have yet to hammer out many of the details. Democrats and Republicans disagree about a formula to distribute health care aid to states and which agency should oversee a stepped

up testing program. According to people familiar with the discussions, the package would inject billions into the tapped out paycheck Protection program, which aims to help small businesses keep paying workers. The SBA program has already exhausted the three hundred and fifty billion dollars it was allotted. Just weeks ago. It also includes funding for hospitals, particularly in rural areas, and

a testing program. Over the weekend, a handful of small protests against lockdown measures were met with support by President Donald Trump. That support goes against the guidance of his own administration's experts. Dr Anthony Fauci, the country's top infectious disease expert, said today that reopening WHO soon would damage the economy in the long run, not just public health. Faucia was asked on ABC's Good Morning America to respond to protesters who resisted stay at home orders with chants

of fire. Fauci, Clearly, this is something that is hurting from the standpoint of economics, from the standpoint of things that have nothing to do with the virus. But unless we get the virus under control, the real recovery economically is not gonna happen. So what you do, if you jump the gun and go into a situation where you have a big speed spike, you're gonna set yourself back.

It's gonna backfire. That's the problem. In Germany, which has been more successful than the US at limiting the outbreak spread, Chancellor Angela Merkel also warned that the country shouldn't move too quickly to ease up on social distancing measures. The Chancellor said that raises the risk of ending up with an even stricter national lockdown. In remarks on Monday, she said the country has made progress but not yet reached its target. Cases in Germany rose Monday by the smallest

amount this month, and now for today's main story. Before COVID nineteen started spreading around the US, the country was already attempting to deal with another health crisis, opioid dependency. Although opioid treatment programs are considered essential public facilities and are allowed to stay open during statewide stay at home orders, experts are worried the coronavirus could exacerbate the opioid epidemic,

possibly leading to more overdoses. Producer Jordan Gospure looked into how clinics and federal regulations are adapting to meet the knee of patients. For some patients with opioid use disorder, getting their daily dose of methadone, the prescription drug typically used to treat opioid dependency, is an essential part of their lives, but now standing in line or being in a crowded waiting room at an outpatient treatment program could

increase the risk for COVID nineteen infection. Dr Sue Kim is the medical director of the Harm Reduction Coalition and an addiction medicine attending physician. We know that people who use drugs are often they could be at higher risk for acquiring this, or they might have conditions that predispose them to doing poorly if they do acquire covid um So it's it's a very difficult situation. Those with opioid use disorder are already more at risk of homelessness and

incarceration than those the general population. Now they may be enabled to get necessary medications and treatments vital to the recovery. In the US, methodone can only be dispensed at highly regulated and monitored opioid treatment programs. There are nearly two thousand of these programs across the country that see thousands

of patients. Many patients taking methodone or the prescription bupenorphine to treat their opioid use disorder aren't able to stay at home because of strict government regulations that limit the way these medications are prescribed and dispensed. Before the coronavirus pandemic, Some patients over time were able to take home a limited number of doses because they gained the trust of the clinic, but even the most trusted patient generally had to return to the clinic or pharmacy once a week

for a supervised dose. The federal government temporarily relaxed restrictions in March for some patients to take home up to a month's worth of their daily methodone or bupanorphine doses, depending on their stability and treatment. Addiction advocates have along pushed for these changes, and research shows at making inti

addiction medications more easily available cuts opioid overdoses in half. Still, even during a pandemic, Dr Kim says clinicians are leery about giving patients take hoome doses because they're afraid they'll be lost, stolen, sold early to an overdose. And these clinics are are each operating into you know, they might operate independently, but they are all overseen by particular state opioid treatment authority who dispenses the kind of the advice

and the regulations. But it needs to trickle down to clinics, and clinics end up having to make a lot of decisions for their patients. It's incredibly complex. Opioid treatment facilities around the country have had to change the rehabilitation techniques in the face of the coronavirus pandemic. New patients can now be prescribed even orphine virtually or by phone, but for people recovering from opioid used disorder, the new guidelines

have been inconsistent. There have been reports of some states requiring patients with take hoom do is to come into the clinic. Despite changes in federal guidelines. Other clinics are having problems tracking the medications substance of use them into Health services have finally issued some protocols in recent weeks. That's starting to make some difference in what towns and cities can do, but there's still a lot of confusion

and a lot of fear. Even when a clinic is business as usual, those patients who pay cash for their medication are unable to afford more than their daily prescription. I recently spoke with Melissa Dunford, who started the Faces of Opioids Facebook group in sen for those who have been affected by the epidemic after a friend fatally overdosed she's heard stories from some of the members who have no recourse but to find the money or forego life

saving treatment. What we're finding is one our cash patients are hosed or screwed over because they might not have money to pay for a thirty day supply and go home with it. So one woman was told, sorry, get the money, or you don't get your medicine and just set out the door. Experts warn that COVID nineteen will only worsen the opoid crisis. Workers at some opioid treatment facilities don't have enough face masks and gloves, so these

programs are limiting their hours or shutting down completely. Online help groups are working to fill these gaps, but there's a risk that social isolation or an interruption to treatment may make it harder for some people to stay in recovery. Withdrawal sometimes mimics the symptoms of the coronavirus, so there's a fear that physicians evaluating patients with opioid use disorder

will fail to identify cases of COVID nineteen. Staying at home may increase feelings of depression and anxiety, and patients who are at an increased risk of relapse and fatal overdose. If they live alone and overdose, no one will be there to administer no losin, the drug used to reverse opioid overdoses, Further complicating the problem, if black market drug supplies decrease, opioid dealers will be more likely to lace

drugs with other dangerous substances like fentyl. Dr Kim says restrictions on movement may also prevent patients from buying drugs from the regular dealer, so out of desperation, will buy drugs from someone else. I've been concerned that a lot of my patients who were managing to get money for harrow and every day now don't have jobs. UM. So you know, everyone is UH in the addiction communities keenly

aware of UM. Of how much we need to get these medications to people, and how life saving they are, and how we can need to be flexible and UM and accommodating so UM and give an orphan and method and are much safer, and we prefer people to beyond those treatments. Health providers in the US are working to make sure patients with opioid use disorder still have access to treatment, even from a distance. As the coronavirus sweeps across the country, closing businesses and forcing many people to

stay at home. Telehealth treatments are more important than ever. Social isolation and an overburdened health system could undermine years of progress officials have made in addressing the opioid crisis. There are fear is that even once the coronavirus is over, it will continue to have profound effects on people with opioid use disorder. That was producer Jordan Gaspore. That's our show for today. For more on the outbreak from one and twenty bureaus around the world, visit Bloomberg dot com,

slash coronavirus and one Small favor. If you appreciate the show, please leave us a review and a rating on Apple Podcasts or Spotify. It's the best way to help more listeners find our global reporting. The Prognosis Daily edition is hosted by Me Laura Carlson. The show was produced by Me Topher Foreheads, Jordan Gaspore, and Magnus Hendrickson. Today's main story was reported by Jordan gas Poore. Original music by Leo Sidran. Our editors are Francesco Levi and Rick Shine.

Francesco Levi is Bloomberg's head of podcasts. Thanks for listening.