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Randy Abbott: COVID-19, addiction and the health care coverage gap

Randy Abbott: COVID-19, addiction and the health care coverage gap

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Addiction took the life of my daughter in 2015, just as it has so cruelly snuffed out so many other promising lights in North Carolina. By 2018, the efforts of devoted families, medical professionals and public servants to curb our state’s opioid crisis showed signs of traction. But the COVID-19 pandemic has dealt these efforts a crushing blow.

Couple this with our state’s failure to find a solution for closing the health insurance coverage gap and we have a disaster — an epidemic within the pandemic.

Now, we must look the challenge of addiction square in the eye and take action — as a matter of life or death. We know treatment works. Recognition of the issue and the exacerbating effect of COVID-19 must remain a priority as we work to close a deadly gap in health care coverage that prevents so many from getting treatment

Like the pandemic, the opioid epidemic reaches far and wide, afflicting people from all walks of life. My daughter was just 24 years old. Others have lost parents. Addiction afflicts construction workers and waitresses as well as lawyers and executives. Opioids and other drugs contributed to the deaths of more than 2,000 North Carolinians in 2017, with tens of thousands more battling the killer.

But North Carolina fought back, bolstering prevention and treatment. Overdose deaths fell by 6% in 2018. At the same time, the number of treated overdoses was up. This indicated that the increasing accessibility of harm reduction services was proving effective for saving lives.

But COVID-19 threatens to upend even our modest progress. Nationally there has been a steady increase in reported overdoses each month since the pandemic began, beginning in February with 16% rising to 42% as of May. In North Carolina, we have seen an increase in emergency room visits due to overdose every month, and officials in both Forsyth and Guilford counties report an increase in people needing naloxone (a medication designed to rapidly reverse opioid overdose).

The pandemic is exacerbating the epidemic. The opposite of addiction is connection, something the pandemic has threatened. Our friends, family and neighbors struggling with addiction and those in or seeking recovery need the continued support and connection of important services like harm reduction and recovery housing. But most recovery houses are self-supporting, which means every resident must be employed to be able to contribute. Job losses due to the pandemic have created a strain on many houses.

But treatment falls away or becomes impossible when people don’t have insurance, something that often comes with employment. With the pandemic raging, more than 1.1 million have filed for unemployment with many losing their job-sponsored health insurance. Still others are now under-insured. Many of them fall into a dangerous limbo we know as the health care coverage gap — earning too much to qualify for the government-supported Medicaid program but too little to purchase their own insurance plans.

These are our neighbors and our friends. Prior to COVID-19, the Kaiser Family Foundation (KFF) estimated that in North Carolina nearly 500,000 vulnerable individuals would enroll in Medicaid expansion coverage by the end of the program’s first year. But COVID-19 has cruelly reshuffled the deck. KFF now estimates that nearly 200,000 more individuals are now stuck in the coverage gap.

Our state leaders — some of the same ones who acted to try to stem the opioid epidemic over the last several years — can close the gap by moving to expand Medicaid, just as voters in conservative Oklahoma and Missouri recently opted to do.

This won’t be an addiction cure-all. We have new COVID-related twists to fight through, including a surge in tainted drugs as dealers dilute their product in an effort to make their strained supplies go further.

But closing the coverage gap so that thousands can get the treatment they need will allow us to turn our full attention to new problems. The pandemic is tough enough without allowing North Carolina’s opioid crisis to spin further out of control.

No society should allow a problem to persist and deepen when a solution is within reach. And no parent should ever lose a child.

Greensboro resident Randy Abbott is the manager of Volunteer Programs for SAFEProject US and serves on the steering committee for Care4Carolina.

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