Dr. Aslam is a Board-Certified Psychiatrist who completed his Residency training in Psychiatry and a Fellowship in Addiction Psychiatry at the Mayo Clinic in Rochester, MN. He has over 20 years of clinical experience and is a member of the American Telemedicine Association, the American Association of Addiction Psychiatry, and the American Association of Pain Management.
Given his special expertise in substance abuse and addiction medicine, we asked Dr. Aslam to share his knowledge with us in this discussion on the effects of the COVID-19 pandemic on the general public as well as those with a history of substance abuse. In particular, we explore the risk of COVID-19 infection in those with a history of substance abuse and discuss the increased level of stress on the public, which has manifested in increased alcohol consumption and other forms of substance use.
myDoqter: The present pandemic has had a greater negative impact from a health standpoint on specific groups of patients. Why are people who have a Substance Use Disorder (SUD) at greater risk for contracting COVID-19?
Dr. Aslam: COVID-19 has disproportionately affected people from low socioeconomic background and a large majority of Substance Use Disorder (SUD) patients come from that particular socio-economic strata. COVID-19 spreads by touching the face, mouth, eyes and through handshakes after coming in contact with an infected site. It also spreads by respiratory droplets, which are formed when we breathe, cough, talk, etc. COVID-19 primarily attacks the lungs; and, therefore it is especially a threat to those who smoke cigarettes, marijuana and vape. People with opioid use disorder and methamphetamine use disorder are also vulnerable due to the effect of these drugs on respiratory and pulmonary health.
myDoqter: Are there factors related to socio-economic conditions that contribute to COVID infection risk?
Dr. Aslam: Substance Use Dependency patients suffer from poverty, homelessness, lack of adequate health care and poor social networks. All of these factors put people with SUD more at risk of contracting COVID-19. Lack of running water in some communities makes it difficult to keep proper hygiene, and inability to wash hands frequently is one of the major ways this virus spreads. Lots of people suffering from SUD are jailed for minor infractions. Incarceration or living in crack houses where a lot of people live in close proximity to each other can easily expose this population to COVID-19.
myDoqter: Many of our youth still have not realized the risks of vaping and that it could, in fact, be very addictive. Could you provide us with further insight into this, Dr. Aslam?
Dr. Aslam: Vaping is increasingly becoming popular among teenagers. 37% of high school seniors reported vaping in 2018. E-cigarettes/Vaping use a battery-powered device that heats a liquid to form vapors or, more accurately, aerosol that the user can inhale (thus “vaping”). These devices heat up various flavorings, as well as nicotine, marijuana, or other potentially harmful substances.
Nicotine is a highly addictive chemical and can affect the developing brain, potentially harming teens and young adults. Nicotine reaches the brain in 10 seconds after inhalation. Nicotine stimulates the reward pathway of the brain by attaching to acetylcholine receptors. As a result of this stimulation, a neurotransmitter called dopamine is released, which creates good feelings in the brain. Adolescent brains are more sensitive to the reward pathway and it becomes difficult to resist using nicotine once the brain gets used to its feel-good effect. Data has shown that adolescents who vape are far more likely to start smoking cigarettes later in their lives.
myDoqter: How does Vaping relate to the risk of contracting COVID-19 and the severity of the disease in the particular person who does vaping?
Dr. Aslam: There are several reports of vaping causing lung problems. Aerosols inhaled during vaping contain chemicals, many of them harmful to the lungs. These particles get absorbed through blood vessels lining the lungs. A recent outbreak of e-cigarette or vaping-associated lung injury (EVALI) has affected close to 3000 people and caused 68 confirmed deaths per the CDC. There is emerging evidence that suggests exposure to aerosols from e-cigarettes diminishes the body’s ability to respond to infections. Therefore, people who vape are at increased risk for complications like pneumonia due to enhanced tissue damage and inflammation from infections like influenza and COVD19.
myDoqter: The statistics for alcoholism as a Substance Use Disorder (SUD) in our country are quite staggering. Typically, many resources are available to help patients cope with this and in many instances, help them control or temporarily overcome the addiction.
Could you share with us some valuable insight as to how patients with alcohol addiction have been affected during the present pandemic, especially taking into account the required social distancing measures?
Dr. Aslam: Multiple post-disaster studies in the past have shown that substance use, especially alcohol, increases following major traumatic events. Sales of alcoholic beverages have increased 55% in the U.S. compared to last year during this time. Hospitals are seeing an increase in admissions as a result of alcohol-related problems. People drink more when they are under stress to self-medicate.
In the wake of the current Coronavirus pandemic, we have seen massive unemployment, social isolation and lack of access to affordable healthcare. All of this is leading to the breakdown of support networks which is extremely important for individuals with substance use disorder. Many individuals rely on self-help groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) for staying abstinent. To observe social distancing due to COVID-19, most of the AA and NA meetings have been shut down.
If the past is an indicator for the future, the COVID-19 pandemic is going to significantly exacerbate the problem of substance use disorder, in particular alcohol use disorder.
To view more information about Dr. Aslam, you can visit: AdvancedPsychCare