As the pandemic drags on, now with the omicron variant taking hold, mental health issues and substance abuse disorders (SUDs) continue to grow. The longer this continues, the more critical the need to be more alert to who may be vulnerable to developing new or deepening mental health issues that may lead to harmful behaviors including dependencies on drugs and alcohol. This topic took center stage at last year’s annual meeting of the American College of Clinical Pharmacy.
During the meeting, as reported in Pain Medicine News, two strategies were emphasized: “stepped-up screening to identify at-risk patients, and medication management.” As the article explained, “This puts pharmacists in an important position to serve as a “second tier of care” for this vulnerable patient population.” https://www.painmedicinenews.com/Online-First/Article/01-22/Pharmacists-More-Watchful-for-Signs-of-Opioid-Use-Disorder-During-Pandemic
140,000 Children Have Lost At Least One Caregiver
While the death rates due to COVID-19 are startling, what’s more staggering is the number of children whose lives have been turned upside down. The number of children who have lost parents and caregivers is so great that the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association declared a national emergency in children’s mental health.
140,000 children lost a caregiver during the pandemic, and these were disproportionately children of color. Rates of depression, anxiety, trauma and loneliness also have increased, with, for example, emergency department visits for suspected suicide attempts rising 51% among girls 12 to 17 years of age in early 2021, compared with early 2019.
Children are not the only ones being affected. Adults too are feeling the strain. According to a CDC (Centers for Disease Control) report, “said 70% of parents or caregivers reported adverse mental health symptoms during the pandemic. Of those, 55% reported anxiety or depression, 54% reported COVID-19–related trauma and 32% experienced serious suicidal thoughts”. https://www.cdc.gov/mmwr/volumes/70/wr/mm7024a3.htm
How Pharmacists Can Help
In addition to stepped-up screening efforts, pharmacists can help optimize mental health and SUD treatment by providing consultations on therapeutic drug monitoring, conversions to and from long acting injectables, and by making other changes to treatment plans already in place. For instance, if someone is on lithium, pharmacists can help providers determine who is an appropriate candidate to forgo labs, and what signs and symptoms of toxicity they should be looking for in those patients and how to educate patients to look for and recognize those signs as well.
As the pandemic lingers, experts and medical professionals have been seeing individuals with undiagnosed mental health challenges or substance use issues present with more severe behaviors during the pandemic than they previously would have. So, instead of diagnosing someone as a patient with potentially problematic substance use or substance misuse, they may jump right to a diagnosis of substance use disorder or a mental health disorder.
We Need Every Professional Touch Point Covered
We are all in this together. The more we can help the at-risk population today, the less dramatic the consequences later. We know, without question, that even decades after this pandemic has been forgotten, the devastation will be evident in the lives of those most affected today.