As Americans have hunkered down to safeguard themselves from Covid-19 infection, too many people also have stocked their homes with potentially harmful items — and the nation soon may be reckoning with the health consequences.
Will consumers come to regret that officials, locality by locality, deemed “essential” and chose to keep open marijuana shops, gun dealers, and liquor stores? Will doctors rue their decision to support patients, understandably unnerved by the pandemic, with a spike in prescriptions of potent and problematic anti-anxiety drugs?
Experts are sounding the alarms — with reasons worth wide public reminder.
The worrisome arms race — in U.S. homes
Researchers in Boston have written in the Annals of Internal of Medicine about the public health threat posed by skyrocketing firearms sales, before the novel coronavirus outbreak and as Americans have sheltered in their homes. Even as jurisdictions tangled with Second Amendment issues over closing or allowing weapons dealers’ sales during the pandemic, the results have been concerning, the experts reported:
“Since February 2020, as U.S. public health efforts have focused on containing the spread of coronavirus disease 2019 (Covid-19), gun sales in the country have skyrocketed. In March, more than 2.5 million firearms were sold, including 1.5 million handguns. In the best of times, increased gun ownership is associated with a heightened risk for firearm-related suicide. These are not the best of times.”
Increased firearm sales matter greatly in discussions about dealing with the nation’s rising and unacceptable levels of suicide, the researchers said:
“The firearm-related suicide crisis was mounting well before Covid-19. From 2006 to 2018, firearm-related suicide rates increased by more than 25%. In 2018 alone, there were 24 432 firearm-related suicides in the United States. Simultaneously, the number of firearm background checks increased from 10,036,933 in 2006 to 28,369,750 in 2019—an annual increase of 14%. However, something new is happening. The heightened gun sales in March 2020 represent an 85% increase compared with March 2019. These are the highest firearm sales ever recorded in the United States. Persons who purchase handguns have a 22-fold higher rate of firearm-related suicide within the first year than those who did not purchase a handgun. Among men, for every 10 percentage points increase in household firearm ownership rates at the state level, there is an increase in firearm suicides of 3.1 per 100 000 persons. Decreased gun restrictions and increased access to firearms are associated with higher firearm-related suicide. On the individual level, the presence of a firearm in a home is associated with a 2- to 10-times greater risk for suicide than in a home without a firearm. This risk applies to all household members, not just the gun owner, and persists for years after the purchase of the firearms.”
The researchers have called on officials to step up in difficult times and just say no to excessive gun sales, while also increasing social support programs that can battle individual’s senses of hopelessness, despair, and depression. They suggest that now is an excellent time for authorities to launch public information campaigns and legislation about safer weapons storage — practices that could prevent heartbreaking instances of youngsters killing themselves and their friends by accident. The measures also can allow owners to keep the unfounded sense of security they may get from weapons, while providing just enough crucial delay so that individuals contemplating harming themselves may be dissuaded, as studies suggest can occur.
If you are in crisis or know someone who may be, please call the National Suicide Prevention Lifeline at 800-273-TALK (8255) or text HOME to 741741. Both work 24/7. More resources are available at SpeakingOfSuicide.com/resources.
We have got huge work to do to remove the stigma of suicide and to combat the underlying issues that may lead to too many tragic instances where people take their own lives. The crushing and necessary response to Covid-19, with soaring joblessness, physical distancing, and other challenges to Americans’ health only complicate this fight.
Is it self-medication, unwelcome intoxication — or something worse?
As Americans struggle with Covid-19 safeguards, including physical distancing and staying in their homes, they have taken to stress-relieving pastimes that may seem fun and harmless but also can veer into significant problems.
Yes, it can be helpful — for those who can — to jump online with video conferences to enjoy congenial companionship with “quarantinis” and Covid-19 happy hours. Why not turn on tunes or stream a movie and consume powerful pot after a tough day of coping with cyber work, or even scary IRL (in real life) job or other experiences, or due to boredom and restlessness, or in trying to escape the household aggravations of roommates or loved ones?
Officials seem to have given the green light to such practices. When heading out to what can be intimidating runs to get needed groceries and supplies, shoppers likely will find in many areas that booze seems in plentiful supply on shelves — and it’s filling many carts, along with food and other household goods. In some areas, to help embattled restaurateurs, officials have relaxed regulations and allowed liquor take-out and delivery, along with food sales. In states where marijuana has been legalized, stores selling it have been allowed to conduct what has become a robust business for many.
As the news site Politico reported:
“Marijuana sales are booming, with some states seeing 20% spikes in sales as anxious Americans prepare to be hunkered down in their homes potentially for months. Weed sellers are staffing up too, hiring laid-off workers from other industries to meet demand. And in the midst of a historic market meltdown, stock prices for cannabis companies have surged, in some cases doubling since the public health crisis began …Nearly all of the 33 states with legal medical or recreational markets have classified marijuana businesses as an essential service, allowing them to remain open even as vast swaths of the retail economy are shuttered. San Francisco and Denver initially announced plans to shut down dispensaries, but immediately backpedaled after a public furor. Weed shops are essentially being treated the same as pharmacies, reflecting a dramatic shift in cultural perceptions about the drug over the last decade.”
Experts at the University of Southern California have posted online this view about Covid-19 and alcohol consumption:
“Alcoholic beverage sales rose by 55% in late March, when many states and public health officials urged residents to stay at home, compared to sales in 2019. While the increase in sales could represent stockpiling for the sheltered weeks ahead, it also signals the potential for alcohol abuse … The combination of the pandemic, its economic fallout and stay-at-home mandates mean conditions are tailor-made for drinking. ‘It’s stressful and boring. People are coping with kids at home, spouses, social stress, financial stress, work stress and the threat of disease. So, it doesn’t surprise me at all that we’ve seen a spike in drinking,’ said John Clapp, professor at the USC Suzanne Dworak-Peck School of Social Work. Clapp says he’s particularly concerned about the potential for relapse as people struggling to overcome substance use find themselves alone facing new challenges.”
Now that the novelty has worn off the tight public health measures designed to deal with the novel coronavirus a small but rising number of people on social media have begun to reconsider their intoxicant use. They’re skipping daily drinking or deciding to curb their getting stoned.
This is important not only for substance abuse concerns but also because experts have cautioned that alcohol abuse, as well as smoking (cigarettes or marijuana) and vaping all can be bad news when it comes to Covid-19, the microscopic parasite that launches a brutal attack on the respiratory system, and, as clinicians are discovering, also plays havoc with the kidneys.
In recent times, before the pandemic, the evidence was clear that too many Americans had serious issues with drinking and marijuana use. This isn’t about prudishness or anyone being a bluenose. As people struggle with the uncertainty, complexity, and grave costs of an infection that has swept the planet, they may need not only respites from reality but their full faculties to deal with a fast-changing Covid-19 world.
Worry grows over prescribing spike in anxiety, insomnia, and depression meds
Although experts warned that the Covid-19 pandemic would cause or worsen mental health concerns for untold numbers of Americans, who knew that a fast-spreading respiratory illness also would cause a worrying spike in clinicians prescribing drugs for anxiety, insomnia, and depression.
The medications — which doctors have expressed rising concern about, particularly in combination with other drugs and alcohol — had been declining in use and popularity.
“[T]he number of prescriptions filled per week for antidepressant, anti-anxiety and anti-insomnia medications increased 21% between Feb. 16 and March 15, peaking the week ending March 15, when Covid-19 was declared a pandemic. It’s understandable. Americans have grown increasingly anxious as they’ve seen this global pandemic upend their lives within a very short time. This analysis, showing that many Americans are turning to medications for relief, demonstrates the serious impact Covid-19 may be having on our nation’s mental health. The greatest increase was in prescriptions for anti-anxiety medications, which rose 34.1% from mid-February to mid-March, including a week-over-week spike of nearly 18% during the week ending March 15. The number of prescriptions filled for antidepressants and sleep disorders increased 18.6% and 14.8%, respectively, from Feb. 16 to March 15.”
Based on an analysis of weekly prescription data from 2015 to 2019, information from pharmacy claims of 3.4 million privately insured people in the U.S., the company also noted that:
“The rise in anti-anxiety medications is particularly striking given data from a new Express Scripts research report, America’s State of Mind, which found that until now, the use of these drugs had been declining over the past five years. The report, which examines mental health medication trends from 2015 through 2019 among 21 million people with employer-funded insurance, documents a decline in the use of anti-anxiety medications of more than 12% and a similar decline in the use of anti-insomnia medications, down 11.3%.”
The company saw a positive development in patients seeking mental health help in unprecedented troubling times. While conceding that patients should not suffer without relief if they experience coronavirus-related psychiatric challenges, it also should be underscored that experts have stepped up their cautions a common class of drugs prescribed for anxiety, insomnia, and depression: benzodiazepines, aka benzos.
Benzos are muscle relaxants and anti-anxiety meds more commonly known by brand names like Valium and Xanax. And the federal government has issued one of its toughest warnings against the dual prescribing and use of opioid painkillers like oxycodone and hydrocodone with benzodiazepines.
As CNN reported before, doctors may too readily prescribe benzos like alprazolam (Xanax), diazepam (Valium), clonazepam (Klonopin) and lorazepam (Ativan):
“Benzodiazepines … can be helpful when taken on a short-term basis. Doctors often prescribe them to relieve acute anxiety, agitation or to help someone sleep. Taken over the long term, they can become addictive. In older adults, the drugs have been shown to increase the risk of falls, cloud judgment and impair memory. There is an increased risk of hospitalization and death for people who take benzos, particularly if they are taken with an opioid. Despite the risks, among the doctor visits at which benzodiazepines were prescribed, approximately one-third involved an overlapping opioid prescription at a rate of 10 annual visits per 100 adults from 2014 to 2016.”
Substance abuse experts have cautioned that Covid-19 may worsen the opioid abuse and overdose crisis, especially as patients may more easily and readily get to illicit drug supplies rather than to sustained mental health therapy and pharmaceutical treatment for problems with potent prescription painkillers.
This all is not good nor acceptable. In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them by dangerous drugs and other commonly abused substances, as well as by defective and dangerous products, mostly of the medical kind but also with firearms. We need to support enlightened government officials and effective and courageous first responders, health care workers, and other people who are doing what is deemed essential but is too often low-paid work. Please heed the public health experts: Stay at home, keep appropriate distances, and wash those hands. Keep up your social contacts, don’t overdo the intoxicants or prescription meds. Don’t smoke or vape. Think hard about whether a firearm needs to be in your home, and whether it can be stored in the safest way possible.
And keep those chins and spirits up. We’ll work together and get through the tough times.