Drugs, Alcohol & The Coronavirus
This entry was posted in Addiction News and tagged addiction and the coronavirus, alcohol and the coronavirus, drugs and the coronavirus on March 12, 2020 by Justin Baksh, MS, LMHC, MCAP, Chief Clinical Officer.
As was announced yesterday, we’re in a global pandemic now. On Sunday, here in the United States, we were officially declared past the point of containment on coronavirus, according to Dr. Scott Gottlieb, former Food and Drug Administration Commissioner, He also urged us to turn our focus to mitigation.
Translation: The coronavirus is out and making the rounds, likely across the country.
In fact, you could have already it. Or, you may be infected and not know it. In any case, there’s no stopping this train.
Case in point: CNN reported on March 11 that over 50 cases of coronavirus had been linked to one person, a 50-year attorney in New Rochelle, NY. His family members, his friends, people at his church, even bartenders at a bar mitzvah he attended… they have all tested positive for the coronavirus. The source of this attorney’s infection? No one knows.
That’s why mitigation includes refraining from contact with large crowds, cancelling big events, or even closing schools, all in an effort to slow down or prevent the spread. With people cropping up with the virus without international travel or known contact with an infected individual, it just makes sense.
This is important though:
There is a big difference between catching the coronavirus and becoming seriously ill (and even dying) from it.
Most people who get the coronavirus recover.
Who is Getting the Coronavirus?
Looking at cases in China, as of February 11, nearly nine out of 10, or 87% of the people who had contracted (and been diagnosed with) coronavirus were aged 30 to 79. Only a little over eight percent of those cases were in their twenties. This rate drops to 1.2% of the cases for teens, and the youngest among them – 9 and younger – clocked in at less than one percent (0.9%) of those diagnosed. Updated data as February 20 held true to these numbers: 78% of the cases diagnosed were with people in the 30 to 69 age range.
That is who is getting the coronavirus (or at least being diagnosed). The vast majority, or 81%, of the people diagnosed
on or before February 11 had mild symptoms. Only about one in seven, or 14%, were experiencing severe symptoms and one in 20, or five percent, were critical.
All of this can either mean that children and young adults have a natural immunity to COVID-19, don’t show symptoms, or don’t develop symptoms of enough severity to warrant a trip to the doctor and testing for the coronavirus.
As far as dying from the virus, the fatality rate is only 2.3% of those diagnosed cases.
However, and you’ll find that the death rate climbs with age. According to the China Center for Disease Control, it has been:
- 14.8% in people 80 and older
- 8.0% percent in patients in their 70s
- 1.3% percent for people in their 50s
- 0.4% percent for people in their 40s
- 0.2% for people 10 to 39
Developing one particular complication significantly ups the chance of dying from coronavirus: acute respiratory distress syndrome (ARDS). Those that developed ARDS (average age of 61) had a death rate of about 50%, versus nine percent for those who didn’t develop this secondary complication (average age, 49). ARDS involves a fluid buildup in the lungs which limits the capacity to take in life-sustaining air, thereby starving your organs of oxygen.
Gender appears to make a difference in the fatality rate as well. Men are dying from the coronavirus at more than double the rate of women (2.8% for men versus 1.7% for women). It’s worth noting that men have a higher incidence of chronic, pre-existing illnesses than do women.
Researchers in China also looked at which existing illnesses were associated with serious complications and fatalities with coronavirus. According to preliminary research published on Medrxiv, even after adjusting for age and smoking status, having one additional disease was associated with a nearly 80% greater changes of serious complications (intensive care, respirator and/or death):
Increased Risk of Serious Complications from Coronavirus by Underlying Condition
- Hepatitis B – 104%
- Cardiovascular Disease – 122%
- Chronic Kidney Disease – 143%
- Diabetes – 142%
- Hypertension (High Blood Pressure) – 160%
- Cancer – 221%
- Cerebrovascular Disease – 227%
- Chronic Obstructive Pulmonary Disease (COPD) – 308%
According to Tom Frieden, former director of the U.S. CDC, about 60% of adults in the country have at least one underlying medical condition.
What About People in Active Addiction? Do They Have to Worry About the Coronavirus?
Everyone is susceptible to contracting the coronavirus. On top of that, it’s well known that addiction drains your immune system like streaming video on an old I-phone. You just don’t fight off infections as well as you would were you not engaged in active addiction.
It’s not the drugs or alcohol themselves, but their effect on the body over time which counts. Organs weaken and
sustain damage. Dehydration and fatigue can set in. Also, people in active addiction tend not to take care of themselves. They may not eat or sleep as they should. All of this contributes to an immune system that isn’t as strong as it should be.
Think of an army: If it’s weak, it’s easier to penetrate the ranks and be conquered. If the army is strong, however, you may not be able to get a foothold.
A strong immune system is also able to quickly recognize and neutralize (defeat) the enemy (pathogens, germs, bacteria and viruses) and eliminate them. In fact, a healthy immune system can fight its own cells that have changed (turncoats) and successfully kill them off as well.
So, people who are in active addiction may very well catch the coronavirus more easily. With an immune system compromised by active addiction, it can be harder to fight off as well.
Those who are 65 and older with a serious underlying medical condition are even more likely to become seriously ill and possibly die from it. It’s worth noting that this follows the pattern of the flu virus in general. It’s not generally a life and death situation, but for those who are older and especially those with a serious physical condition, such as COPD, heart disease, cancer, etc., it can be.
As we all know, addiction knows no age limits. Addiction is also addiction, whether the drug of choice is an illicit substance, prescription drugs or alcohol.
Alcohol & The Immune System
Excessive alcohol consumption has been linked with immune deficiency. Not only does it affect your ability to fight an infection, but it also can damage your organs, slow your body’s ability to heal soft tissue injuries, and increase your chances of developing:
- Acute Respiratory Distress Syndrome (ARDS)
- Digestive System Disruptions (damaging cells that secrete necessary digestive enzymes)
- Alcoholic Hepatitis
- Alcoholic Liver Disease (ALD)
- Liver cancer
- Liver failure
It is worth noting here that ARDS is the complication that is so deadly with the coronavirus.
Chronic alcohol abuse (and drug abuse, by the way) affects your liver the most. It can cause the destruction of your liver cells. Alcoholism is the number one contributor to liver disease illness and death in the United States, according to the National Center for Health Statistics.
Your liver is the primary organ involved in metabolizing alcohol (and drugs) as well as filtering the blood from your digestive tract. It makes proteins that are vital for blood clotting.
Excessive alcohol abuse over a long period of time can also cause an autoimmune disorder, where the body attacks its own cells. There is an increased susceptibility to pneumonia, for example. This can be a problem when you contract the coronavirus (or any flu or other upper respiratory virus). You can be more likely to experience pneumonia, and possibly to experience it more severely.
Drugs & The Immune System
Smoking marijuana irritates the lungs, making you more likely to contract pneumonia or a serious lung infection. (Remember that it’s the lungs that are affected by the most serious complication from the coronavirus). Marijuana has a suppressive effect on your immune system and can also increase your risk for cancer.
Not only does heroin weaken the immune system (as do all opioids) and affect the digestive system, addiction to it often results in a lack of self-care. Addicts have been known to go without sleep or food, which further weakens the immune system. On top of that, injecting drugs through shared needles increases the risk of contracting Hepatitis B, Hepatitis C, HIV, and other viral infections. Fungal and bacterial infections are a concern here as well.
Cocaine disrupts a key protein system function that makes the body less effective in fighting off disease or infection. The method of delivery can also affect you: The mucous membranes of the nose, lungs and throat can be damaged when you snort cocaine, leaving you more susceptible to upper respiratory infections. When crack cocaine is smoked, it can damage the lungs and make you more prone to developing pneumonia and other lung infections. Cocaine users are more likely to suffer from hepatitis, HIV, sexually transmitted diseases and other infections.
Morphine & Other Opioids
Morphine and prescription opioids also suppress three different white blood cell types, leading to a weaker immune system. This includes many prescription opioids, according to the National Institute on Drug Abuse (NIDA).
It’s Not Just About the Coronavirus – You Need to Be Concerned About HIV & Hepatitis as Well
The CDC tells us that 10% HIV diagnoses occur in people who inject drugs. Injection drug use is also implicated in at least 60% of Hepatitis C transmission cases in the U.S. In fact, the CDC recommends that anyone who has ever injected drugs be tested for it. Each Hepatitis-C-infected drug user is likely to infect 20 other people, usually within the first three years of being infected. People who inject drugs are also at a higher risk for contracting Hepatitis B.
There are two primary ways that injection drug users get infected with hepatitis or HIV:
- When sharing needles or other equipment for drug use or preparation
- When they have unprotected sex with an infected partner
Hepatitis & Coronavirus
Hepatitis is a disease of the liver that causes inflammation. There are different types of hepatitis (A, B, C, D, E, and even G). Types B and C can be chronic, meaning lasting three months or more and unable to be cured by medication. They are also the most common viral hepatitis infections transmitted among those who inject drugs. Chronic viral hepatitis, left untreated, can lead to cirrhosis (scarring and loss of liver cells), liver cancer and failure. The most common causes of cirrhosis are alcohol and viral Hepatitis B and C.
While Hepatitis C wasn’t mentioned in the preliminary research from China’s CDC, they did find that Hepatitis B carried a 204% increased risk of serious complications in those who contract the coronavirus.
HIV & Coronavirus
Human immunodeficiency virus (HIV) is a virus that attacks the immune system. Therefore, it affects the ability to fight an infection.
While anyone with a compromised immune system is at increased risk of contracting and having serious complications from coronavirus, those who have low CD4 T-cell counts are at the greatest risk.
In an interview with POZ, Steve Pegram, MD, MPH, of the Vaccine and Infectious Disease Division at Fred Hutchinson Cancer Research Center said:
“It’s all based level of immune suppression… For an HI patient who is on stable antiretroviral therapy and a normal CD4 count, their risk may be slightly increased. People often lump HIV patients with other immunosuppressed patients, but HIV is a different disease than it was years ago. For people who have a reconstituted immune system because of treatment, I think the risk is not going to be tremendously different.”
Interestingly, it has been reported that certain HIV medications have shown activity against COVID-19.
What Can You Do To Help?
Unfortunately, most people in active addiction aren’t worried about the coronavirus, hepatitis, or HIV. The disease of addiction progresses to the point where all that matters is the next fix, at any cost. The possibility of contracting another disease – even if it could be permanent and life-altering – does not factor into the equation.
However, the possibility of contracting and developing serious complications from the coronavirus can be yet another reason for family and friends of the addicted to be ready with a plan for treatment. It can also be another impetus for staging an intervention, another reason to talk with your loved one about their destructive path, and another way to try to broach the subject.
Treatment really is the most effective way to help those struggling addiction. Getting addicts there is the challenge; and catching them in a state of mind that is ready and willing to accept the help that is offered is paramount.