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Addressing the Syndemic of Addiction, COVID-19, and Structural Racism by Strengthening the Workforce

By Sara Becker 

New England ATTC

According to the latest data from the Centers for Disease Control and Prevention, over 105,000 Americans have died and at least 1.7 million Americans have been infected with the novel coronavirus disease (COVID-19). Social distancing measures put in place to contain the spread have decimated entire sectors of the United States economy, with the stock market dropping so precipitously that it erased three years of gains. Unemployment rates are also at historically high levels with the national rate rapidly approaching 15%. In a few short months, COVID-19 has upended our country and harmed millions of Americans.

Data on the toll of COVID-19 are troubling in aggregate, but even more concerning when we consider those Americans hit the hardest. Recent commentary by NIDA director Nora Volkow (2020) underscored how individuals who use opioids are at increased risk for the most adverse consequences of COVID-19 due to both direct (e.g., slowed breathing due to opioid use) and indirect (e.g., housing instability, incarceration) pathways. In addition, Black Americans and Hispanics have been disproportionately affected by COVID-19: emerging regional data suggests that the COVID-19 death rate for Black and Hispanic Americans is about 2.5 times higher than for whites. The disproportionate toll of disease reflects the effects of structural racism, which manifests in increased risk of underlying health conditions (e.g., chronic respiratory disease); decreased access to testing and care; and decreased ability to socially isolate due to factors such as crowded living conditions and employment in sectors deemed essential. Taken together, these data indicate that the United States is in the midst of a syndemic - defined as the interaction of a set of linked health problems involving two or more conditions, interacting synergistically and contributing to excess burden of disease. Addressing the syndemic of addiction, COVID-19, and structural racism requires responses on multiple levels and across multiple fronts. One of those fronts is ensuring that the addiction treatment workforce is equipped with the tools needed to help patients facing these interacting epidemics.

The Addiction Technology Transfer Center (ATTC) Network has been working to meet this challenge by developing new products and resources focused on these intertwined public health issues. The National Coordinating Office hosted a Listening Session and a 5-part Strategic Discussion Series focused on emerging issues around COVID-19 and social determinants of health. The Listening Session solicited feedback on ways COVID-19 has highlighted racial and ethnic disparities, and each Strategic Discussion focused on concrete actions that could be taken to support specific communities of color.

Regional ATTCs have also risen to the challenge to create new tools for the addiction workforce during these unprecedented times. The New England ATTC has developed multiple products including a 2-part webinar series (in partnership with the New England Mental Health Technology Transfer Center) focused on the intersection of addiction, mental health, and COVID-19; a training focused on Trauma-Informed Approaches to Substance Use Assessment and Intervention (which includes new content on how to sensitively assess and address the trauma of racism and the traumas inflicted by COVID-19); and a workshop on Cultural Intelligence and Cultural Humility (which has been adapted to address the disparities and racism highlighted by COVID-19). The New England ATTC has also partnered with the South Africa HIV ATTC to develop a series of products focused on provider self-care in recognition of the toll that caretaking places on front-line health professionals. Finally, in October 2020 the New England ATTC will proudly host this year’s national Addiction Health Services Research Conference (delivered fully virtually)! One of the plenary talks by Dr. Ayana Jordan will specifically address the intersection of structural racism and addiction, and spotlight awards will be given to addiction researchers from underrepresented minority groups.

The New England ATTC is proud to join other Regional ATTCs in not only building the skills of the SUD workforce but also providing supportive strategies for sustaining hope and encouraging self-compassion during this trying times. Please visit the New England ATTC’s COVID-19 resource page to see the latest products and training events devoted to addressing this syndemic.

Published:
07/02/2020
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The opinions expressed herein are the views of the authors and do not reflect the official position of the Department of Health and Human Services (DHHS), SAMHSA, CSAT or the ATTC Network. No official support or endorsement of DHHS, SAMHSA, or CSAT for the opinions of authors presented in this e-publication is intended or should be inferred.

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