The drug overdose epidemic that swept through the United States over the past decade commanded the attention of public health providers, researchers, criminal justice practitioners, and policymakers at the federal, state, and local levels. Because of its severity and associated mortality rates, the epidemic became a priority among leaders across multiple sectors. As collaboration across these sectors matured, researchers and practitioners began to develop evidence-informed strategies to slow the spread of the epidemic. But the progress that was underway appears to have abruptly stopped when the COVID-19 pandemic emerged and fundamentally altered many aspects of American life.

Findings

• Early data suggest the COVID-19 pandemic has halted progress on reducing the incidence of substance use disorders (SUDs) and overdose deaths.
  • More than 40 states have reported increases in opioid-related fatalities since governors and local officials began implementing pandemic-related responses.

• COVID-19 has significantly altered the delivery of SUD treatment in the justice system.
  • Mandatory lockdowns, restrictions on movement, social distancing guidelines, orders limiting access to facilities for non-essential workers, and the absence of in-person treatment have created gaps in the system’s ability to identify and monitor the needs and legal requirements of people with SUDs, and to intervene when they are in distress.

• As justice system officials adapt to a COVID-constrained environment, some are using telemedicine to ensure continuation of treatment and counseling in both community and correctional settings.
  • That said, many are unable to access needed technology and some concerns remain about efficacy and suitability of such innovations.