NIH Leaders to Discuss How Pandemic Is Changing Research

Most experts agree the stress of the COVID-19 pandemic has had adverse effects on the mental health of Americans. At APA’s online Annual Meeting, the directors of the National Institute of Mental Health (NIMH) and National Institute on Drug Abuse (NIDA) will discuss how the pandemic is impacting their research programs.

NIDA Director Nora Volkow, M.D., will focus her lecture “Collision of the Opioid Crisis and the COVID-19 Pandemic” on how the pandemic has complicated efforts to contain the opioid crisis in the United States.

Following a modest but welcome drop in opioid-related deaths in 2018, opioid-related deaths spiked the following year due to a rise of fentanyl-laced products and more people using opioids in combination with cocaine or other stimulants, Volkow told Psychiatric News. The pandemic has made the situation only worse, she noted. Data from the Centers for Disease Control and Prevention (CDC) suggest that opioid overdoses in the United States rose 18% between March and May of 2020, as states began implementing lockdown measures. Preliminary data from the CDC also suggest the trend of more overdoses and overdose deaths has since continued, she said.

“There is a series of issues to blame,” Volkow noted. “With the shutdowns, access to treatment for substance use was reduced, while feelings of despair have increased.” She added that social isolation requirements during the pandemic have impacted the number of people whose overdose could be reversed by naloxone.

Socioeconomic determinants of health, such as income and education, are also going in the wrong direction during the pandemic, Volkow continued. “This is exacerbating all manner of adverse mental health outcomes and is especially hitting Black communities. We need to be proactive and address these socioeconomic factors.”

Volkow said a priority at NIDA is to obtain detailed knowledge about pandemic-related opioid use, such as the characteristics of people who are overdosing, the drugs they are using, and the interventions that are reaching people. The institute will primarily provide additional funding to existing projects to leverage the research infrastructure already in place, Volkow said.

One such project is the recently initiated HEALing Communities Study, which is looking at optimal ways to integrate prevention, overdose treatment, and medication-based treatment in 67 diverse communities in four states (Kentucky, Massachusetts, New York, and Ohio). Volkow noted this initiative offers a prime opportunity to understand how COVID-19 has impacted the opioid epidemic in both rural and urban settings.

NIDA is also challenging investigators to come up with new models to track substance use outcomes such as overdoses and deaths. The pandemic has demonstrated how important the collection of data in real-time can be for saving lives, she noted. “Substance use trends and hotspots also change quickly, yet we still rely on CDC data that are at least six months old,” Volkow said. “We need to know which drugs are causing problems in any given space and time.”

Chia-Chi Charlie Chang

Over at NIMH, Director Joshua Gordon, M.D., Ph.D., is taking the longer view. Nearly one year into the pandemic, some of the psychiatric impacts of COVID-19 are just starting to get attention, he said. These include psychoses associated with acute COVID-19 syndrome and the symptoms that so-called “long-haulers” are experiencing for weeks or months after the acute phase has resolved, many of which are neuropsychiatric in nature. The pandemic has also led to upticks in the number of people experiencing mood, anxiety, and substance use disorders.

In his lecture, “Mental Health Research in the Era of Competing Crises,” Gordon will discuss multiple NIMH projects examining the intersection of COVID-19 and mental health. One major effort is a multi-institute initiative to study the social, behavioral, and economic impacts of the COVID-19 pandemic on the health of underserved and vulnerable populations.

The NIH-wide collaborative is led by NIMH, the National Institute on Minority Health and Health Disparities, the National Institute on Aging, and the Office of Behavioral and Social Sciences Research. Together, this initiative has supplemented more than 50 existing grants so that investigators can expand their studies to capture more data on vulnerable populations. The collaborative is also funding new studies exploring digitally based interventions to extend the reach and effectiveness of health care in underserved areas and/or community interventions to mitigate some of the adverse health impacts of the pandemic on these vulnerable communities.

“The death of George Floyd and the consequent societal reckoning with racism and racial inequality have brought renewed focus to our efforts in health disparities research at NIMH,” Gordon told Psychiatric News. He pointed to a comprehensive report released by the Congressional Black Caucus that indicated suicide rates have been rising faster for Black youth than for any other racial/ethnic group over the past decade—and this was even before the pandemic hit; this topic will be the focus of one of NIMH’s other sponsored sessions. “We need to understand the reasons for this disparity and develop tailored interventions to stem this disturbing trend,” he said. ■