Cerebrum Winter 2022

What remains to be seen is how long regulatory relief measures will stay in place. Will they become permanent, or will we backslide? As Americans return to the office and its associated etiquette, will alcohol consumption return to pre-pandemic levels, or has a new—and elevated—normal been created? With new and perhaps future variants delaying any hope of an abrupt end to the pandemic, it remains critical that we leverage the insights that have been gained about disparities and vulnerable groups into new preventative and proactive measures. This is particularly true in regard to teenagers. Given the heightened stress reactivity of adolescence, and the possibility of long-lasting neural changes linked to Covid experiences, we must focus attention and support not only to help affected teens today, but to mitigate the development of addiction-linked psychopathologies in the future. Stay tuned. l

surprising then that social environment or high-stress exposure at this time produces heightened vulnerability to anxiety-related disorders, a factor that is linked with a rise in alcohol and drug use associated with increased likelihood of addiction later in life. Out of the Storm While the emergence of new variants and uncertainty prolongs our fragile state, the pandemic has not been all doom and gloom. The Covid storm, like any crisis, has also provided opportunities—including a chance to develop new strategies to help individuals suffering from substance use disorders. Perhaps one of the most unexpected outcomes of the pandemic has been the profound relaxation in regulatory laws that govern addiction treatment, particularly for the use of buprenorphine , a medication for opioid-use disorder. Buprenorphine, like heroin or oxycodone, is an opioid, but it is nowhere near as euphorogenic or intoxicating. Substituting a very safe medication like buprenorphine for a very unsafe drug like heroin dramatically lowers the risk of overdose. Before the pandemic, it was very difficult to enroll someone onto buprenorphine over the phone or internet due to regulatory laws requiring in-person assessment for treatment. During the pandemic, virtual therapy became commonplace. Hard-to-reach areas that required a long drive for personal contact could now be accessed via an internet connection. Another silver lining of the regulatory relief that occurred during the pandemic was the relaxation of laws regarding methadone maintenance treatment. Prior to Covid, many patients enrolled in methadone programs had to come to the clinic six days a week to pick up their dose. During Covid, they were able to stay safe in their homes and visit the clinic on a weekly or bi-weekly basis in order to pick up several doses at one time. While it is still too early to judge the epidemiological impact of these liberalized policies, they have been very well-received by patients. In addition, accessing self-help groups like AA was easier during the pandemic for some people, as connecting through the phone or computer provided a protective layer of anonymity that overcame concerns about attending in person. Networks expanded, and new connections were made as people in New York City could suddenly join groups in Los Angeles or London. There is quite literally an AA meeting happening online every hour of every day —great news for those in recovery.



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