|
As people across the U.S. and the rest of the world contend with coronavirus disease 2019 (COVID-19), the research community should be alert to the possibility that it could hit some populations with substance use disorders (SUDs) particularly hard. Because it attacks the lungs, the coronavirus that causes COVID-19 could be an especially serious threat to those who smoke tobacco or marijuana or who vape. People with opioid use disorder (OUD) and methamphetamine use disorder may also be vulnerable due to those drugs’ effects on respiratory and pulmonary health. Additionally, individuals with a substance use disorder are more likely to experience homelessness or incarceration than those in the general population, and these circumstances pose unique challenges regarding transmission of the virus that causes COVID-19. All these possibilities should be a focus of active surveillance as we work to understand this emerging health threat.
Vaping, like smoking, may also harm lung health. Whether it can lead to COPD is still unknown, but emerging evidence suggests that exposure to aerosols from e-cigarettes harms the cells of the lung and diminishes the ability to respond to infection. In one NIH-supported study, for instance, influenza virus-infected mice exposed to these aerosols had enhanced tissue damage and inflammation. People who use opioids at high doses medically or who have OUD face separate challenges to their respiratory health. Since opioids act in the brainstem to slow breathing, their use not only puts the user at risk of life-threatening or fatal overdose, it may also cause a harmful decrease in oxygen in the blood (hypoxemia). Lack of oxygen can be especially damaging to the brain; while brain cells can withstand short periods of low oxygen, they can suffer damage when this state persists. Chronic respiratory disease is already known to increase overdose mortality risk among people taking opioids, and thus diminished lung capacity from COVID-19 could similarly endanger this population. A history of methamphetamine use may also put people at risk. Methamphetamine constricts the blood vessels, which is one of the properties that contributes to pulmonary damage and pulmonary hypertension in people who use it. Clinicians should be prepared to monitor the possible adverse effects of methamphetamine use, the prevalence of which is increasing in our country, when treating those with COVID-19. Retrieved from https://www.drugabuse.gov/about-nida/noras-blog/2020/03/covid-19-potential-implications-individuals-substance-use-disorders According to NIDA, The National Institute on Drug Abuse; Science Spotlight April 26, 201710/21/2017
An analysis of national survey data indicates that laws legalizing medical marijuana use are associated with increases in illicit cannabis use and cannabis use disorders among adults. The research was funded by the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), both part of the National Institutes of Health.
Comparing overall trends in states with medical marijuana laws to states without these laws, the authors examined data from three NIAAA-supported surveys conducted in 1991-1992, 2001-2002, and 2012-2013. In addition, the definition of cannabis use disorder was based upon the DSM-IV definition of cannabis abuse or dependence in the past 12 months. The authors estimate that an additional 1.1 million adult illicit cannabis users and an additional 500,000 adults with a DSM-IV cannabis disorder may be attributable to medical marijuana law passage. However, investigators also note there could be other contributing factors. These findings underscore the importance of examining how more permissive state marijuana laws can increase the risk of cannabis-related health consequences. An accompanying commentary on the article by NIDA scientists highlights the potential negative effects of cannabis on mental health. NIDA. (2017, April 26). Illicit cannabis use and use disorders increase in states with medical marijuana laws. Retrieved from https://www.drugabuse.gov/news-events/news-releases/2017/04/illicit-cannabis-use-use-disorders-increase-in-states-medical-marijuana-laws on 2017, October 21 The realization that the Holy Spirit is grieved is always quick, dramatic and unmistakable. Still, it usually takes me some time before I acknowledge that I need to ask God if I have displeased Him in any way. Have I been thinking critical or judgmental thoughts? These “secret” sins start in the mind, but soon manifest themselves in gossip, slander and self-righteousness. The longer I wait to face God and ask Him to reveal my sin to me the longer I will suffer. The increasing absence of peace and grace, and a feeling of discomfort that grows into an inexplicable sense of dread, continues until I specifically ask God, “What have I done to displease You, Lord? I want to repent of whatever it is, and stop practicing it. Lord, create in me a clean heart; renew a righteous spirit in me. Please don’t take away Your Holy Spirit.” Because when the Holy Spirit is grieved by my bad attitude, I lose touch with Him. Although my circumstances haven’t noticeably changed, His presence is noticeably absent and my ability to deal with life’s disappointments, big or small, becomes very hard because the anointing “goes away” when I am disobedient, and it’s His anointing that breaks strongholds. Case in point:
One morning, after two days of growing depression, I finally asked the Lord during my devotional time, what I was doing or not doing to displease Him. Immediately I “knew” in my spirit that my thoughts and attitude had displeased God. After a brief pause, I started to reason with God why I did not want to do something that I knew He wanted me to do. It wasn’t some big or hard to do thing. Just a matter of giving up some of my time to lend support to a couple of hurting women from my church. I have a tendency to be selfish with my time and not naturally compassionate either, so here was an opportunity for God to provide some healing stretching in this area of my life. A small thing, yes, but isn’t it always the small things that trip us up? I did not actually say “No!” to the Lord. I started by reasoning why I shouldn’t, wouldn’t and couldn’t extend myself to meet with these women outside of church. This is how it started. We have a support and recovery ministry at my church. Men and women meet separately once a week. The group leader was going away for a week so our upcoming weekly group meeting was cancelled. At the last meeting, some of the girls decided to get together on their own in place of the cancelled meeting. Right from the start, I declined. I was struggling to attend these step studies as it were and not interested in “hanging out” with the group outside of the church meetings. As I was leaving, one of the women, we’ll call her “Kelly,” insisted that she would call me anyway on Wednesday to confirm whether I would come or not. That was Thursday, but it was after Sunday’s service that I decided that I definitely did not want to go out, specifically not with Kelly. It was one of those ant hills that got blown into a mountain, but I ignored that realization. During the Sunday service, Kelly had interrupted my worship (rudely, I thought) to invite herself into my arms, opened wide in worship and start talking to me. “I saw your open arms and I thought that’s for me and I just had to come over for a hug,” she said smiling broadly. I was surprised by the abrupt interruption but I was polite and still. After mentioning that she hoped we could get together on Thursday and that she would call me Wednesday, she left, still smiling happily. Kelly is an attractive and youthful woman probably in her mid forties. She has been widowed for five years now like me and mainly on that basis believes that we have a lot in common. Driving home from church that Sunday, I decided that I was definitely not going out with her the following Thursday. I told God, “I don’t have to if I don’t want to, do I? I mean, she is so pushy and needy, besides by her own admission she has had a number of unhappy relationships with men since she’s been widowed. She is probably still dating and looking for a mate. Not the kind of person I want to “hang out with,” I thought mercilessly. “I don’t want any part of any of that.” This is what I was thinking and bringing to the Lord! At first, the Holy Spirit was just quiet, so I continued over the next day to justify myself more and more convinced that the decision was mine and I was right. But that uncomfortable, empty feeling I get when the Holy Spirit is grieved, would not go away. It was not until Wednesday morning that I couldn’t stand the “silence” any longer, and I repented before the Lord. Then my “aha” moment came: Gently the truth became crystal clear, I realized: “You think you are better than her. Kelly is not the problem. Your fear of intimacy, pride and lack of compassion are really the problems! Like the ripple in a pond, there was an instant realization of numerous other unpleasant characteristics of mine. Awed by God’s never-ending mercy and concern for me in spite of my flaws, I felt deeply saddened and ashamed. I asked God to forgive me for my stubborn self- righteousness and merciless attitude. Mercifully, I cannot remember most of what He showed me that needs to change. If I did I would probably be severely depressed, but I know God will work these things out in me, and I want Him to and I can trust Him because I know, He loves me and He will never leave me, reject me or abandon me. He will work in my life changing me to be more and more like Christ, until I go home to be with Him. After thought: I met with Kelly and another woman from the group at Panera. We prayed and laughed, and had wonderful fellowship together in the Lord… |
Lord, You are sovereign.
You decide when, and where, and how. You are the Holy One, Who dwells in the midst of the praises of Your people. Let us bless the Lord, Who is worthy to receive all glory, and thank Him for His goodness! |