Did you know that loneliness - the sadness we feel when we’re apart or separated from our loved ones, like parents, siblings, partners and friends, or even from society itself - is affecting more and more adults, and actually appears to worsen with each new generation of Americans?In addition, this loneliness, this sad sense of separation, is a prominent precursor to depression and other mental health disorders, and a major contributing factor in substance use and, later, drug addiction, among its other effects.For decades and decades, and long before “coronavirus,” “social distancing” and “quarantine” became commonplace words and phrases in our daily conversations, the U.S. was experiencing an ever-worsening plague - one of simply feeling alone - and it’s still with us.Unsurprisingly, the COVID-19 pandemic has made this “loneliness epidemic” far more pervasive throughout the nation, and far more concerning to mental health experts, especially as many of them are now predicting a wave of post-pandemic mental health and behavioral issues as a result of both the physical and socio-environmental effects of COVID-19, resulting in a new public mental health emergency on the very near-horizon.“We have supply shortages and economic stress, fear of illness, all of our disrupted routines… There's a real grief in all of that. We don't have a vaccine for our mental health like we do for our physical health.”- Lisa Carlson, MPH, MCHES, renowned public health expert (2020)So, should we listen?...Well, these same expert voices were 100% correct in predicting the rapid spike in fatal drug overdoses as the pandemic and its effects really kicked in across the U.S. In fact, record numbers of drug users died by opioid-related overdose in 2020, as recently acknowledged by the U.S. Centers for Disease Control & Prevention (CDC).Furthermore, they correctly predicted the rise in relapse rates as those in addiction recovery were left to look solely online for their support (from treatment and counseling, to their 12-Step meetings), and, lastly, they were more than proved right when it came to the growing influence across the entire U.S. of the synthetic opioid fentanyl in today’s illicit drug trade.Think about it. It’s a succession of undeniable consequences with severe effects on U.S. public health. It’s only prudent to listen to them now.Loneliness, Depression and Self-MedicationIn 2018, the global health service company Cigna, in partnership with market research firm Ipsos, released the results from their national “loneliness” survey, which utilized the “UCLA Loneliness Scale” - a frequently referenced and acknowledged academic measure for loneliness, involving a 20-item questionnaire developed to assess subjective feelings of being lonely and social isolation.The survey revealed that most U.S. adults should be considered as lonely, and that feeling or sense of loneliness has further increased with each subsequent generation. The survey revealed a number of other worrying findings, too:43% of U.S. adults often or always feel that their relationships are not meaningful, and that they are isolated from othersGeneration Z (adults aged 18-22) is the loneliest generation, and appear to be in worse health than older generationsRespondents defined as “very heavy users of social media” had a loneliness score of 43.5%, only marginally higher than those who never use social media (41.7%)Predictive Factors for Substance AddictionAs we now understand from extensive research on the subject, there is no one single factor that determines the likelihood of an addiction developing from substance use. Moreover, it’s a combination of possible factors that can be predictive when assessing an individual’s risk of addiction.However, the more “predictive boxes” that are ticked, the higher the likelihood of substance addiction, as individuals look to “self-medicate” to deal with their struggling mental health. Predictive factors include:Biology: It is believed that about half of an individual's risk for addiction is solely genetic. Additionally, gender, ethnicity, and the presence of mental disorders will further increase risk.Environment: An individual’s personal environment includes many different factors, such as family and friends, economic status, quality of life, peer pressure, physical and sexual abuse, early exposure to drugs, stress, and parental guidance.Development: Furthermore, these genetic and environmental factors will interact with an individual’s development (particularly in teenagers) to affect addiction risk. Using substances at any age can lead to addiction; however, the earlier the drug use begins, the more likely it will progress to addiction.Loneliness, as we’ve discussed above, can act as both an environmental and a biological factor in addiction risk (especially if it leads to a depressive or other disorder), resulting in a much higher risk for the later development of substance addiction, and, as we’ve mentioned previously, the COVID-19 pandemic has only made this “loneliness epidemic” more pervasive and more concerning in the opinion of mental health experts.Unfortunately, it doesn’t end there.Post-Viral Inflammation and Mood Disorder DevelopmentMedical researchers have long known about the direct link between inflammation, a natural biological response to viruses like COVID-19, and the subsequent development of mood disorders, such as depression. Additionally, they have also demonstrated that inflammation and mood are so intrinsically linked that the presence of inflammation may induce or exacerbate a mood disorder.A “Tsunami” of DepressionAn Irish Journal of Psychological Medicine article, published in May, 2020, and entitled “Fallout from the COVID-19 Pandemic - Should We Prepare for a Tsunami of Post Viral Depression?,” highlights this link, and predicts that 2021 will see a tidal wave of depressive disorders and other behavioral issues.“How is this possible?” you may ask.During the period when an individual has a viral infection, they experience decreased cellular immunity, and their body produces neuromodulators and immunomodulating agents to cope with this. However, these agents can then penetrate the brain when the blood-central nervous system (CNS) barrier is compromised - common during time of stress, infection and inflammation.In short, these neuromodulators inhibit our brain’s neurotransmitters, and so create feelings of depression and other negative responses, such as severe fatigue.COVID-19 Survivors and Mental IllnessFurther and more up-to-date research, in the form of an analysis of existing COVID-19 data by the psychiatry department at the University of Oxford, UK, has shown that around 1 in 8 people (13%) who have had Covid-19 are now being diagnosed with their first psychiatric or neurological illness - this occurs within 6 months of testing positive for the virus.This is a major public health concern because, as of the end of January, 2021, the U.S. had already seen nearly 26.5 million confirmed cases of coronavirus. If that wasn’t enough to create a brand new demographic of “self-medicating” individuals susceptible to substance addiction, it gets worse.The research further concluded that those figures rose to an alarming 1 in 3 (33.6%) when patients with a previous history of psychiatric or neurological illnesses were included. Furthermore, it’s worth noting that the Oxford study used, obviously with permission, relevant data from 236,379 U.S. survivors of the COVID-19 virus.Both of these in-depth studies simply add to the robust body of evidence that stresses the coronavirus pandemic and its consequential effects will lead to many more individuals with mental health disorders, such as major depressive disorder (clinical depression), other neuropsychiatric disorders, and a range of behavioral issues, which will undoubtedly include substance use disorders, and will instigate a rise in illicit drug use.Depression, Drug Overdose and The Dark Spectre of SuicideAs we slowly begin to navigate our way through 2021, still with over 100,000 new cases of coronavirus being diagnosed in the U.S. on a daily basis, we can but hope that the vaccine rollout will soon begin to have a positive effect on the nation’s seemingly futile battle with the pandemic, and that one day, possibly in the summer but far more likely in the fall, the CDC and other major U.S. public health bodies will announce a kind of tentative victory.However, by the time it does finally happen, further extensive and severe damage will have already been done to the collective mental health of the nation. It begs another question:How exactly will this new public mental health emergency manifest itself?Sadly, it will be more of the same of what was witnessed in 2020, with similar record numbers of premature deaths either through drug overdose (predominantly, involving fentanyl and other high potency opioids and their analogs) or the dark spectre that pervades any crisis of the mind - suicide, the ultimate self-medication.Like overdose, in the midst of this pandemic, the issue of suicide has never been far from the legitimate concerns of mental health experts.Finally, as this article has demonstrated, one clear feature of the looming public mental health crisis facing the post-pandemic U.S. will be a significant rise in the use and abuse of illicit substances - from opioids to cocaine, and from counterfeit prescriptions to methamphetamine - all of which are now being cut with the far cheaper product of fentanyl, and its analogs, by America’s perpetual dealer - the Mexican drug cartels.And, just like the coronavirus pandemic, exactly as Dr. Fauci stated, it will “get worse, much worse before it gets better.”
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