Public-health measures should not trigger another wave of unintended consequences.

On November 5, the New York Times reported that four major companies are closing in on a $26 billion settlement of lawsuits over their roles in America’s opioid epidemic, which has claimed over 450,000 lives since 1999. Pharmaceutical-drug distributors McKesson, Cardinal Health, and AmerisourceBergen have agreed to pay $21 billion over 18 years. Johnson & Johnson, a pharmaceutical manufacturer, will pay $5 billion, primarily in the first three years of the settlement.

Additionally, $2 billion will go to private lawyers who represent local governments in affected communities. “The deal gets money to all of the communities in the United States that are suffering from insult upon injury, first from the opioid epidemic and now with COVID as well,” Paul Hanley Jr., the settlement’s lead lawyer, said.

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This is a major step forward in repairing communities ravaged by the epidemic, many of which are overwhelmingly poor and rural, and had manufacturing-based economies hollowed out by job outsourcing long before COVID-19. But now that a new wave of coronavirus cases is being recorded — and Joe Biden is projected to be the next president — the possibility of another round of lockdowns may loom larger for these communities, despite lingering debate over the effectiveness of the initial lockdowns. CNBC reports that Dr. Ezekiel Emanuel, now named to Biden’s COVID task force, has not ruled out a national lockdown to mitigate the spread.

As Biden’s team weighs this option, however, it should consider the unintended consequences of the first lockdown on opioid use.

According to a brief October report from the American Medical Association, the AMA “is greatly concerned by an increasing number of reports from national, state, and local media suggesting increases in opioid—and other drug-related mortality—particularly from illicitly manufactured fentanyl.” And since the pandemic’s onset, “more than 40 states have reported increases in opioid-related mortality.”

Robert G. Kanter, an internationally renowned recovery and family-advocacy expert who helped pass the Family Support Services for Addiction Act, recently spoke with National Review on how a second lockdown could affect the opioid crisis.

“As an individual in recovery, I can tell you that those suffering from substance-use disorder will find every excuse imaginable to not seek treatment, especially being admitted to a hospital detox when they rationalize that they may contract COVID,” Kanter said.

The number of hospital beds being converted to COVID units would decrease the beds dedicated to detoxing and assisting recovering addicts, Kanter said. And rehab centers would need to quarantine individuals for long periods of time, limiting “square footage.”

“This makes admission to the facility more difficult to attain and forces those needing to be ‘off the streets’ left with no alternative,” he explained.

Another consequence that a public-health bureaucrat may neglect concerns recovery programs, and the logistical issues of social distancing and limiting gatherings. “Twelve-step abstinence-based recovery programs (i.e., Alcoholics Anonymous, Narcotics Anonymous) exist as in-person meetings where individuals can maintain long-term sobriety and be accountable to their peers,” Kanter said. “These meetings will be shut down (as before) and their chances of maintaining their sobriety over virtual meetings is reduced exponentially.”

Whether it is in Arkansas, Delaware, or Nevada, and whether it is from the social isolation of quarantines, high unemployment and other economic distress, or the difficulties of online learning, American citizens are in a tough position, and the lockdowns seemingly have intensified the opioid epidemic. One hopes that a Biden administration finds a middle ground in dealing with COVID-19. Public-health measures should not trigger another wave of unintended consequences, and reverse the progress made in combating other issues, such as the opioid epidemic.

Kanter concluded, “When you combine the removal of all these treatment options, along with the potent fentanyl now being cut into the street drugs, you have a recipe for disaster.”