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Persons experiencing addiction may be at very high risk of infectious disease like COVID-19 due to high rates of smoking, recent imprisonment, conditions like HIV/AIDS, and high-risk behaviors (Ezzati et al. 2002; Farhoudian, et al. 2020). During the COVID-19 pandemic, most courts have shuttered, and treatment center admissions have halted, yet the opioid crisis rages on. Addiction intersects with material hardship, trauma, broken institutions, and human frailty in a multidimensional web of disadvantage (Desmond and Western 2018)—a process illustrated by COVID-19.
Perhaps the most poignant image of the coronavirus pandemic captures desperate family members, with tears streaming down their faces, their noses pressed against hospital doors, barred from entry to visit their loved ones. But families are not just tragic icons at life’s end; they are often its choreographers. A large national survey that predated the pandemic found that 70 percent of Americans over age 60 who required medical decisions during the final days of their lives lacked the capacity to make them.