How COVID-19 Caused Drug Shortages and Changed the Way People Access Medications

When the pandemic hit in early 2020, most people worried about masks, ventilators, and hospital beds. But behind the scenes, something just as dangerous was unfolding: drug shortages. Insulin, antibiotics, blood pressure pills, even basic painkillers - they started disappearing from pharmacy shelves. At the same time, people who used drugs illegally faced a different kind of crisis: their supply became more deadly. The pandemic didn’t just spread a virus - it broke the system that keeps medicines flowing.

Why Did Medications Vanish So Fast?

The problem wasn’t that factories shut down overnight. It was that the global supply chain for drugs was built on thin threads. Most of the active ingredients in pills - the actual medicine - came from just two countries: China and India. When lockdowns hit those regions, production slowed. Shipping containers sat idle at ports. Workers got sick. Suddenly, the raw materials for common medications couldn’t reach U.S. and Australian pharmacies.

A major study in JAMA Network Open found that between February and April 2020, nearly one in three drug supply reports turned into actual shortages. That’s 34% of drugs with reported issues becoming hard to find. Some of the hardest-hit drugs were the ones used in hospitals - sedatives for ICU patients, antibiotics for infections, and even the drugs used to intubate people on ventilators. Hospitals scrambled. Doctors had to switch to less effective alternatives or stretch doses further than they ever should have.

By May 2020, things started to calm down. Why? Because the FDA stepped in. They started pushing manufacturers harder, fast-tracking inspections, and demanding better communication. The crisis didn’t disappear, but the worst of it passed. Still, the damage was done. People with chronic conditions like diabetes or heart disease went weeks without their usual meds. Some rationed pills. Others turned to online pharmacies with no quality control. A single missed dose of blood pressure medication can lead to a stroke. That’s not a hypothetical risk - it happened to thousands.

The Illicit Drug Market Got More Dangerous

While hospitals fought over antibiotics, another crisis was brewing on the streets. The illegal drug market didn’t collapse - it changed. With borders closed and traditional smuggling routes disrupted, traffickers started cutting drugs with stronger, cheaper, and deadlier substances. Fentanyl, a synthetic opioid 50 times stronger than heroin, became the go-to additive. It’s cheap to make, easy to transport, and terrifyingly potent.

People who used drugs didn’t know what they were getting anymore. A Reddit user from June 2020 wrote: “The street supply got weird after lockdowns started - people were getting knocked out by doses that used to be normal. Turned out to be fentanyl-laced.” That wasn’t an isolated story. In states like West Virginia, Kentucky, and Tennessee, overdose deaths jumped more than 50% in a single year. The CDC reported nearly 100,000 overdose deaths between May 2020 and April 2021 - up from 77,000 the year before. That’s a 31% increase in just 12 months.

Why did this happen? It wasn’t just about supply. Lockdowns destroyed the social safety nets that kept people alive. Needle exchanges closed. Support groups moved online - if people had internet. Many people with addiction lost their jobs, their housing, their connections. Without those human touchpoints - the group meetings, the peer counselors, the harm reduction workers - relapse became more likely. And when you relapse after a break, your tolerance drops. You take the same dose you used to, and you overdose.

Telehealth Helped Some - But Left Others Behind

One of the few bright spots was the sudden rise of telehealth for addiction treatment. Before the pandemic, getting a prescription for buprenorphine - a life-saving medication for opioid use disorder - usually meant in-person visits every week. During the pandemic, the government allowed doctors to prescribe it over video calls. In just two months, telehealth prescriptions for buprenorphine jumped from 13% to 95% of all prescriptions.

For people in rural areas or without transportation, this was a game-changer. One woman in rural Queensland told her doctor she hadn’t been able to get to her clinic in six months. After switching to telehealth, she started taking her medication regularly again. But not everyone benefited. Older adults struggled with Zoom. People without smartphones or stable Wi-Fi were left out. One harm reduction worker in Brisbane said, “We had a guy who came to the clinic every day for his methadone. He didn’t own a phone. We couldn’t reach him. We didn’t know if he was alive until he showed up three weeks later.”

Even when telehealth worked, other services vanished. Needle exchange programs cut hours. Supervised consumption sites shut down. In Philadelphia, one program reported a 40% drop in services during the first lockdown. That meant more shared needles, more infections, more deaths.

What’s Still Broken Today?

The good news? Drug shortages for essential medicines have mostly returned to pre-pandemic levels. The bad news? The system is still fragile. The same supply chain that failed in 2020 hasn’t been fixed. The U.S. still imports 80% of its active pharmaceutical ingredients from overseas. Companies still cut corners to save a few cents per pill. And the economic pressure to keep drug prices low means manufacturers won’t stockpile extra supply - even though we now know how dangerous that is.

Meanwhile, the overdose crisis hasn’t slowed. In 2022, over 107,000 people died of drug overdoses in the U.S. alone. Fentanyl is now found in almost every major drug - cocaine, meth, even fake prescription pills sold as oxycodone. People don’t even know they’re taking it until it’s too late.

And the mental health toll? It’s still climbing. People who lost jobs, loved ones, or stability during the pandemic are still struggling. Many didn’t get treatment. Now, years later, they’re using drugs to cope. The system isn’t ready for this wave.

What Needs to Change

There are solutions - but they require political will, not just medical fixes.

First, we need domestic manufacturing. Not just for vaccines - for the basic medicines we rely on every day. The 2023 National Defense Authorization Act took a small step by requiring more transparency in drug supply chains. That’s a start. But we need incentives to build real production capacity here, not just in India and China.

Second, harm reduction services need funding - not cuts. Needle exchanges, naloxone distribution, and supervised sites save lives. Boston distributed 30% more naloxone kits in 2020 than in 2019. That’s how you fight overdoses: by giving people the tools to survive until they’re ready for treatment.

Third, telehealth must be made permanent and accessible. Not just for prescriptions - for counseling, peer support, and crisis intervention. But we also need to fix the digital divide. If you don’t have a phone or internet, you shouldn’t be denied care.

Lastly, we have to stop treating addiction as a crime. People who use drugs are more likely to die from stigma than from the drugs themselves. Fear of arrest kept many from seeking help during the pandemic. That has to change.

What You Can Do

If you or someone you know relies on regular medication, keep a 30-day supply on hand. Don’t wait for a shortage to start worrying. Talk to your pharmacist about alternatives if your usual drug isn’t available.

If you’re concerned about someone using drugs, learn where to get naloxone. It’s free in many places. It can reverse an overdose in minutes. Know the signs: slow breathing, blue lips, unresponsiveness. Act fast.

And if you’re a policymaker, a pharmacist, or a healthcare worker - push for change. The system didn’t fail because of bad luck. It failed because we chose to ignore the cracks for years. The pandemic didn’t create this crisis. It just exposed it.