The COVID-19 pandemic has had a large impact on addiction treatment centers, making it more difficult for people with substance use disorders to find treatment, according to the Los Angeles Times.

Some people have stayed away from drug or alcohol treatment because they are fearful of contracting COVID-19, the article notes. According to Marvin Ventrell, CEO of the National Association of Addiction Treatment Providers, many of the group’s members had a drop of as much as 40% to 50% in patient numbers in March and April.

Treatment centers generally have double-occupancy bedrooms, shared spaces and group therapy. People being treated for addiction are more likely than the general population to have other health conditions that put them at higher risk of having a severe case of COVID-19, such as diabetes or heart disease.

“It’s hard to underestimate the effects of the pandemic on the community with opioid use disorder,” said Dr. Caleb Alexander, a professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health.