Since starting his first recovery home in 2017, Jonathan Allen has lost very few residents to overdoses.
In 2020, he had two clients overdose and die after leaving one of Allen’s Primary Purpose recovery homes.
One man packed and left in the middle of the night after months of being sober.
Frustrated with the restrictions put in place due to the coronavirus coupled with a desire to reconnect with his family, he bolted. The man went home and thought he could use one more time.
“He died,” Allen said. “It was pretty much the same with the second resident.”
After years of decline in the number of overdose deaths, Fayette County hit a grim milestone in 2020: the number of overdose deaths surpassed 200 for the first time since overdose deaths were recorded. Preliminary records show those deaths at 209, a number that will likely increase as more toxicology and causes of death are determined.
That’s 81 more deaths than the 128 overdose deaths in 2019 and 22 more deaths than the one-time high of 187 overdoses in 2017.
Although statewide overdose deaths are not released until June, longtime Kentucky Office of Drug Control Policy Executive Director Van Ingram said it’s likely the state will also see a similar jump in overdose deaths. Overdose deaths are up across the country due to the pandemic, he said.
“It’s heartbreaking,” said Amy Baker, substance use disorder intervention program coordinator for the city of Lexington. “I know two moms who have lost their adult children.”
SHUTDOWNS, RESTRICTIONS ON TREATMENT PLUS JOB LOSSES BEHIND SPIKE
Restrictions put in place to stop the spread of the coronavirus meant many face-to-face support meetings and other therapies were stopped or curtailed, Baker said.
“With the social distancing recommendations put in place to reduce COVID infections, we saw a drastic reduction in mutual support meetings, a significant reduction in face-to-face individual treatment sessions, a reduction in the number of in-person group therapy sessions and a reduction in the number of individuals some residential programs could admit due to the need to provide more space,” Baker said.
People in recovery need connection, she said.
“While certainly not an intended consequence, the loss of support and connection and access to in-person services, particularly for individuals with no access to virtual meetings or telehealth, sometimes had devastating consequences.”
Many in the early stages of recovery work service sector jobs — waiting tables, working in restaurant kitchens or cleaning rooms for hotels. That employment sector was hit particularly hard by coronavirus-related job losses.
“The stress of the pandemic, coupled with job losses and a sense of hopelessness, it’s is a recipe for disaster,” Baker said.
Lexington Fire Department, the city’s ambulance service, saw a rapid rise in the number of doses of naloxone administered in April, May and June when most businesses were closed due to the coronavirus. Naloxone is an opioid overdose reversal drug, sometimes known by its commercial name Narcan.
In March, the department administered 68 doses of naloxone for overdoses. In April, the number jumped to 118. In May, it was 168. In June, the department administered 111 doses, according to data provided by the fire department.
“We are now seeing those numbers come back down,” said Capt. Seth Lockard, who oversees the fire department’s community paramedicine program. By October, it was down to 87 doses. That’s approximately the same number of doses administered in October 2019.
PROLIFERATION OF FENTANYL
Another factor likely driving the number of fatal overdoses is more lethal street drugs, said Ingram, who has headed the state’s office of drug control policy since 2004.
“In addition to the stress caused by the pandemic, we believe the increase is due to a rise in illicit fentanyl and its analogs within the drug supply. The problem is also exacerbated by the widespread availability of potent, inexpensive methamphetamine,” said Ingram.
Baker agreed.
“You can’t buy just pure heroin anymore,” Baker said. Almost all heroin is laced with fentanyl, a stronger and more lethal opioid than heroin.
Worse, fentanyl is now being found in methamphetamine and cocaine. Methamphetamine users who have no tolerance for opioids are far more likely to overdose on methamphetamine laced with fentanyl.
Maria Slone, an overdose outreach project coordinator for the Lexington Fire Department, said users often tell her that they didn’t know what was in the drug they took.
“People are not getting what they think they are getting,” Slone said. Even pills are now being laced with fentanyl and other stronger opioids.
Slone and a team from the department’s community paramedicine program visit each person the department revives after an overdose. The goal is to encourage people to go to treatment. Thanks to a grant from the University of Kentucky, the outreach team is also giving naloxone kits to those who overdosed and survived.Play VideoDuration 1:02Fentanyl: A Hidden DangerNIDA’s Dr. Wilson Compton, one of the authors of the report about fentanyl-related overdose deaths, explains more about the of the report’s findings.
‘A SHOT OF HOPE’
Baker is optimistic Fayette County will be able to reverse the rise of overdose deaths in 2021. The city is upping its harm reduction services, making naloxone more available, and increasing programs to keep people in treatment.
The city set aside $40,000 in October for a new program that would help people in recovery homes that have lost their jobs and can’t pay rent. Recovery homes do not bill insurance or receive federal or state funding. Residents pay rent and live in a home with other people in recovery.
When COVID-19 hit in March, many of the people in those homes either lost their service-based jobs or couldn’t get a job, said Allen, who runs five recovery homes and is poised to open a sixth.
About a dozen of his residents were able to receive $400 payments to help cover their rent. Allen doesn’t kick anyone out who can’t pay rent as long as they stay sober. But when that back rent adds up, it creates stress and contributes to feelings of helplessness, Allen said.
The city money helped those residents stay in recovery and stay sober, Allen said.
“It was like a shot of hope,” Allen said of the rental assistance. It likely saved some of his residents’ lives, he said.
Baker said the pilot program, which ran from October to December, is now out of money but has helped keep 100 people in recovery. Allen said he hopes the city finds additional money in its upcoming budget, so people who want to live in recovery homes but don’t have rent money can do so.
The Fayette County Health Department, which runs the needle exchange program, gave out 3,333 naloxone kits in its second year, which ended Sept. 30. From October to January, it gave out 1,279 kits. Its needle exchange and harm reduction program operated throughout the pandemic and “never missed a single day,” Baker said.
In addition, Lockard said the Fayette County Detention Center gives naloxone kits to people who want one when they are discharged from the jail. Those kits are also paid for through a University of Kentucky HEALing Communities grant.
People are most at-risk for a fatal overdose when they leave treatment or jail.
“Their body’s tolerance is greatly decreased because they have not been using,” Lockard said.
The fire department recently received grant money to add a second social worker — in addition to Slone — to its overdose outreach team. The extra person will help it expand services and keep track of those who overdosed and survived.
That team tries to make contact — within 24 to 48 hours — with each overdose victim who was revived. With hundreds of overdoses each month, the team needs more people, Lockard said.
Another reason for optimism? Most of the treatment programs and group meetings, such as Alcoholics Anonymous and Narcotics Anonymous, that had to halt or move online in the beginning months of the pandemic are now meeting in person again, Baker said. The same is true for many in-person therapy meetings.
‘DON’T BE DISCOURAGED’
Baker said Kentucky has dramatically increased its outpatient and inpatient treatment options for all substance abuse disorders, not just opioid addiction, over the past several years.
“Don’t be discouraged. Reach out. Get online. Call. Do whatever it is that works for you,” Baker said. “There are people who are willing to help you any time of day.”
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