As the death toll contributed to COVID-19 nears 430,000 in the United States alone, there’s another number that’s just as alarming but not receiving the same attention, even though the two are connected: Overdose deaths.
In the 12 months ending in May 2020, more than 81,000 drug overdose deaths were reported by the Centers for Disease Control and Prevention, the highest number ever recorded in a one-year period. Data for all of 2020 is not available yet, but that number is sure to rise once the new data is released.
The numbers in Kentucky and Nelson County are just as startling.
Overdose deaths in Nelson County saw a sharp increase over the last three years according to Bardstown City Councilwoman Betty Hart, who is the head of Nelson County Addiction Response Effort (NelCARE), and Nelson County coroner Field Houghlin.
“The number of overdoses we have, it’s quite staggering when you look at it,” Hart told the Bardstown Rotary Club at a recent meeting.
According to Houghlin, Nelson County had six drug overdose deaths in 2018, seven in 2019 and 16 in 2020. Houghlin said it was beyond his expertise to make a connection between covid and overdose deaths. Still, the numbers do show a significant increase since the pandemic started.
“These numbers just include overdoses that happened in Nelson County,” Houghlin said. “If you were a Nelson County resident but you OD’d in say Jefferson County, I wouldn’t have that. That would be in Jefferson County’s numbers.”
“As a community we need to do whatever we can to improve this,” Hart said.
“In Kentucky the overdose trends have increased 50-100% over 2019 figures,” said Danesh Mazloomdoost, MD, medical director at Wellward Regenerative Medicine in Lexington. “The increasing trends are for all substances of abuse, but opioids continue to be the leading agent, with fentanyl showing up more regularly.”
Mazloomdoost sees a direct correlation between the pandemic and the increase in overdose deaths.
Mazloomdoost said two things intensify addiction — increases in stress or further declines in an ability to cope.
“The pandemic has been a major disrupter for everyone and everyone has felt the stress in different forms — frustration, boredom, fatigue and anxiety,” Mazloomdoost said. “This increase in stress affects us all, but especially those among us who have a struggle like addiction.”
The disruption to in-person treatment and recovery services may also be a factor, according to experts. People also are more likely to be taking drugs alone, which means no friend or family member to call 911 or administer overdose-reversing medication. And because of the pandemic, group meetings and face-to-face therapy are no longer the norm, which can add fuel to the fire.
Mental health care systems stressed
“The pandemic further adds to the struggle because, like all healthcare systems, mental health resources are stressed because of radical operational changes,” Mazloomdoost said.
“The disruption to daily life due to the COVID-19 pandemic has hit those with substance use disorder hard,” said former CDC Director Dr. Robert Redfield. “As we continue the fight to end this pandemic, it’s important to not lose sight of different groups being affected in other ways. We need to take care of people suffering from unintended consequences.”
Mazloomdoost said that while everybody seeks to distance their consciousness from life’s realities (in healthy ways like connection, community and exercise, which creates and releases the brain’s “happy” chemicals to sustain us during hardships), addicts lose the ability to engage those parts of the brain through choices and instead become reliant on chemicals.
“Initially people might take a drug to tap into that escape, but very quickly the brain adapts,” he said.
Addiction not limited to certain areas
According to Mazloomdoost, the rise in overdose deaths during the pandemic knows no geographical boundaries. Residents in urban and rural settings both face their own deficits in the struggle with addiction.
“While historically substance abuse tended to be more metro and alcohol abuse more rural, the norms are fluxing rapidly,” he said. “Prescription opioids leveled access barriers and in some ways fed a rural problem to outpace urban. At this point both communities face similar challenges with variants of their own.”
Pandemic has seen rise in deadly drug cocktails
According to a USA Today story, the COVID-19 pandemic has caused supply problems for drug dealers, so they are increasingly mixing cheap and deadly fentanyl into heroin, cocaine and methamphetamine. A researcher at Syracuse University who studies drug overdose trends said they don’t suspect there is a bunch of new people who suddenly started using drugs because of covid. If anything, they think the supply of drugs people are already using is more contaminated.
Synthetic opioids (primarily illicitly manufactured fentanyl) appear to be the primary driver of the increases in overdose deaths, increasing 38.4% from the 12-month period leading up to June 2019 compared with the 12-month period leading up to May 2020.
Treatment access falls short
Mazloomdoost said that mental health access and resources continue to fall short of the enormous demand for treatment, and the Kentucky Medical Association continues to advocate for mental health parity and improved access to substance abuse treatments like Medication Assisted Therapy (MAT).
“Logistical and financial barriers should not be a limiting factor to catching up with this problem,” he said, noting that new opportunities have been explored as a result of the CARES Act and that these assist access by liberalizing the use of digital and remote health platforms and having financial parity with in-person visits.
Read the full article here.