Opioid abuse and overdoses surge anew, worsened by Covid-19 pandemic

drugcrisisjulyodwoes-300x219With the novel coronavirus crushing the economy and helping to fuel joblessness, individuals’ isolation, and increasing hopelessness and despair among the already troubled, the opioid drug abuse and overdose crisis again is worsening — and fast.

As the Washington Post reported of what had been one of the nation’s leading public health nightmares before the Covid-19 pandemic:

“In Roanoke County, Va., police have responded to twice as many fatal overdoses in recent months as in all of last year. In Kentucky, which just celebrated its first decline in overdose deaths after five years of crisis, many towns are experiencing an abrupt reversal in the numbers. Nationwide, federal and local officials are reporting alarming spikes in drug overdoses — a hidden epidemic within the coronavirus pandemic.

“Emerging evidence suggests that the continued isolationeconomic devastation and disruptions to the drug trade in recent months are fueling the surge … Suspected overdoses nationally — not all of them fatal — jumped 18% in March compared with last year, 29% in April and 42% in May, according to the Overdose Detection Mapping Application Program, a federal initiative that collects data from ambulance teams, hospitals and police. In some jurisdictions, such as Milwaukee County, dispatch calls for overdoses have increased more than 50%.”

The extent of the situation’s decline may be understated and slow to become public, as official data lags and trickles in, the newspaper reported, adding that the resurgent opioid crisis caught authorities somewhat off guard. They initially theorized that the pandemic’s public health shutdowns would disrupt criminal networks and behaviors, reducing street drug supplies and dealing. But as the Washington Post reported:

“As traditional supply lines are disrupted, people who use drugs appear to be seeking out new suppliers and substances they are less familiar with, increasing the risk of overdose and death. Synthetic drugs and less common substances are increasingly showing up in autopsies and toxicology reports, medical examiners say. Social distancing has also sequestered people, leaving them to take drugs alone and making it less likely that someone else will be there to call 911 or to administer the lifesaving overdose antidote naloxone, also known as Narcan. Making matters worse, many treatment centers, drug courts and recovery programs have been forced to close or significantly scale back during shutdowns. With plunging revenue for services and little financial relief from the government, some now teeter on the brink of financial collapse.”

The coronavirus’ emotional and mental toll also has added to the opioid crisis’ harms, experts reported:

“Addiction is a disease of isolation. ‘It’s when you feel alone, stigmatized and hopeless that you are most vulnerable and at risk,’ said Robert Ashford, who runs a recovery center in Philadelphia and has been in recovery for seven years. ‘So much of addiction has nothing to do with the substance itself. It has to do with pain or distress or needs that aren’t being met.’ As the pandemic has pushed massive doses of fear, uncertainty, anxiety and depression into people’s lives, it has cut off the human connections that help ease those burdens.”

It also has not helped that the economy is in a tailspin and unemployment not only is setting records but catching tens of millions of workers with a suddenness and speed not seen in prior economic calamities, experts say.

Years of battling the opioid crisis had, perhaps, begun to show results, with authorities reporting earlier this year, based on 2018 data, an overdose decline. As the coronavirus became the No. 1 public health menace, killing almost 130,000 Americans and infecting more than 2.7 million people, the federal focus on the opioid crisis has faltered. As the Washington Post noted:

“When the Democratic-controlled House passed a $3 trillion coronavirus relief bill in May, the legislation, dubbed the Heroes Act, designated $3 billion for mental health and substance use disorders programs — seven times more than the amount Congress approved in March. But the White House and Republicans have declared the bill dead on arrival, leaving it unclear whether any additional funding will go toward programs for mental health and substance use disorders.”

This is terrible news. In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them and their loved ones by dangerous and harmful drugs. The opioid crisis — fueled by greed and deception by Big Pharma, doctors, nurses, hospitals, insurers, and others in health care — has been responsible for at least 400,000 Americans’ deaths since 2000, according to the Brookings Institution.

Researchers the think tank recently assembled to tackle the crisis added this:

“[It has contributed] to an historic decline in U.S. life expectancy. Overdose death data only capture part of the epidemic’s damage. Millions of people are having their lives and the lives of their families severely damaged by substance dependence. Opioid use disorder puts them at higher risk for various infectious diseases, depression, and suicide. Without adequate treatment, and in some cases even despite receiving treatment, it undermines their capacity to engage in productive economic activity and maintain good family relations, while substance dependence-related behaviors can subject them to criminal prosecution and imprisonment.

“In 2018, self-reports to a household survey generated an estimate of 2.35 million Americans suffering from [opioid abuse] and for many reasons that is likely a substantial underestimate. The opioid epidemic also generates vast national economic and social costs. The U.S. Council of Economic Advisors put the cost at roughly $700 billion, 3.4% of GDP, in 2018.”

The Brookings researchers, as have their counterparts at organizations like the independent, nonpartisan RAND Corp., have put forth detailed, well-reasoned, and potentially effective ways for officials to attack the lethal and debilitating opioid crisis. Their proposals require a sustained, complex, and well-supported fight by federal authorities, notably lawmakers and regulators.

They have not been fully up to the task, as both the pandemic and the opioid crisis resurgence indicate. They need to do far more, and voters and taxpayers must push them to do so, because the alternative is nothing less than grim. We have much work to do.

Credit: Graphic, above, from the Washington Post, based on data from the federal Overdose Detection Mapping Application Program
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