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Drug overdoses climb during COVID-19 pandemic

Officials nationwide report spikes less than a year after the Trump administration touted progress in battling the crisis

Drug overdoses have risen in some areas during the COVID-19 pandemic, less than a year after the Trump administration touted decreases in the nation’s overdose epidemic.

From Memphis to Milwaukee, a range of cities and counties across the country are reporting spikes in fatal and nonfatal overdoses.

Last year, Trump administration officials highlighted progress toward curbing the U.S. overdose crisis of the last decade. In January, Centers for Disease Control and Prevention data confirmed that the drug overdose death rate fell by 4.6 percent in 2018, after a record-high number of deaths in 2017. 

[HHS cheers overdose drop but urges states to cap Medicaid]

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A May 13 report tracking nationwide overdose data, with a focus on six unnamed states with the most reliable information, found that two of the six states had a statistically significant rise in overdoses since the pandemic began. The report, by a part of the federal Office of National Drug Control Policy, uses Overdose Data Mapping Application Program surveillance information. 

Aliese Alter, the ODMAP program manager who works with the Washington/Baltimore office that produced the report, said historical data modeling did not predict the national increase in overdose data submitted since the onset of COVID-19.

Nationally, suspected overdose submissions to ODMAP rose nearly 16.6 percent this year, based on a 30-day rolling mean comparison of January through April 2019 to the same time frame in 2020.

The raw numbers show an increase of almost 11.4 percent for fatal overdoses, and an increase of 18.6 percent for nonfatal overdoses during that time frame. 

Alter cautioned that it is too early to draw any sweeping conclusions. She said the group is working to release more regional data this week.

Experts worry about the impact the pandemic will have on the death rate due to drug and alcohol use.

“Never did I imagine the nation would be experiencing the coinciding of mental health issues and infectious disease that my training addressed,” Elinore McCance-Katz, the Department of Health and Human Services assistant secretary for mental health and substance use, said at a White House cabinet meeting last week.

Before the pandemic, about 120,000 individuals died from drug overdose and suicide per year, said McCance-Katz, who is a psychiatrist with a doctorate in infectious disease epidemiology.

“How many more lives are we willing to sacrifice in the name of containing the virus?” she said. “We’ve worked so hard in states and communities across this country to combat epidemics like the opioids crisis. Why are we willing to forget those efforts now or deem them less important?”

HHS Secretary Alex Azar, in the same meeting, said by one estimate, the recession from the pandemic will lead to at least an extra 65,000 deaths from drug overdose, alcohol abuse and suicide over 10 years. He was referring to median data from a report by the Well Being Trust and the Robert Graham Center for Policy Studies in Family Medicine and Primary Care released this month. 

Concerns around the country

In an interview with CQ Roll Call, Sen. Tim Kaine, D-Va., said he has already seen the effects in his state. He would like to see more mental health provisions and funding in subsequent COVID-19 legislation.

“Hospitals in Virginia are reporting increases in overdoses. And people might be using drugs to self-medicate or ease their tensions that way, or people who have a history of substance use disorder who now don’t have the group therapy sessions and then they have extra anxiety on top of that. We’re seeing an uptick in things like that,” said Kaine.

He hopes that the numbers will decrease as restrictions are lifted.

“As we start to reopen, people will be able to re-engage with their social safety net, whether that’s friends and family or whether that’s group therapy sessions or clinic visits. That should help. I think this is going to take a while,” he said.

Virginia Gov. Ralph Northam, a Democrat, separately raised concerns.

“In Roanoke County, dispatchers have responded to twice as many fatal overdoses in the first five months of this year than they did in all of 2019,” Northam said in a news conference last week. “The Northern Shenandoah Region has also seen a substantial increase in overdoses, both fatal and nonfatal, compared to the same time last year.”

National CDC data is not expected to be available for several months, but some local data was already reported.

Milwaukee reported an increase in drug-related deaths, according to Sara Schreiber, forensic technical director at the Milwaukee County Medical Examiner’s Office.

Milwaukee has been crunching data between 2019 and 2020 to measure the increases in deaths, though not all of the data from so far this year is available yet.

In 2019, the county had 158 confirmed cases throughout the entire year, and as of last week, the county had almost hit that number already.

“This year, already we have confirmed 155 to today’s date, and we have plenty more that are pending where the toxics isn’t complete,” Schreiber said last week. “We’re already essentially at the number of confirmed cases we had last year, and I know we have more to come.”

Schreiber said overdose deaths have been rising in general recently but the first half of this year was especially high. She heard similar reports from other Wisconsin counties.

“All those extra stressors are there; it’s really the perfect storm for something awful to happen,” she said.

In Tennessee, Shelby County, where Memphis is located, has seen an increase in both fatal and nonfatal overdoses.

“While the COVID-19 crisis is very troubling and challenging for our county, we are also still in the middle of an opioid epidemic,” said Shelby County Mayor Lee Harris, noting that opioid overdoses grew dramatically in recent years in both rural areas and cities like Memphis. “Unfortunately, it’s getting worse.”

[For Some in Congress, the Opioid Crisis Is Personal]

Last week, the Shelby County Health Department issued an overdose spike alert for the 33-day period from April 13 to May 15, during which there were 437 suspected overdose events. Of those, 68 were fatal.

Prior to that, the county reported 58 fatal overdoses from April 7 to May 7, the most in a 30-day period since the health department began tracking this data on Jan. 1, 2019.

“This spike in fentanyl overdoses is unprecedented,” said Western Tennessee U.S. Attorney Michael Dunavant.

Local authorities plan a multidisciplinary response through a coalition of county and federal offices.

Franklin County, Ohio, which includes the state capital of Columbus, also reported 50 percent more deaths in the first four months of the year compared with the same period in 2019.

Erie County, New York, which includes Buffalo, recorded 85 fatal drug overdoses in the first four months of the year, a sharp increase from 48 over the same time frame in 2019.

Experts caution it is early to know how this will play out and what the long-term effects could be.

The Well Being Trust analysis that Azar mentioned last week outlines nine possible scenarios leading to additional deaths from drugs, alcohol, and suicide. Depending on which outcome occurs, extra deaths could range from 27,644 to 154,037 over the next decade, with 75,000 additional deaths the most likely from 2020 to 2029, the study found.

“Deaths of despair have been on the rise for the last decade, and in the context of COVID-19, deaths of despair should be seen as the epidemic within the pandemic,” the report reads.

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