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COVID-19 pandemic fuels record-high drug overdose deaths

The Centers for Disease Control reported preliminary data that 88,000 people died from drug overdoses between August 2019 and 2020.  A heroin user prepares to inject himself on March 23, 2016 in New London, CT.{ } (Photo by John Moore/Getty Images)
The Centers for Disease Control reported preliminary data that 88,000 people died from drug overdoses between August 2019 and 2020. A heroin user prepares to inject himself on March 23, 2016 in New London, CT. (Photo by John Moore/Getty Images)
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Early government data confirmed the worst fears that the COVID-19 pandemic fueled the drug addiction crisis and opioid deaths skyrocketed.

The Centers for Disease Control and Prevention reported preliminary data that 88,295 people died from a drug overdose in the months between August 2019 and 2020, marking a 27% increase over the previous year. Opioids and synthetic opioids, like fentanyl, drove the most fatalities.

Overdose deaths were already accelerating in the months before the pandemic. In 2019, the United States saw the highest recorded number of drug overdose deaths in its history. Social isolation, financial insecurity, unemployment and the loss of family and friends to COVID-19 made the situation that much worse.

Addiction specialists reported anecdotally about increased relapses as treatment programs were disrupted and people were cut off from their regular support networks. The CDC documented increasing reports of depression, anxiety and substance abuse, particularly among younger Americans.

The new drug overdose data from the pandemic showed people in the prime of their lives were dying at the highest rate. Most fatalities were recorded in men and women between 35-44 years old, followed by 25-34-year-olds.

"We must stop this heartbreaking and seemingly endless loss and soon," said Acting Director of the White House Office of National Drug Control Policy Regina LaBelle at the virtual Rx Drug Abuse and Heroin Summit this week. "If trends hold, soon we could be looking at six-figure overdose deaths in a single year for the first time."

The challenge of reversing that trend will fall to President Joe Biden, who inherited a bigger drug crisis than any previous president at the same time as a once-a-century pandemic. Biden, whose son struggled with substance abuse, said his administration would not neglect the country's addiction problem.

"In the shadow of a pandemic that has occupied our attention and claimed more than half a million lives, we can't lose sight of these other epidemics," Biden said in a keynote address to the Rx Drug Abuse and Heroin Summit. "We need to meet this crisis with urgent action."

The American Recovery Plan, passed in March, authorized $4 billion in the American Recovery Plan for the Substance Abuse and Mental Health Services Administration (SAMHSA) to combat addiction and the rising incidence of psychological problems during the pandemic.

The massive COVID relief package included $1.5 billion for substance abuse prevention and treatment and more than $400 million to support community behavioral health clinics.

Recognizing the vulnerabilities of people with addiction disorders during the pandemic, Congress previously approved $425 million in the CARES Act to expand access to substance abuse treatment.

That is only the beginning of what is needed to address the challenge, said LaBelle. "The American Rescue Plan is a good place to start and a good down payment from Congress. It is just the beginning."

Addiction treatment is a rare, bipartisan issue on Capitol Hill that is continuing to compel lawmakers' attention. Republican Rep. Tom Cole, R-Okla., agreed that the recent funding has made a difference. "But it's clear to me we have to do more moving forward, particularly with the impact of the pandemic," Cole told summit attendees.

West Virginia Democratic Sen. Joe Manchin noted the combined impact of the COVID-19 pandemic and the opioid epidemic has been devastating for his state, which was ground zero for the prescription opioid crisis.

“Treatment centers and clinics have struggled to stay afloat during the pandemic as patient volumes dropped and facility costs increased, further risking access to necessary treatment," Manchin told Politico. "They need funding and support now more than ever."

Much of the funding will be available as block grants to states to implement treatment, prevention and recovery strategies, including supporting community health clinics. It could also help offset the immense societal costs of the drug overdoses crisis, which CDC estimates are more than $1 trillion every year.

Drug deaths briefly leveled off in 2018, showing their first decline in 20 years. By 2019, the numbers were ticking up before accelerating dramatically in 2020. A projection by the Commonwealth Fund estimated the total overdose deaths during 2020 would likely exceed CDC projections and hit 90,000.

According to its report, 24 states and Washington, D.C. saw at least a 30% increase in overdose deaths during the first eight months of 2020 compared to the previous year. D.C. saw an estimated 72% increase in overdose deaths, while South Carolina and Louisiana saw a 60% increase. Across the board, opioids accounted for three-quarters of the overdose deaths.

Getting those numbers down again will be a challenge, but there was evidence that U.S. efforts to combat the drug problem were starting to move in the right direction before 2020.

Both the Obama and Trump administrations started devoting more resources to the opioid epidemic with policies like the Comprehensive Addiction and Recovery Act (CARA) and the SUPPORT for Patients and Communities Act.

Billions of dollars began flowing into drug abuse prevention, treatment and recovery programs and drug interdiction. First responders and emergency contacts were given access to life-saving opioid overdose reversal drugs like naloxone. States were adopting harm reduction strategies and expanding care options. Thousands of recovery facilities were opening across the country with more providers focused on evidence-based treatment, including medications like buprenorphine, methadone and naltrexone.

Importantly, advocates and influencers who struggled with substance use disorders were working to challenge the stigma around addiction.

"We have made a lot of strides," said Jessica Hulsey, the founder and CEO of the Addiction Policy Forum. "The challenge is going to be to take all of this innovation, the lessons we learned and take it to scale, so we reach all the people who are struggling, and many times they are struggling in silence."

Earlier this month, the White House released a seven-point list of its first-year drug policy priorities, which focuses on expanding many of the programs that have proven effective in substance use recovery.

One pillar of the administration's approach will be to expand access and eliminate barriers to people seeking medication-assisted treatment for opioid addiction. During the pandemic, SAMHSA granted waivers for providers to remotely prescribe buprenorphine to patients with opioid use disorders. The Biden administration is continuing that waiver and working to make those treatments more readily available.

The administration recognized the importance of harm reduction programs and will work to expand access to naloxone, fentanyl test strips and syringe services to contain rising cases of Hepatitis C and HIV associated with injection drug use. Where necessary, the administration said it would identify state laws that restrict access.

Additionally, the White House drug policy will confront racial equity issues around access to treatment and over-incarceration of Black and minority groups for nonviolent drug crimes. Similarly, it will focus on reducing barriers to employment that plague many people in long-term recovery.

President Biden pledged to provide the resources to combat the drug scourge. In remarks earlier this week, he shared his sense of grief with those who have lost loved ones to addiction but also hope.

"We also celebrate those who are recovering. We hold them in our hearts and commit ourselves to helping more families know the joy and relief of recovery," the president said. "To those still struggling, I want you to know that I see you and we’re going to beat this thing together."

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If you or someone you know is in need of help for a substance use disorder call SAMHSA’s National Helpline at 1-800-662-HELP or visit their website, here.

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