The pandemic continues to affect virtually every aspect of American life, and that, sadly, also includes those suffering with an addiction – including opioids.
It’s holiday season, 2020. Undoubtedly, a different kind of festive season than normal for many Americans, but… it’s still the holidays, nonetheless.
However, for many families, there’ll be empty places at the dinner table this year – loved ones missing not because of the dreaded and awful coronavirus pandemic that continues to tragically affect the U.S., but from fatal opioid drug overdoses, part of a national epidemic that was here long before COVID-19 ever became part of our vocabulary.
Take a few moments out of this day to look back at the statistical data for the U.S. opioid epidemic, and you’ll see the highest peak in opioid-related fatal overdoses was during the first half of 2017 – in virtually every state across the nation. Only 3 short years ago, U.S. citizens were dying at a rate of around 130 every single day.
It’s difficult to fully comprehend, but it happened – surely, we’d never see such death rates again (we’ll get to the dreaded “corona” shortly, which is now, more tragically, taking many more lives per day).
Back to the opioid epidemic.
A range of pain-killing medications, arguably misbranded by Big Pharma, were being prescribed freely across the U.S. in a practice that went on for over 20 years, leaving thousands upon thousands unknowingly dependent on powerful narcotics, and with a chronic medical condition – opioid use disorder (OUD).
Like the layered tragedy of a Shakespeare play, just when you thought things were actually looking up (as the national rate of opioid-related deaths began to noticeably fall), along came a global accident-waiting-to-happen – the COVID-19 pandemic.
Take a further few moments to access everyone’s favorite search engine, type in “US Covid Latest 2020,” and you’ll see the latest statistics about how badly the nation has been hit by the pandemic. Over 335,000 deaths, and still rising.
However, the pandemic continues to affect virtually every aspect of American life, and that, sadly, also includes those suffering with an addiction – including opioids.
In Beaver County, Pennsylvania, District Attorney David Lozier recently spoke about how his region is being affected by the virus in terms of the detrimental impact on people’s mental wellbeing, including rates of opioid use and addiction:
“COVID has sucked the wind out of every other issue. Now this year, the [drug overdose] numbers are going up like 2016 and the first half of 2017. We’re seeing an increase in domestic violence, Childline and child abuse calls, a worsening mental health picture, and worsening drug and alcohol pictures. The people who need support services or who are in treatment… It’s all been by phone. They haven’t had the in-person contact they need.”
So it begs the question – what exactly is the current status of addiction recovery in Pennsylvania?
To answer this, we first need to look at how Pennsylvania stood last year (2019 seems a remarkably long time ago now, doesn’t it?) with respect to substance addiction rates and addiction treatment levels, and how the state stands now, after around half a year of severe socio-economic disruption, including mandatory lockdowns and long periods of social isolation for its residents.
How COVID-19 Has Radically Altered Addiction Recovery
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2019, Pennsylvania rehab centers saw more than 19,000 admissions. There’s little doubt, the fight against the opioid epidemic was still being fought (a situation destined to last many years). However, many thousands of Pennsylvania residents were still becoming addicted to the prescriptions written out by their family doctor.
According to a research study by the Perelman School of Medicine at the University of Pennsylvania, in Philadelphia, it was found that excessive, high-dose opioid prescriptions were still being routinely prescribed following common, minor day-patient surgeries – at a strength strictly advised against by the Centers for Disease Control & Prevention (CDC), for the purpose of reducing the number of opioid-related fatal overdoses.
So how was the level of access to opioid addiction treatment at this time?
In short – increasing. For example, under the Blue Guardian program in Lehigh County, PA, police and other first responders would notify the program when they had responded to an opioid overdose. Later, an officer and a certified recovery specialist would visit the person to follow up and discuss their treatment options.
This hands-on approach was highly successful, as confirmed by Layne Turner, Lehigh County’s drug and alcohol administrator. She stated that, “Of the 52 individual face-to-face meetings, 34 individuals entered treatment. The lesson learned is when the face-to-face contacts are made, 65% of the time individuals enter treatment.”
Clearly, the state of Pennsylvania was moving in the right direction when it came to accessing and providing opioid addiction treatment for opioid abusers and addicts. In fact, a rate of 65% is far, far higher than the national average for the numbers of drug addicts who make it into such treatment. In 2019, that national rate stood at a lowly 10-13%.
When you consider that recent estimates say one-fifth of U.S. citizens who have clinical depression or an anxiety disorder will also have a substance use disorder (SUD), like OUD, you quickly understand that the very last thing the nation needed in fighting addiction was the soon-to-arrive COVID-19 pandemic, with its resulting lockdowns and isolation.
“The concerns we have are related to the big challenges people are facing right now with COVID: isolation and uncertainty resulting in very high levels of stress.”
Nora Volkow, Director of the National Institute for Drug Abuse
The (first) year of the COVID-19 pandemic arrived, leading to the “isolation and uncertainty” and “very high levels of stress” quoted above. Fatal drug overdoses – not just from opioids, but now including cocaine and methamphetamine – are spiking alarmingly across the nation.
Just like any other U.S. industry, the addiction treatment field has been hit hard, with many rehab centers, including those in Pennsylvania, facing financial collapse if things don’t improve soon. Many treatment centers report clients not making their scheduled treatment appointments – either the simple fear of coronavirus infection, or, worryingly, because more and more of those in recovery are experiencing overdoses and relapses.
In an effort to meet the changing conditions, addiction treatment centers have also had to invest in new “telemedicine” technology to be able to provide services, where clients receive counseling and other treatment via their computer screens.
Nonprofits have struggled to treat their clients. In a recent survey, 44% of members from the National Council for Behavioral Health say they will easily run out of money in the next 6 months.
Interestingly, if you look at the 2019-related paragraphs above, you’ll see words like “admissions,” “individual face-to-face meetings,” “right direction, “access” and “contact.” All of these are being heard less and less, if at all, for many recovering addicts in 2020.
The sad proof of this lies in the national rise in fatal drug overdoses, as described by the American Medical Association in its updated Issue Brief (October, 2020), which reports that more than 40 states have “reported increases [around 18% – nearly a fifth] in opioid-related mortality, as well as ongoing concerns for those with a mental illness or substance use disorder.”
And, lo and behold, guess what? Yes, sadly, Pennsylvania is again one of those 40.
Addiction Recovery = Hope
However gloomy-sounding this article may appear at first glance, there is a distinctly positive and hopeful side.
The sphere of addiction treatment, providing long-term, sustainable recovery for OUD sufferers and those with other SUDs, is recovering itself, and this is happening in a number of essential ways:
- More and more of Pennsylvania’s facilities and clinics are becoming accustomed to the necessary COVID-19 protocols and regulations required in running their treatment options, from residential care, to Partial-Hospitalization Programs (PHPs), Outpatient Programs, and their own counseling sessions and group support meetings.
- Telemedicine technology, with the addiction experts looking on, is growing, expanding and even researching its own effectiveness as a method of healthcare provision for those with SUDs and mental health issues.
- As for the telemedicine “patient,” they are becoming more accustomed to accessing their treatment, care and support online, just like the vast numbers of those in AA and NA when virtually “attending” their own 12-Step meetings.
- If you’re looking for Pennsylvania’s online 12-Step meetings, the links for these are provided here:
- Finally, the use of Medically Assisted Treatment (MAT), such as the provision of methadone and other MAT drugs for opioid replacement, has had its own regulations relaxed, thus increasing its range of access to those who need it.
Dr. Mark Fuller, the Medical Director of Addiction Medicine at the Center of Inclusion Health, part of the Allegheny Health Network in Pittsburg, PA, recently stated, “Some folks say that the opposite of addiction is connection – connecting with a therapist, or other friends in recovery, or your 12-step meeting. Those connections are a really powerful part of recovery and really a key step in helping people stay clean and sober.”
How many of Pennsylvania’s reported 800 licensed drug abuse and addiction treatment centers, both nonprofit and for-profit, will survive 2021 remains to be seen. Without the vital professional connections these treatment centers provide, and without the social “recovery community” connections referred to by Dr. Mark Fuller in the quote above, there will clearly be fewer inspiring stories of real addiction recovery happening across the state during this year of coronavirus.
However, for now, with the excellent strategies listed above, the vast field of addiction treatment – just like the rest of us – is starting to get to grips with the strong and undeniable challenges that lie ahead.