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Update on Overdose Increases During COVID-19

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Current data shows that more than 1.9 million people worldwide have died from COVID-19, including almost 370,000 Americans. While these are shocking numbers, they do not include the many people who have died from COVID-related mental health challenges. Experts believe the virus continues to contribute to drug and alcohol overdose deaths, suicide, and the exacerbation of other mental health disorders.

COVID-19 is not only causing widespread illness and death, but it is also increasing economic distress, social isolation, and anxiety, all risk factors for those actively using drugs or alcohol, and for those in recovery.

In an interview with Fox News last year, Dr. Nora Volkow, Director of the National Institute on Drug Abuse, estimated that drug overdoses had increased 30 to 40 percent since the initial outbreak of the virus.

The interview quotes Volkow as stating, “There are reports that more people are dying from overdoses [and] that people who were in recovery are now relapsing.” She places much of the blame on the forced isolation brought about by the virus, saying it is especially dangerous to those struggling with addiction and recovery.

The American Medical Association (AMA) recently released a brief stating they are “greatly concerned” over the increase in drug overdose fatalities during the COVID-19 health crisis. The brief, issued in December 2020, reports that more than 40 states have seen increases in opioid-related mortality and concerns over the increase in mental health and substance use disorders.

A recent article by Alexandra Kelley, a writer for The Hill, discusses new CDC data showing a “steady uptick in overdose deaths, coinciding with the COVID-19 pandemic.” The article quotes CDC Director Robert Redfield as saying, “The disruption to daily life due to the COVID-19 pandemic has hit those with substance use disorder hard.”

How is COVID-19 Driving the Increase in Overdose Deaths?

Over 81,000 people died from drug overdoses between May 2019 and May 2020, according to the Centers for Disease Control and Prevention (CDC). This is the greatest number of overdose deaths ever recorded in a 12-month period. When the complete data from 2020 is analyzed in the next few months, experts expect overdose deaths for the calendar year 2020 to set a new record.

A Kaiser Foundation poll conducted in July 2020 found 53 percent of those surveyed reported increased worry, stress, and other mental health problems related to COVID-19. Economic distress, social isolation, and anxiety are all risk factors for those actively using drugs or alcohol and for those in recovery.

COVID-19 Related Factors Affecting Mental Health and Overdoses

The COVID-19 pandemic has increased many of the common risk factors for addiction, including isolation, loneliness, and boredom. Some of the factors that have led to an increase in overdoses during this time include:

  • Isolation due to lockdowns and social distancing requirements
  • Distress over financial problems
  • Boredom and loneliness
  • Increased stress and anxiety related to fear of contracting virus
  • Anxiety due to disruption of a normal routine
  • Lack of in-person support groups and counseling services
  • Disruption of personal support systems

People are driven to use addictive substances for a variety of reasons, often in an attempt to self-medicate. Reasons may include:

  • Seeking to ease physical pain, which may start with misuse of prescribed pain medication
  • Seeking to ease emotional pain and mental health issues, such as loneliness, anxiety disorders, depression, trauma, and PTSD
  • Seeking to feel better during challenging situations, since drug use increases dopamine levels in the brain, delivering pleasure and a sense of well-being

Other factors that may increase drug or alcohol use include the pressure to fit in with social groups, an individual’s genetics, and family history.

COVID-19 has cut many people off from loved ones, enforced self-isolation, contributed to boredom, and increased anxiety, stress, and depression. Disrupted routines, the loss of in-person support meetings and counseling, and a collapse of other support structures all increase the risk of relapse and overdose.

Limited Access to Overdose Prevention During COVID-19

A December 2020 article by journalist Zachary Siegel in New York Magazine’s Intelligencer website points out another possible link between COVID-19 and overdose deaths. He states public health experts believe “isolation during the pandemic has led more people to use drugs alone with no one around to revive them or call 911 if they overdose.”

Opioids, including illegal fentanyl, cocaine, heroin, and methamphetamines cause the greatest percentage of overdose deaths in the U.S. Deaths from illegally manufactured fentanyl increased over 38 percent between 2019 and 2020, accounting for the largest number of deaths.

If administered quickly, the drug naloxone can reverse the effects of an overdose from opioids. In cases of fentanyl overdose, it may require several doses of naloxone. Most U.S. states allow the purchase of naloxone without a prescription, so anyone can use it in case of an overdose emergency. Widespread isolation, however, has resulted in many people using drugs alone, and, in case of overdose, there is no one present to administer naloxone or to call for help.

What Is Being Done to Address the Crisis?

To help those affected by COVID-19, the House and Senate recently signed a second stimulus package, which includes funds to expand:

  • Vaccine procurement and distribution
  • Test and trace measures to help understand and slow the spread of the virus
  • Other public health efforts focused on stopping the spread of the virus
  • The package also provides direct relief to many Americans in the form of:
  • $600 checks to individuals meeting income guidelines
  • $300 weekly boost in unemployment benefits
  • Rental assistance
  • Food assistance programs
  • Aid to small businesses

See the Intelligencer article “What Is in the $900 Billion Second Stimulus Package?” for more information.

In response to the increase in drug overdose deaths coinciding with the COVID-19 pandemic, the CDC Health Alert Network recently issued an advisory for medical and public health professionals, first responders, harm reduction organizations, and other community partners.

The CDC advisory recommends the following actions:

  • Make sure essential services are available to communities that face the highest risk of overdose.
  • More widely distribute naloxone and teach the general public about overdose prevention.
  • Increase the general public’s awareness of substance use disorders and access to treatment for those who need it.
  • “Intervene early” with people at the highest risk for overdose.
  • Improve the detection of overdose “outbreaks” so healthcare providers and states can respond more effectively.

The American Medical Association also strongly encourages governors and state legislators to continue DEA and SAMHSA emergency guidelines instituted in response to the pandemic until both public health emergencies — COVID-19 and the opioid crisis — are contained. The AMA agrees with the CDC recommendations listed above and also recommends:

  • Continue to make it easier for patients to be evaluated and prescribed care via telemedicine.
  • Reduce barriers to treatment, including prior authorization for medication.
  • “Meaningfully enforce” parity requirements for mental health and substance use treatment.
  • Make it easier for patients managing severe pain to get the medications they need.
  • Use harm reduction best practices like clean needle and syringe programs.
  • Make the general public more aware of the need to carry naloxone and how to use the medication during an overdose.
  • Increase the number of locations that educate people on overdose prevention and provide naloxone.
  • Ensure the general public understands that frequently checking on people who use drugs can save their life.

If you are experiencing anxiety, depression, or another mental health issue, find you are abusing addictive substances, or believe your recovery is threatened during this difficult time, help is available. Contact your doctor or reach out to an addiction specialist for guidance.

Turning Point of Tampa has offered Licensed Residential Treatment for Addiction, Eating Disorders and Dual Diagnosis in Tampa since 1987. If you need help or know someone who does, please contact our admissions department at 813-882-3003800-397-3006 or admissions@tpoftampa.com.