Although our Opioid Crisis Exposed series concluded two years ago, the epidemic hasn’t concluded — one bit. After staggering high overdose deaths gripped the Westshore in 2017, those numbers began to see a slight decline in subsequent years as recovery resources became more prominent.
Despite a few ebbs and flows, the epidemic seemed to finally be heading in a better direction. Although still declared a public health crisis, overdose rates and fatalities were remaining stagnant or slightly declining each month. This may not sound like a huge feat, but after years of overflowing coroners offices and consistent spikes in overdose deaths, it’s the small victory advocates for addiction and recovery have been hoping and praying for.
As 2020 rolled around and the COVID-19 pandemic became the epidemic’s worst enemy. The Scientific Committee on Opioid Prevention and Education, a task force created by Ohio Attorney General Dave Yost, found chilling new lows in the epidemic in 2020. The task force’s analysis found that the overdose death rate in the state during the second quarter (May-Aug.) of 2020 was the highest that it's been in ten years, since the epidemic began.
Although the coronavirus is not directly to blame, the collateral damage it caused on the epidemic is definitely of note. The following four trends could be what caused this spike in fatalities:
The stay-at-home order and curfews were put in place in an effort to keep the number of state coronavirus cases manageable. What came along with these new regulations was social isolation. Those who were already using found their addiction worsening, since all there was to do was stay home and get high all day. Those who had the chance to work from home no longer had to hide their habits from coworkers. Those who lost their jobs received unemployment which potentially continued to fuel their habit. It became particularly harmful for those who lived and used alone, for there was no one there to revive them if they overdosed.
Those who were teetering on the edge of abuse and dependence may have succumbed to their impulses due to stress, anxiety, depression and social isolation. I’ve seen many people come to 12-step meetings last summer who shared that their addiction reached new lows when we were urged to stay at home.
Few In-Person meetings
Businesses and restaurants weren’t the only ones suffering the repercussions of the state shutdown last year to help slow the spread. Churches were also prohibited from holding services and activities, which runs a lot deeper than just Sunday worship. Many 12-step meetings and recovery support groups met in church basements and school rooms. So when the churches were closed, so were meetings. Many moved to an online format or have since opened or relocated as the state has begun to reopen. But in-person meetings are far and few between now compared to what they were pre-pandemic.
I’ve seen this closure take its toll on newcomers and old-timers in recovery alike. As meetings began to move to zoom, some groups were plagued with hackers or internet connection issues. To solve this problem, passwords had to be created to gain access to meetings. So now instead of just driving to a church to attend a meeting, a newcomer would have to have access to a phone or the internet, research what day and time these meetings were, access the zoom link and then login with a password. This made it even more difficult for those struggling to take the plunge into recovery to do so.
Although 12-step service members have bent over backwards to keep people informed about meeting changes, it’s still another hurdle in the process. Even as someone who has been in a 12-step program for years, it can be difficult to keep up with what meetings are open now, if they’ve relocated or switched times, which are still on zoom and which ones were forced to close. I couldn’t imagine trying to handle all of that information if I were just getting clean.
And for those who were already clean but struggling? Missing those in-person connections broke them. I saw people who have been clean for months, a couple years or even close to a decade relapse in the past year. Some of them have made it back to recovery, others to jail or prison, some of them are still out using and a few of them only live in the obituaries now.
Closed off treatment facilities
As social distancing and quarantine protocols became more commonplace, treatment facilities had to follow suit to keep things safe and prevent coronavirus outbreaks. For sober houses and inpatient facilities, this often meant having less beds available in order to comply with state regulations. Treatment access and availability have been an ongoing battle in the state since the start of the epidemic, and adhering to these new regulations did that battle no favors. The same amount of (if not more) people were seeking treatment, but the treatment centers capacity and resources to help those seeking help were crippled by COVID-19 regulations.
Some treatment centers often hosted 12-step meetings, welcomed speakers into their facilities or took their clients to outside meetings. This is particularly valuable to those in early stages of recovery so they can connect with other recovering addicts with substantial clean time who can help support or sponsor them. But with the fear of bringing the virus into their facility, many of these practices were temporarily halted or completely stopped until further notice, thus depriving the clients of those meaningful messages and connections. Unfortunately, these treatment facilities had no other choice, and their first priority was to keep their clients safe and healthy.
Prominence of fentanyl
Potentially the most chilling new trend is the rise of fentanyl. The powerful opioid, which is 50 times more potent than heroin, has been the leading cause of overdose fatalities in the county for the past five years. The drug has been cut into heroin and cocaine in recent years, oftentimes unbeknownst to the user. But just as those addicted to opioids began to choose heroin over prescription pills due to cost and availability back in previous years, the same trend is happening with fentanyl.
A close friend of mine who was using recently told me that most people willingly do fentanyl now, that heroin is much more difficult to come by nowadays. Drug dealers are more likely to have fentanyl, even carfentanil (the elephant tranquilizer that is the strongest opiate analog known in the U.S., 100 times more potent than fentanyl) than they are heroin in Ohio. It only takes a tiny bit of fentanyl to experience a very intense high, which has made it more appealing to addicts. So now instead of unknowingly using the drug as it's laced into heroin or cocaine, those who are using drugs are seeking it out and choosing to do it.
As the state begins to open back up, I can only hope that access to recovery resources will too. It’s one thing to battle an epidemic, but to do so in a pandemic has caused devastating losses to hundreds of families across the county.
Maureen Bole is a graphic artist, journalist, clothing designer and recovering addict. She may be reached at firstname.lastname@example.org or 440-871-5797.