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Author: Don Obrien

America’s opioid crisis made worse by ‘can of worms’ opened during pandemic


The overdose crisis in the U.S. is continuing to worsen as a result of the coronavirus pandemic. 

Drug overdose deaths increased by 30.8% for the 12-month period ending March 2021, according to the latest provisional data from the CDC’s National Center for Health Statistics, with reported numbers reaching a record high of 96,779. The CDC noted that the number is likely an undercount given incomplete data.

“By the end of 2020, we knew that the number of overdoses for 2020 were going to be higher than any other year previously,” Katharine Harris, a Glassell fellow in drug policy at Rice University, told Yahoo Finance. “I think that it became pretty clear early on that any kind of optimism in 2019 that maybe there would be a downward trend in overdoses was very quickly obliterated by that provisional data from 2020 that we saw.”

Synthetic opioids like fentanyl were by far the main driver of these fatal overdoses, accounting for more than 63% of opioid-related deaths. 

“The synthetic opioids, it’s really this can of worms that’s open now,” Harris said. “Not a lot that we can do to get it back, to reel it in.”

Pandemic ‘worsened a lot of things’

The coronavirus pandemic has had devastating effects on people’s mental health, whether due to social isolation, loss of loved ones, financial instability, or loss of employment.

“You hear stories of people who are in recovery for a few years and then all of a sudden they lose their jobs … they’re anxious, they’re stressed, and so they relapse,” Bryce Pardo, a policy researcher at the RAND Corporation, told Yahoo Finance. “And because they’re relapsing, they don’t have a tolerance anymore, and they go out and the market is transitioning to a much more potent variant of a drug being sold.”

For those struggling with substance use disorder, the pandemic also “curtailed access that people had to certain harm reduction services,” Harris noted. This includes methadone clinics and rehabilitation services.

“It became a lot harder for some people, for example, to get access to their methadone and things like that, although a lot of cities have taken great pains to try to make sure that people still have access,” she continued. “There are a lot of needle exchange programs, for example, that have tried to remain open. Some cities like New York had methadone delivery programs, so there have been efforts to try and make sure people still get the services that they need at the same time.”

Not every state was equally unfortunate. Vermont saw an 85.1% increase in fatal drug overdoses while West Virginia experienced a 62.1% increase. States like California, Nebraska, Kentucky, and Tennessee also saw troubling upticks. 

Furthermore, as a result of social distancing orders, those who are using opioids are more likely to be consuming them alone, putting them at a higher risk of overdosing.

“The disruptions that are caused by the pandemic have worsened a lot of things,” Harris said. “The isolation, for example. People were very reliant on a group therapy model that disappeared for a long time in the beginning. A lot of it moved too soon, but for some people, that’s not really going to cut it. I do think that we would have continued to see a rise in the synthetic opioid-related overdoses, but the pandemic worsened it.”

With synthetic opioids, ‘the margin of error is much narrower’

According to Pardo, it’s largely illegally manufactured fentanyl that’s causing these deaths.

“It might be that some states were hit later towards the end of 2020 as fentanyl continued to make its march in other markets, or people just got tired of the pandemic and relapsed into drug use,” Pardo told Yahoo Finance, “and they’re buying basically what they thought was heroin and take fentanyl. We need to see what this looks like when we get the full data set out, but the numbers still overall are going upwards which is not good.”

Fentanyl began showing up in the heroin supply back around 2015, according to Harris, who explained that it proliferated because of its potency and portability, which makes it easier to evade authorities.

A man volunteers for Prevention Point Philadelphia and Step Up to the Plate in the Kensington neighborhood on July 19, 2021 in Philadelphia. (Photo by Spencer Platt/Getty Images)

A man volunteers for Prevention Point Philadelphia and Step Up to the Plate in the Kensington neighborhood on July 19, 2021 in Philadelphia. (Photo by Spencer Platt/Getty Images)

“You need such a smaller quantity,” Harris said. “People can send it through the mail, for example, and it’s relatively cheap because of the way it’s manufactured in a lab. It doesn’t come from some sort of natural source. It’s not reliant on crop activity or anything like that.”

Because of that, it’s also “immensely profitable” for those who are selling the drugs, she explained. But because it’s more potent, the risk of overdose from it is also much higher.

“The margin of error is much narrower,” Pardo said. “So because of that, you’re seeing people who would typically use their normal dose overdose and die because they’re not aware that fentanyl’s in that product or you have people who come into contact with fake pills that are made to look like they’re of prescription origin overdosing and dying because they’re not aware.”

He added: “They go out and buy what they typically buy and then come to find out that the baggie they just blew by doesn’t contain heroin anymore. It’s fentanyl or mixed with fentanyl and they overdose and die. So it’s a combination of factors.”

Harris also attributed the rise in the use of synthetic opioids to the regulation of prescription opioids, as more states have been cracking down on doctors prescribing painkillers. 

Rich and Peg shoot-up a mix of heroin and fentanyl on a street in Kensington on July 19, 2021 in Philadelphia. (Photo by Spencer Platt/Getty Images)

Rich and Peg shoot up a mix of heroin and fentanyl on a street in Kensington on July 19, 2021, in Philadelphia. (Photo by Spencer Platt/Getty Images)

“If you look at the provisional overdose data by drug class, you can see that the overdoses related to natural and semisynthetic opioids, which are prescription opioids, are basically level and have declined slightly in the last couple of years,” Harris said. “Those are really staying steady because that’s something that the government is able to control the supply of better.”

But there is an unintended consequence from this: Those who are seeking drugs turn to less reputable sources, such as online sellers or people they don’t know.

“Then you’re more likely to get something that contains a much more potent drug in it,” Harris said. “People might think they’re protected because they’re buying these pills and they don’t realize how common it is now for these things to be counterfeit substances.”

The best solution starts with education, she added.

“I really think moving forward, it’s important to both educate individuals about those risks and also provide resources for people so they can figure out what they’re taking,” she added. “It’s kind of a harm reduction approach, but I think that’s something we really, really need to do if we’re going to address the immediate threat of continued overdoses.”

Adriana Belmonte is a reporter and editor covering politics and health care policy for Yahoo Finance. You can follow her on Twitter @adrianambells and reach her at adriana@yahoofinance.com.

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