2020 was undeniably a year of change. Never, ever before have we seen the immense scale of the socio-economic disruption that resulted, the level of loneliness created, and the tragic, ever-ascending mortality rates that the coronavirus pandemic brought to us all – to our lives, our neighborhoods (regardless of whether we’re in Akron, Ohio or Anchorage, Alaska), and our nation.
However, as one American rapper puts it, relatively succinctly, “The bad news is nothing lasts forever; the good news is nothing lasts forever.” He’s right, too.
The nationwide vaccine rollout, however faltering and sporadic it may appear, is still a nationwide vaccine rollout, nonetheless, and, at some point during this year, the pandemic will have been brought under some level of control. Thankfully.
Sadly, whether you’re living in Akron, Anchorage or Anywhere Else, U.S.A., you are still not going to feel like there’s any semblance of control, as we’re pushed from one public health emergency into another.
Before the pandemic flew in and seemingly changed everything – from grocery shopping to how we work for a living – the state of Ohio and the rest of the U.S. had been battling against another public health emergency – the national opioid epidemic.
After such a promising start in dealing with the opioid crisis, from physician’s pain-killing prescriptions being seriously curtailed under new guidance from The Centers for Disease Control and Prevention (CDC), to the widespread distribution of the life-saving NARCAN® overdose-reversal medication (more on this later), the response, admittedly, began to slip.
“If you haven’t used for a while, and you go back and use – particularly heroin with fentanyl or something – your tolerance is much lower. It’s easier to overdose.” – Cheri Walter, CEO of the Ohio Association of County Behavioral Health Authorities
In fact, as more qualifiable data becomes available, it would appear that 2019 was, at that time, the worst year for opioid-related deaths in many parts of the U.S. Unsurprisingly, after a year like the one we’ve just had, indications are that 2020 is now officially the worst on record for fatal opioid-related overdoses – the vast majority caused by just one potentially lethal substance, the synthetic opioid fentanyl.
2020 – the year of the coronavirus, and the year when the opioid epidemic was as bad as it had ever been. Here’s a prime example: In December of last year, mainstream media were reporting that fatal drug overdoses in the city of San Francisco were outpacing deaths due to COVID-19 by a ratio of 3 to 1. It could have been far worse, however; many lives were fortunately saved by the widespread availability of NARCAN® in the city, reportedly used at least 3,000 times in 2020.
In Akron, Ohio, the picture was similar. If it wasn’t for one particular project – Project DAWN (again, more on this later) – providing, distributing, and constantly pushing for the wider availability of NARCAN®, many more Ohioans would have died prematurely in 2020.
Drug Addicts & The “Other” Victims of COVID-19
You do not need to have tested positive for the coronavirus to become one of its many, many victims. Those with mental health disorders, particularly major depressive disorder (clinical depression), those with an active substance use disorder (SUD), those in addiction recovery whose support networks, such as counseling and 12-Step meetings, have all moved online, those who are constantly living below the poverty line, those who are homeless, those with an abusive home-life… the list, regretfully, goes on and on.
Additionally, let’s not forget children – they will suffer for years to come from school closures, and the pandemic’s wide-ranging effects on their mental health, those with disabilities have virtually been imprisoned because of the temporary closures of vital services, like transportation, health visitors have been unable to check on the development of babies and toddlers, and those in abusive households have become virtually “invisible” to social services there to protect them.
When the coronavirus pandemic hit the U.S. and became the only front page story people were reading, the vulnerable groups listed above were still there, just trying to make it through as best they could, and, importantly, still in need of their vital support, assistance and treatment.
Spotlight on Ohio: Fatal Opioid-Related Overdoses in 2020
Current statistics for fatal opioid-related overdoses in Summit County (home to Akron), Ohio, can be found at the Overdose Mortality Dashboard maintained by Summit County Public Health. However, detailed and up-to-date statistics have still not been finalized for 2019, so, in order to get an insight into the state’s opioid overdoses, we need to look at the comparable statistics of Franklin County.
According to statistics released by Franklin County Coroner Dr. Anahi Ortiz, the county experienced 437 drug overdose deaths during the first 6 months of 2020. This equates to a deeply troubling 73.7% increase from the same period in 2019. In October of last year, Dr. Ortiz commented, “It saddens me every day to see this get worse and to see the reports. It saddens me to feel what those families of the loved ones must be feeling at this time.”
Fentanyl has been the primary factor in this drastic increase in fatal drug overdoses over the last 2 years, and Franklin County is no exception. Out of the 437 deaths mentioned previously, 85.5% of them were directly linked to fentanyl.
“The unfortunate thing is a lot of businesses have shut down, but the selling of illicit drugs has not.” – Cheri Walter, CEO of the Ohio Association of County Behavioral Health Authorities
Federal clarification of a major fentanyl crisis, and its place within the overall opioid epidemic, came in mid-December, when the CDC reported that more than 81,000 overdose deaths in the U.S. occurred in the 12-month period ending in May, 2020 – many of which, again, were attributable to fentanyl. This tragic death toll represented the highest number ever recorded in the U.S.
Ohio has unfortunately been breaking records, too. In May, 2020, at least 532 Ohioans died of an opioid-related overdose, making it the deadliest drug overdose month in at least 14 years, according to state health department data.
As Cheri Walter, CEO of the Ohio Association of County Behavioral Health Authorities, stated in April of last year, “People are scared, they’re depressed, they don’t know what’s next. If you haven’t used for a while, and you go back and use – particularly heroin with fentanyl or something – your tolerance is much lower. It’s easier to overdose.”
“We’re seeing people coming out of the jails, nonviolent offenders being released, if part of their issue was addiction, again, after a period of time of not using, their tolerance drops. They use, and then we see an increase in overdose deaths. The unfortunate thing is a lot of businesses have shut down, but the selling of illicit drugs has not.”
What is NARCAN® & How Does It Work?
NARCAN® Nasal Spray, the first nasal formulation of the overdose reversal medication naloxone, is an FDA approved for the treatment of known or suspected opioid overdose. Specifically designed for use within the community, NARCAN®, being a nasal spray, is needle-free and ready to use, which makes the administration of the medication far easier.
Most accidental overdoses occur in a home-type setting, and so the nasal spray was developed for first responders, like paramedics and the police, as well as family, friends, and caregivers – with no specific medical training required. However, most U.S naloxone- distribution programs do offer training as a matter of course.
Known or suspected opioid overdoses have clear symptoms of either respiratory problems and / or severe sleepiness or being unable to respond. As easy as it is to administer, NARCAN® requires immediate use, and, importantly, it does not take the place of emergency medical care. Once the first dose has been given, emergency medical help should be contacted immediately, even if the overdose victim wakes up.
Furthermore (and a sad indictment of today’s society), NARCAN® nasal spray is formulated to be safe and effective in children for known or suspected opioid overdose.
Naloxone, known as an opioid antagonist, works by binding to opioid receptors in the brain, thereby blocking the effects of whichever opioid has been taken, either heroin, fentanyl, prescription painkiller, or another opioid. It can quickly restore a normal respiration pattern to a person whose breathing has either slowed or stopped as a result of an opioid overdose.
Opioid Overdose: Signs & Symptoms
The signs and symptoms of an opioid overdose emergency that you should look for include:
- Poor respiration – breathing will either be slow or absent
- Severe sleepiness or general lack of normal responsiveness
- Slow heartbeat
- Low blood pressure
- Cold and clammy skin
- Pinprick-sized pupils
- Bluish nails and lips
Project DAWN: Ohio’s Response Continues to Save Lives
To its immense credit, Ohio moved early in the fight against the opioid epidemic, and the state has saved thousands of lives in the process through its highly successful “Project DAWN,” which has been running since 2013.
The project is named after one early victim of an opioid-related overdose – Leslie Dawn Cooper, of Portsmouth, Ohio, who died at the age of just 34. However, like many overdose victims in the earlier years of the opioid epidemic, she did not die alone – she was surrounded by her friends. However, no one with Lesley Dawn that night had the overdose reversal medication – NARCAN® – that could have saved her life.
Project DAWN, which stands for Deaths Avoided With Naloxone, was originally started by the Ohio Department of Health (ODH) in Scioto County in 2013, and, soon afterwards, a program for the harder-hit Cuyahoga County was founded by Dr. Joan Papp, MD, an emergency physician at MetroHealth in Cleveland.
Project DAWN is a dual-edged initiative – to provide important opioid overdose education, including the dangers of opioids, and how to identify an opioid overdose, and, secondly, to distribute NARCAN® to those people who are likely to suffer or witness an overdose, along with the appropriate training to administer the medication, too.
It is difficult for the ODH to source sufficiently accurate data regarding who many lives have been saved by Project Dawn since its inception (they do know the distributed number, but not the figure pertaining to its use, successful or otherwise), but they do acknowledge the number runs into thousands and thousands.
Mental Health: The Next U.S. Public Health Crisis
Programs like Project DAWN, which provides free naloxone kits, Columbus Public Health’s Project LIFE program, which provides residents with access to free fentanyl testing strips (to ensure the drugs they are using do not contain the potent synthetic opioid), and the emergence of more needle exchanges and the introduction of new safe injection sites in Ohio, can all contribute to the fight against the opioid epidemic in the future, which is now fast becoming the “fentanyl epidemic.”
However, this continuing national public health crisis is about to be upstaged (again) during 2021 by a predicted and rapid surge in mental health disorders and behavioral issues emanating from the coronavirus pandemic and its wide-reaching consequential effects.
In other words, it doesn’t matter if you caught COVID-19 or not, you may be at risk of rapidly declining mental health, which, if left untreated, could result in a health disorder or ongoing behavioral issue.
In fact, many mental health experts have been giving stern warnings of this new mental health crisis since the pandemic first established itself in the U.S., and brand new research on the resulting impact of the coronavirus is now providing the evidence.
According to an analysis of existing U.S. data by the psychiatry department at the University of Oxford, England, 1 in 8 people (13%), who have had Covid-19, are being diagnosed with their first psychiatric or neurological illness within 6 months of testing positive for the virus. It is important to remember, as of the middle of January, 2021, the U.S. has already seen over 26 million confirmed cases of coronavirus. In Ohio, the state has seen over 893,000 confirmed cases.
Additionally, the analysis further found that those figures rose to an alarming 1 in 3 (33.6%) when patients with a previous history of psychiatric or neurological illnesses were included. As we know, a previous history of poor mental health is a factor in the development of substance addiction, and vice versa.
Furthermore, these research findings add to the growing body of evidence that shows the inflammation caused by this type of virus weakens the protective barrier of the central nervous system and allows blood-borne cells used to fight the virus to enter the brain, which can also result in mental illness or brain disorders.
How SpringBoard Recovery Can Help
SpringBoard Recovery, located in Scottsdale, Arizona – a 4½ hour flight from Cleveland, Ohio, provides the perfect opportunity to escape from the relapse triggers, and the difficult situations, people, and places of your substance use (not to mention, perhaps, the weather), to a professional drug and alcohol addiction treatment facility with a host of evidence-based treatments and therapies designed to put you straight on the path to a sustainable, long-term recovery.
Why not check out our Frequently Asked Questions page for further information, or, better yet, simply give us a call to find out how SpringBoard Recovery can help you? We understand that getting and staying clean and sober is exceptionally challenging, but we also understand that with the right support network and recovery tools, which we provide, it is definitely attainable.
- World Health Organization: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
- National Institute on Drug Abuse: https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis
- Centers for Disease Control and Prevention: https://www.cdc.gov/
- Drug Poisoning Deaths in Summit County: https://app.powerbi.com/view?r=eyJrIjoiNWU5ZmQ3NjAtYzU2Ni00YmRmLTlkNDMtMDMwODUwYWNlODQ2IiwidCI6ImJiMWI0YjU2LTQ4N2EtNGIyMy04YTI0LWEzYWVmNjVlMTFmZiIsImMiOjF9
- Overdose Deaths: https://public.tableau.com/views/CFCAP/ODdeath_Dash?%3Adisplay_count=y&publish=yes&%3Aorigin=viz_share_link&%3AshowVizHome=no
- Centers for Disease Control and Prevention: https://www.cdc.gov/media/releases/2020/p1218-overdose-deaths-covid-19.html
- National Institute on Drug Abuse: https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-reversal-naloxone-narcan-evzio
- MetroHealth: https://www.metrohealth.org/office-of-opioid-safety
- The City of Columbus: https://www.columbus.gov/Templates/Detail.aspx?id=2147505536
- medRxiv: https://www.medrxiv.org/content/10.1101/2021.01.16.21249950v1.full.pdf