California, the state often identified by the world’s media as the “hotspot” of the year-long and continuing spread of the coronavirus throughout the U.S., has another dubious claim-to-fame arising from the pandemic. During 2020, the “Year of COVID-19,” which has resulted in a massive nationwide death toll that’s still rising, a staggering 3 times more residents in the city of San Diego, CA actually died from something else completely – a fatal drug overdose.
At a time when the nation’s focus has been firmly planted upon the pandemic, and the majority of the population continues to endure the seemingly never-ending wait for its coronavirus vaccine, statistical evidence continues to come to light on the devastating impact and tragic influence of the synthetic opioid fentanyl across the state of California during 2020.
Even as word of a potentially lethal coronavirus began to appear in worldwide media headlines at the beginning of 2020, the U.S. was still dealing with a severe public health emergency of its very own – the national opioid epidemic.
After a year like 2020, the outlook, which should have been looking far better by now if we’re being truly honest, is beginning to look decidedly bleak – at least, for the foreseeable future.
Remember, there’s no vaccine for substance addiction, and there’s no vaccine for the worrying decline in public mental health that we’re continuing to witness either – a fact that is destined to have even further repercussions (more on this later) as we move further into 2021.
San Diego County & The Fentanyl Epidemic
In July and August of last year, the numbers of drug overdose deaths in San Diego County were more than 50% higher than they were just 4 months prior. In real terms, the percentage equated to an awful average of 3 people dying every single day in the County.
The combination of an unprecedented surge in one of the most lethal opioids available – fentanyl (between 50-100 times more potent than morphine) – and a viral pandemic that has socially-distanced us all, created high unemployment, severe socio-economic disruption, and forced vast swathes of working people and their families to live paycheck to paycheck, has had a devastating impact.
When more people are dying of an illicit drug overdose – more often than not, an accidental one – than by a worldwide pandemic that has killed millions globally, and nearly half a million Americans alone, then surely something vital and intrinsic to the “social status quo” has gone very wrong, very quickly.
Social Isolation & Poisoned Drugs
COVID-19 forced (i). severe restrictions in access to vital care and support, such as drug addiction and mental health treatment, 12-Step, and other group meetings, and so on, (ii). unseen disruptions to the illegal drug supply leaving addicts forced to use unknown products, and (iii). the worsening economic issues that lead to an increase in drug use.
“It’s more useful to think of the fentanyl crisis as a mass poisoning than as a traditional drug epidemic. The margin of error is so narrow – one more milligram, and that could put you in the grave.” – Bryce Pardo, associate policy researcher, RAND Corporation, and lead author of “The Future of Fentanyl and Other Synthetic Opioids”
Sadly, with all eyes on the virus, vulnerable parts of society were left to deal with everything on their own, and, as we have always known, isolation kills. Recovering addicts, constantly reliant on their support network, were left, unforgivably, alone.
Fentanyl has been the flame that has ignited absolutely everything around it.
For example, throughout 2019, San Diego County recorded a total of 152 fentanyl-related overdose deaths. By the first week of August 2020, 233 fentanyl-related deaths had already been recorded.
Clearly, the impetus behind this tragic escalation is the synthetic opioid, especially when you consider that the unscrupulous Mexican drug cartels and home-grown drug organizations have been “cutting” all their other illicit drugs with the lad-made opioid – it’s in cocaine, methamphetamine, counterfeit prescriptions, and in other opioids, like heroin.
“If you spend time with someone who uses drugs or is a drug user, the County strongly encourages you to carry naloxone with you.” – Dr. Luke Bergmann, Director of Behavioral Health Services, San Diego County Health and Human Services Agency
It’s not just in San Diego either. Overdose deaths across the state of California rose 26.8% in the period between June 2019 and June 2020. Nationally, when compared with the same period, overdose deaths across the country rose 21.3%.
With this stream of San Diegans dying, the county’s health officials have asked the medical community to keep increasing access to naloxone (the opioid overdose reversal medication) to prevent fentanyl-related deaths. However, it’s of no use if an addict overdoses alone.
The “War on Drugs” is Over – We Lost
Towards the end of last September, the U.S. Department of Justice announced the final outcome of a darknet-based crackdown on prolific drug dealers – over USD $6.5 million was seized, arrests worldwide totalled 179 (with 121 in the U.S.), and over 275 kilograms of illicit drugs, including fentanyl, oxycodone, hydrocodone, methamphetamine, heroin, cocaine, ecstasy, and MDMA, were recovered here in the U.S. alone.
Named “Operation DisrupTor” (as it was concentrated on the Tor Browser), illegal online marketplaces across the globe were relentlessly targeted. In California, according to the DOJ, law enforcement officials took apart an online MDMA and methamphetamine operation, which was linked to “18,000 illicit sales to customers in at least 35 states and in numerous countries around the world.”
However, and as impressive-sounding, as this is, those in global drug law enforcement realize all too well that it’s the tip of a very large iceberg. Nonetheless, the international cooperation involved is a clear sign of how future disruptive operations will work – with more country-to-country communication, resources and information shared for the greater good.
Let’s face it. Nixon’s so-called “War on Drugs” (announced around 50 years ago now) was doomed to fail, and, unsurprisingly, it has done so.
The U.S.’s biggest supplier of illegal narcotics still remains the Mexican drug cartels, and it is these very groups that have created the “mass poisoning” mentioned previously. But, you may ask, why hit your customer base with so many deaths?
Simple. As ever, it always comes down to financial profit, and fentanyl is far cheaper, far easier to manufacture, and far easier to traffic than the likes of heroin and cocaine. It’s the very reason every illegal drug is being cut with the synthetic opioid – pure profit, no more.
The 2020 U.S. Drug Policy: Invest in Prevention & Treatment
On December 1, 2020, the day that the white flag in the “War on Drugs” was finally raised, the final report from a congressionally-mandated Western Hemisphere Drug Policy Commission was published.
It’s the U.S.’s new drug policy, and its central focus is the investment in substance addiction prevention and treatment. It’s no longer a war to be won – it’s a public health emergency to be dealt with on all levels, primarily by prevention through drug education and outreach, and professional evidence-based treatment for those who are addicted to drugs.
The premise behind this focus is a practical one – it is impossible to control the supply of dangerous, potentially lethal illicit drugs, without reducing the actual demand for them.
Additionally, the report demands the U.S. moves away from policies that clearly had little or no effect, such as “drug interdiction” (preventing the drugs from reaching their destination), eradicating crops, and other more traditional counternarcotics tools. In other words, the previous policy was broken, so it’s time to fix it.
The Next U.S. Epidemic: Depression & Other Mental Health Disorders
Unfortunately, the far-reaching effects of the coronavirus pandemic do not stop simply because enough of the population has been vaccinated to reach the desired “herd immunity.” It is these knock-on effects that will be guiding U.S. health policy in the short to mid-term future.
One of the most worrying of concerns is the already declining state of mental health and wellbeing within the U.S. population. Eminent psychologists and addiction experts are now predicting that the next public health emergency will revolve around the current state of our mental health – a state that will actually worsen in time, as opposed to recovering naturally.
This will involve vast swathes of the U.S. population that were infected with the coronavirus (currently, that figure stands at over 27 million), as they develop clinically diagnosed mental health disorders, neuropsychiatric illnesses, and an array of associated behavioral issues – borne from the virus’s physical infection and the associated inflammation.
Post-Viral Infection & Rising Mental Illness Directly Linked
Medical scientists and researchers have long known that the inflammation caused by a virus of this type will weaken the protective barrier of a patient’s central nervous system, and allow the passage of blood-borne cells used to fight the virus to enter the brain.
These cells, important for fighting the spread of the virus in the body, are, unfortunately, highly detrimental to our normal brain function and the neurotransmitters relied upon, and can subsequently cause the development of mood disorders – most notably, depression.
According to a recent analysis of existing data by the psychiatry department at the University of Oxford, UK, 1 in 8 people (13%) who have had Covid-19 are now being diagnosed with their first psychiatric or neurological illness within 6 months of testing positive for the virus. The data is derived from the electronic records of 236,379 hospitalized and non-hospitalized U.S. patients with a confirmed diagnosis of Covid-19 who survived the disease.
Furthermore, the analysis found that this ratio rose to an alarming 1 in 3 (33.6%) when patients with a previous history of psychiatric or neurological illnesses were included. As we are all too aware, a history of poor mental health can be a critical factor in the development of substance addiction, and vice versa.
As Dr. Darrell G. Kirch, President and CEO, Association of American Medical Colleges (AAMC), recently stated, “We face a broad range of mental health issues, including the acute problems of opioid addiction and increasing rates of depression and suicide. I think one of the great tragedies is that some of the most seriously mentally ill individuals are homeless or are caught in a revolving door between prison and the street.”
Telehealth Update: Phone Calls Won’t Cut It
A recent report by the RAND Corporation, a nonprofit health policy research organization, has highlighted a fundamental concern about how online video-based telehealth is being delivered to the U.S. public, and its data is derived from California.
It would appear that many low-income patients had to make do with audio-only communication – in other words, a simple phone call.
“Lower-income patients may face unique barriers to accessing video visits. These are important considerations for policymakers if telehealth continues to be widely embraced in the future.” – Lori Uscher-Pines, lead author and senior policy researcher at the RAND Corporation
During 2020, and now continuing into 2021, telehealth is now a vital component of healthcare, with many medical appointments moving online, including mental health and addiction treatment. For the clinics that serve low-income patients, it allowed them to offer access to healthcare when many organizations were temporarily forced to close – such as residential addiction rehabs.
After studying more than 500 clinic locations across the state of California, the report found that:
- Approximately half of primary care medical “visits” from March to August, 2020 were conducted via telehealth
- Over 77% percent of behavioral health “visits” were conducted via telehealth during the same period
- Telehealth “visits” (by type) were predominantly a telephone-only service
- Among primary care medical visits, 48.5% were via telephone, 3.4% were via video, and 48.1% were in person
- However, the percentages change for behavioral health, with 63.3% (nearly two-thirds) via telephone, 13.9% via video, and 22.8% in person
In fact, California was one of the first states to pass a telehealth law – the Telemedicine Development Act of 1996. However, the Act contains no legislation regarding the reimbursement of care delivered by email, phone or fax. Therefore, it is left up to the health insurers, and the signs are that, once the pandemic is controlled, audio-only telehealth will no longer be covered by these insurance programs.
SpringBoard Recovery: We Treat Opioid Addiction
At SpringBoard Recovery, regardless of where you live, we can help you. Our professional drug and alcohol rehab facility, located in Scottsdale, Arizona (a non-stop flight between San Diego and Phoenix is around 1½ hours or less), offers a range of drug treatment programs are designed to ensure you have the best possible chance to move on with your life, opioid-free, and work towards a sustainable, long-term recovery.
Finding addiction treatment out of your home state can be a true blessing in disguise, enabling you to free yourself from the distractions, temptations and possible relapse triggers of your local area. Contact us today for more information.
- National Institute on Drug Abuse: https://www.drugabuse.gov/drug-topics/fentanyl
- Centers for Disease Control and Prevention: https://www.cdc.gov/drugoverdose/epidemic/index.html
- Harvard Health Publishing: https://www.health.harvard.edu/addiction/substance-addiction
- California Department of Public Health: https://skylab.cdph.ca.gov/ODdash/
- RAND Corporation: https://www.rand.org/pubs/research_reports/RR3117.html
- United States Drug Enforcement Administration: https://www.dea.gov/factsheets/fentanyl
- The United States Department of Justice: https://www.justice.gov/opa/speech/deputy-attorney-general-jeffrey-rosen-delivers-remarks-announcement-results-operation
- U.S. House of Representatives Committee on Foreign Affairs: https://foreignaffairs.house.gov/press-releases?ID=9D43F49D-7B2F-4398-B141-A2262575B3AC
- medRxiv: https://www.medrxiv.org/content/10.1101/2021.01.16.21249950v1.full.pdf
- AAMC: https://www.aamc.org/
- JAMA Network: https://jamanetwork.com/journals/jama/fullarticle/2776166?guestAccessKey=1cbe677e-5cda-4394-9933-078d1fcfecaf