The last thing the U.S. needed in the midst of an apparently failing battle against the home-grown opioid epidemic was for a global pandemic to strike the nation, but strike the nation COVID-19 subsequently did.
In fact, it did far more than forcibly hit the nation – you could say, among other dramatic effects, it knocked the U.S.’s failing health system way out of the park, and the huge year-on-year increase in fatal drug overdoses, seen both in Chicago and mirrored nationally, can be seen as a clear testament to the social devastation it has wreaked, especially for the young.
The ongoing opioid crisis had left the U.S. health system facing worrying challenges, such as a decidedly inadequate addiction treatment workforce, unequal payment levels for addiction treatment services, a profound lack of access to treatment options, particularly for the vulnerable, and disjointed education protocols for its health professionals.
These challenges not only got worse with the arrival of the COVID-19 virus; in many cases, they have become insurmountable. However, there are those in positions of real decision-making in national policy that is trying to reverse the virtually unworkable situation.
The Action Collaborative on Countering the U.S. Opioid Epidemic of the U.S. National Academy of Medicine (NAM), a specially commissioned group of expert clinicians and physicians, recently announced its work to fight against the crisis will continue well into the future, as it is now estimated that 2.5 million U.S. citizens struggle with either “opioid dependence” or diagnosed opioid use disorder (OUD).
NAM President Victor J. Dzau, chair of the Action Collaborative, stated his hope was that the collaborative could “establish an ecosystem of care that supports the continuum of prevention and ensures high-quality, evidence-based, and person-centered care for all.” He continued, “The COVID-19 pandemic has clearly demonstrated that the system by which we care for those with addiction is inadequate and fragile.”
Co-chair of the Action Collaborative, Ruth Katz, Vice President and Executive Director of the Health, Medicine, & Society Program at the renowned Aspen Institute, in Aspen, Colorado, added, “The weaknesses in the health system that we identified and studied before the pandemic has become impossible to ignore. The need for a robust framework designed to be responsive not only to the current opioid epidemic but also to future waves of substance misuse is critical.”
COVID-19 & Overdose Fatalities: Focus on Chicagoland
In the nation’s “Windy City,” Chicago, the tempest rages on and on. Overdose data, taken from 2020 in Cook County, home to a large swathe of “Chicagoland” (the combined area of metropolitan and outlying Chicago), has a real and shocking tale to tell, and, perhaps, an important lesson to be learned, too.
A recent CDC report on overdose mortality in the region, featured in their “Notes From the Field” series, showed that the average number of people dying of opioid overdoses in Cook County increased by more than 20% last year, as state residents were told to abide by the stay-at-home order that came into force on March 21, 2020, and was to last for 11 weeks.
Researchers from Illinois’ Northwestern University and the Cook County Medical Examiner’s Office examined opioid overdose deaths in direct relation to the state stay-at-home order.
“I’m not a bad person, you know, I’m a normal human being that struggles with something.” – Cormac Burke [speaking in 2019], from Lombard, Chicago suburb – died from a methamphetamine overdose, aged 22 years, June 18, 2020
Together, the researchers found that, on average, about 23 people died per week of an opioid overdose in Cook County in 2019. The number increased to 35.1 deaths per week in the weeks leading up to the stay-at-home order in 2020. From late March onwards, the weekly average of fatal opioid overdoses increased by about 24% to approximately 43.4 per week. Afterward, and on into early October, according to the researcher’s analysis, average weekly deaths dropped back down to 31.2, still significantly higher than the previous year.
As numerous amounts of data from recent research studies are released, their exhaustive conclusions are drawn, and study authors continue to write their many reports, one thing is clear in all of this:
The combination of continued illicit drug use among the young, the imposed isolation and school closures brought by the pandemic, the rise in availability of fentanyl and fentanyl analogs, and drug dealers selling other illicit drugs, like meth and cocaine, now cut with these potent, synthetic opioids, has together led to way too many premature young deaths, way too many mourning families, and way too many youthful and hopeful futures lost.
Mathew LeBlanc (1995-2020)
One of these sadly premature deaths occurred in West Dundee, a Chicago suburb, lying in the far northwest of Chicagoland. Mathew LeBlanc, a 24-year-old local artist, died from a drug overdose on May 19, 2020, in the West Dundee home he shared with his mother, Nicole Caceres. She said her creative son had struggled with substance addiction, and the pandemic made things far worse: ““Losing my son was absolutely devastating. That social isolation was devastating to him. He was stuck in the house a lot, and 12-step meetings were online.”
Now, the Mathew’s family – Nicole, Tony, Sydney Caceres & Jessica LeBlanc – spread the message about the dangers of drug overdose and substance use with their Love LeB Project, started in honor of Mathew and the art he created. The Project raises money by selling T-shirts featuring his artwork, which it then passes on to Shatterproof, a national nonprofit dedicated to reversing the U.S. addiction crisis.
As Nicole Caceres said, “If I can somehow change someone else’s life or make a difference in the fight against overdose and substance use disorder, that’s my number one.”
Unfortunately, Mathew’s story is not a rare or even unusual case. Many more mothers like Nicole Caceres are now spending time alone in their child’s bedroom, looking around at their loved one’s belongings, and wondering what could have been done differently, and how their child’s future would have turned out if it wasn’t for the enforced circumstances of last year.
This sad story also asks a question, too. During the pandemic, special care was taken with “high risk” groups – those suffering from chronic conditions that made them more susceptible to the effects of the coronavirus. In light of this, should it have been considered that young people like Mathew were also in a “high risk” group?
Other Stories From Chicagoland
Rise in “Poly-Pharmacy”: In DuPage County, home to an area of Chicago’s expansive suburbia, DuPage Coroner Richard Jorgensen stated that the rise in fatal drug overdoses was directly linked to a shift in what he termed as “poly-pharmacy.” “We continue to see a very large number of drugs mixed in together,” said Jorgensen, citing toxicology reports that showed various combinations of “marijuana, Xanax, cocaine, and heroin or fentanyl.”
The DuPage Coroner further stated that these lethal mixes can cause problems for police officers and other first responders who use naloxone to reverse an overdose: “Narcan [the brand name for naloxone] does not work against cocaine in that instance.” Lastly, Jorgensen reported that most of the 112 overdose deaths witnessed in DuPage County involved fentanyl, which had as many as 60 distinct variations locally, based on its potency.
Drug Overdose Scenes Now Potential Homicides: In an effort to hold drug dealers far more accountable for selling life-threatening substances, DuPage, Lake, and McHenry counties have been pursuing murder charges ever since the state’s drug-induced homicide law was put into place.
Chief Brendan Deenihan, Chicago Police Dept. stated, “When they eventually rule that, hey, the cause and manner here was overdose, if detectives processed the scene accordingly on the front end, then we can go back, work with our narcotics officers, we can try to figure out where they purchased from.”
One such homicide investigation saw a Chicago man, Alejandro Junco, finally sentenced to 10 years in prison this year for selling heroin to a 20-year-old man from Batavia who fatally overdosed back in 2018. After the investigation, it was found that the heroin which had been purchased from Junco had been laced with huge amounts of fentanyl.
The Physical & Mental Vulnerability of Young Substance Addicts
The young people of Chicagoland – children, adolescents, and teenagers – have never been more vulnerable, as “poly-pharmacy” in illegal drugs becomes more common, access to full mental health and addiction treatment still has restrictions, and educational establishments remain uncertain whether to resume in-person classes or not.
All this comes as the Centres for Disease Control and Prevention (CDC) announced that, based on provisional data, death from COVID-19 in 2020 was the third leading cause of mortality in the U.S. Furthermore, the death rate increased by 15.9% from 2019 to 2020, rising from 715.2 to 828.7 deaths per 100,000 people.
Substance Use & COVID-19 Physical Susceptibility
As COVID-19 numbers now continue to rise once more, a new medical research study by the National Institute on Drug Abuse (NIDA) has highlighted a direct link between substance use and a higher risk for coronavirus infection. The study’s authors stated that as well as the compromised lung and heart function of substance users, their “social marginalization” can also play a direct role in increased infection risk.
Emergency medicine physician at Rush University Medical Center in Chicago, Dr. Henry Swoboda, commented, “When we look at groups of people who are at higher risk for coronavirus, we’re looking at people who are more and more socially marginalized. And I think that is true of our substance using population.”
The NIDA study on “Substance Use Disorders and COVID-19 Susceptibility” found that people recently diagnosed with substance use disorders (SUD), including alcohol, cannabis, cocaine, and tobacco in addition to opioids, require more care. The researchers studied levels of in-patient care, and discovered the following:
- Those with SUDs had a 41% hospitalization rate, compared to 30% for those who did not, and
- The death rate among patients with SUDs was 9.6%, compared to 6.6% in patients with no addictions
The results in the African American group were deeply troublesome. Those with a recent opioid use disorder (OUD) diagnosis were more than 4 times more likely to develop COVID-19, compared to the white demographic.
As the director of the CDC, Dr. Rochelle Walensky recently reflected during a White House COVID-19 press briefing on the “feeling I have of impending doom,” Dr. Swoboda suggested a new initiative: “This paper highlights the need to both screen and treat patients with substance use disorders as part of a strategy to address the coronavirus pandemic. So if we are identifying populations at risk and they have a disease that is modifiable, then we should treat that disease.”
Teenage Mental Health Care Needs Skyrocketed from 2020 Onwards
It’s not just physically that young people continue to be affected by the ongoing pandemic.
A research study report, published by FAIR Health, entitled “The Impact of COVID-19 on Pediatric Mental Health,” found U.S. teenagers’ demand for care for mental health fairly skyrocketed in 2020.
This conclusion was drawn from all the medical insurance claim lines analysed in the study, particularly for (i). Intentional self-harm (nearly doubling in March and April, compared with the previous year), and (ii). Drug overdose (rising by 94.91% in March and 119.31% in April, 2020).
Additionally, the CDC has found that U.S. hospitals saw a 24% increase in the number of mental health emergency visits for children aged 5-11, and a 31% increase for children aged 12-17, include suicide attempts.
In response to these studies and other disturbing clinical reports on the state of wellbeing for the nation’s young, the Center for Law and Social Policy (CLASP) recently called on Congress to prioritize young people’s recovery by making a targeted $7.5 billion investment in the mental health of youth aged 16-25.
The respected, Chicago-based Kennedy Forum Illinois, an organization set up to challenge mental health and addiction issues, agreed the investment would be commensurate with the dramatic need for youth mobile crisis response, peer support, expanded access to telehealth, culturally responsive Adverse Childhood Experiences (ACEs) screening, and more.
2020 “Monitoring the Future” (MTF) Survey Results
Finally, returning to the NIDA, the results of the annual “Monitoring the Future” (MTF) survey
had some relatively encouraging news, as it showed continued low levels of most forms of substance use among teens, including opioid use. These results were despite the dramatic and dire effects opioids had on all older age groups, including young adults, in 2020.
Director of the NIDA, Dr. Nora Volkow, recently wrote, “It is important to investigate the consequences of social distancing and virtual classes on adolescent drug experimentation and use, since those are strongly influenced by peer pressure and group dynamics.”
However, for the likes of 24-year-old Mathew LeBlanc and 22-year-old Cormac Burke, both young adults from Chicagoland and both victims of a fatal drug overdose during the pandemic, this new-found importance has sadly all but passed them by.
SpringBoard Recovery: Co-Occurring Disorder in Young People
SpringBoard Recovery serves the Chicago area. Co-occurring disorder, the simultaneous presence of a SUD and a mental health disorder, such as severe depression or anxiety, is one of the expert clinical features of drug and alcohol addiction treatment programs at SpringBoard Recovery in Scottsdale, Arizona. Contact us today to find out more.