‘Epidemic in the middle of a pandemic’

COVID-19 affecting overdose and relapse rates

The social isolation many are experiencing due to COVID-19 precautions is thought to be behind the higher rates in relapses, drug overdoses and people seeking treatment for substance abuse this year.

Experts say social isolation can make people more likely to use or abuse substances as a method of coping. It’s also more likely to pose challenges when it comes to getting treatment.

Data from the state Department of Public Health shows there have been 912 confirmed fatal drug overdoses in 2020 as of midSeptember with 266 cases pending toxicology confirmation. The confirmed cases are up from 560 just three months ago, in mid-June.

In all of last year, the state reported 1,200 unintentional drug overdose related deaths.

There were 452 calls to the Connecticut Poison Control Center for suspected opioid overdoses in September, according to data from the Connecticut Emergency Medical Services Statewide Opioid Reporting Directive. Calls have been increasing throughout the course of the year with a high of 470 suspected opioid overdoses called into CPCC in August.

All Connecticut certified and licensed EMS organizations and providers report suspected overdoses to the CPCC. Last September, the directive reported 370 calls.

Of the 452 calls this September, 175 came from Hartford County, 100 from New Haven County, 80 from Fairfield County, 37 from New London County, 21 from Middlesex County, 19 from Windham County, 11 from Litchfield County and nine from Tolland County. Most of the patients (141) were between the ages of 25 and 34, and 23 calls resulted in fatal overdoses.

Across the region, addiction treatment centers are also reporting higher rates of relapse in their clients.

“Without a doubt, the pandemic has had a direct impact on the lives of everyone,” said Alan Mathis, CEO of LifeBridge Community Services which offers behavioral and youth health services to people in Fairfield County. “Even persons with relatively healthy mental outlooks have been challenged by loneliness, anxiety, depression, and a disconnect from their everyday support systems whether that is work, family or friends.

“These are the same underlying factors that contribute to substance abuse,” he added.

Dr. Andre Newfield, chairman of psychiatry at Hartford HealthCare and St. Vincent’s Medical Center, said more people dying of overdoses means there’s more who are overdosing and not dying and even more who are using.

“A certain number of people who use substances are going to end up overdosing,” Newfield said. “If numbers rise on the relapse side, numbers will rise on the overdose side. That’s just going to follow.”

Hartford HealthCare didn’t have data on the number of overdoses they’ve treated so far in 2020, but Newfield said he’s been seeing rates increase. One factor, he said, is people getting money from stimulus checks which can enable spending on drugs or alcohol. Another factor is social isolation.

“They’re more depressed, more anxious and turn to coping mechanisms that lead to a certain percentage of people that are overdosing,” he said. “The people who had a glass of wine with dinner are now turning to a bottle of wine and the people who stuck with pills might be turning to heroin...People are always going to be using substances, but the numbers and severity are going up.”

Data from Liberation Programs, which treats people with substance use disorders at sites in Greenwich, Stamford, Norwalk had that taken out from and Bridgeport, shows about under them,” Hamilton said. 61 percent of people in their “The result is some people substance abuse treatment changing their use of alcohol programs reported eliminatin particular. People tend to ing their use from January be drinking again just to feel through April. better. It’s not a good strate

In May, the numbers tookgy.” a drop, with 49 percent of Mathis said at LifeBridge, people reporting eliminathey have seen a 20 percent tion, meaning 11 percent of increase in people including people were using subhelp with substance misuse stances again. Those numin their treatment plan goals. bers have hovered between Complicating the matter is 43 and 52 percent elimaccess to treatment, particination since then. ularly in-person treatment.

The state’s stay-at-home Lifebridge’s centers in order went into effect in Bridgeport and Fairfield March and many businesses have been closed since stayed closed as a result March, leading to staff relyuntil mid-May. ing on video and phone

Liberation Programs CEO programs. The bulk of cliJohn Hamilton said social ents use telehealth with only isolation can also decrease six percent having access to dopamine levels which invideo sessions. Despite this, creases the likelihood of the center reports they’re depression and subsequent still conducting over 1,800 substance abuse. sessions a month.

“Sometimes people have “One thing the pandemic lost jobs and with that a has done is shine a spotlight sense of hope,” Hamilton on the many holes that exist said. “A big factor in recovin the social fabric of our ery is having hope... Recovcommunities and the fact ery is about hope and gratthat our mental health sysitude and relapse is about tem was at best fragmented despair.” pre-pandemic,” Mathis said.

Hamilton said he’s also “Easy access was not there seen an increased interest in for everyone and now it is their programs as many more elusive than ever...Litpeople struggle to cope with tle can replace the important heightened anxiety that’s connections that exist in come from the pandemic human to human in counand the social, emotional seling sessions. A phone and financial impacts of it. conversation or staring at a

“There’s a new population screen are not the same of individuals who’d never thing.” sought help before who had Yet some places, like Retheir routine, sense of purcovery Network of Propose and bright future and grams, a nonprofit which offers residential and inpatient substance abuse recovery programs in the greater Bridgeport area, are bucking the trends. RNP reported only three overdoses this year among clients, with two being fatal. In 2019, they had 12 overdoses, seven of which were fatal, which was down from 16 overdoses in 2018.

But, Jennifer Kolakowski, CEO of RNP, said they’ve noticed a decrease in both referrals and walk-ins, likely due to COVID concerns. RNP has remained open throughout the pandemic, but had to reduce the capacity of their in-person programs. Instead, they’ve been using telehealth which Kolakowski said has been critical for treatment but also challenging for many clients.

“A lot of individuals if they have a phone or technology, they don't necessarily want to spend all their time on telehealth,” she said. “There's some individuals that are in some ways more engaged because they have a little more privacy and then others, it’s more challenging in terms of opening up.

“It’s alarming because it’s an epidemic in the middle of a pandemic,” she added. “Obviously the pandemic is extraordinary but it has eclipsed to some degree the attention needed to the fact this epidemic is so detrimental.”