Opioid crisis growing in Puerto Rico after Hurricane Maria
HUMACAO, Puerto Rico — Jose Carlos Laviena emptied his pockets, took off his shoes and waited to die.
He had just injected himself with a new type of heroin that his dealer was promoting, but the high was so strong that Mr. Laviena thought he had overdosed. The 35-year-old was preparing his body for how he wanted to be found.
“It’s truly something super strong,” he said, referring to what he believes was heroin mixed with fentanyl.
Mr. Laviena’s near-fatal experience in an abandoned trailer in southeast Puerto Rico is one of many signs that the island hasn’t been spared from the opioid crisis that has plagued the U.S. mainland — a problem that seems to have grown as a result of a devastating hurricane.
The government is struggling to keep up and failed to apply for a multimillion dollar U.S. grant that advocates say could have helped save lives.
More than 600 fentanylrelated overdoses and 60 deaths were reported in Puerto Rico in 2017, largely before Hurricane Maria, up from 200 overdoses and eight deaths the previous year. While that’s less dire than the crisis in some U.S. states, activists and experts say the problem appears to be expanding rapidly as use of fentanyl spreads more widely here.
The U.S. Drug Enforcement Administration and local nonprofit groups say they believe that deaths and overdoses are far higher than the official numbers indicate because the island’s government recently stopped trying to count fatal overdoses due to financial constraints.
Despite that, the U.S. territory never applied for a $7.8 million award from Congress to help get people into treatment.
“It’s ridiculous. There’s a lot of need for that money,” said Carmen Davila, a nurse who helps drug addicts in rural Puerto Rico. She worries the number of overdoses will increase and questioned the 612 overdoses reported in 2017 by the government. “I’d say it’s three times that amount based on the testimonies of people we’ve helped, and that’s a conservative estimate.”
Julissa Perez, spokeswoman for Puerto Rico’s Administration of Services for Mental Health and Addiction, said it was too difficult for the agency struggling with staffing cuts to apply for the new grant while also coordinating work under earlier grants and programs.
“I am extremely worried, because this represents an epidemic that has not been acknowledged,” said Puerto Rico territorial Sen. Jose Vargas Vidot, a doctor known for his volunteer work with drug addicts on the island. “In the 30 years that I’ve been on the streets, I have never seen three to four deaths a week in just one neighborhood, in just one street … Everything changed immensely after Hurricane Maria.”
Dr. Vargas said the heavy presence of law enforcement on the island after the Category 4 storm hit on Sept. 20, 2017, coupled with a lengthy paralysis of all modes of transportation used by smugglers, led drug dealers to substitute imported heroin with fentanyl, which was available at hospitals since it is legally produced in Puerto Rico. He said he and other doctors received anonymous tips that criminals were threatening hospital staff if they did not hand over fentanyl supplies.
As many patients lacked access to basic health care for weeks after the hurricane hit, pharmacies began refilling prescriptions without a doctor’s authorization as a humanitarian move, he said. In addition, mental disorders were exacerbated after Maria.