‘EPIDEMIC IN THE MIDDLE OF A PANDEMIC’
COVID-19 impacting overdose and relapse rates, treatment
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 midJune.
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 and Bridgeport, shows about 61 percent of people in their substance abuse treatment programs reported eliminating their use from January through April.
In May, the numbers took a drop, with 49 percent of people reporting elimination, meaning 11 percent of people were using substances again. Those numbers have hovered between 43 and 52 percent elimination since then.
The state’s stay-at-home order went into effect in March and many businesses stayed closed as a result until mid-May.
Liberation Programs CEO John Hamilton said social isolation can also decrease dopamine levels which increases the likelihood of depression and subsequent substance abuse.
“Sometimes people have lost jobs and with that a sense of hope,” Hamilton said. “A big factor in recovery is having hope... Recovery is about hope and gratitude and relapse is about despair.”
Hamilton said he’s also seen an increased interest in their programs as many people struggle to cope with heightened anxiety that’s come from the pandemic and the social, emotional and financial impacts of it.
“There’s a new population of individuals who’d never sought help before who had their routine, sense of purpose and bright future and had that taken out from under them,” Hamilton said. “The result is some people changing their use of alcohol in particular. People tend to be drinking again just to feel better. It’s not a good strategy.”
Mathis said at LifeBridge, they have seen a 20 percent increase in people including help with substance misuse in their treatment plan goals.
Complicating the matter is access to treatment, particularly in-person treatment. Lifebridge’s centers in Bridgeport and Fairfield have been closed since March, leading to staff relying on video and phone programs. The bulk of clients use telehealth with only six percent having access to video sessions. Despite this, the center reports they’re still conducting over 1,800 sessions a month.
“One thing the pandemic has done is shine a spotlight on the many holes that exist in the social fabric of our communities and the fact that our mental health system was at best fragmented pre-pandemic,” Mathis said. “Easy access was not there for everyone and now it is more elusive than ever ... Little can replace the important connections that exist in human to human in counseling sessions. A phone conversation or staring at a screen are not the same thing.”
Yet some places, like Recovery Network of Programs, a nonprofit which offers residential and in-patient 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.”