2020 'exacerbated all of the issues' driving record drug abuse in America

The coronavirus pandemic has had devastating mental health effects on Americans, and drug abuse is hitting record levels.

New data from the Centers for Disease Control and Prevention (CDC) revealed that over 81,000 drug overdose deaths occurred in the U.S. in the 12-month period ending in May 2020. That’s the highest number ever recorded by the CDC.

“This pandemic and all that’s come along with it has really just exacerbated those vulnerabilities and the shortcomings of our own approach to treating those people,” Dr. Ryan Marino, a medical toxicologist and emergency physician based out of Ohio, told Yahoo Finance.

In San Francisco, the number of overdose deaths (621) outpaced COVID-related deaths (173) in 2020.

More than 40 states reported annual increases in opioid overdose deaths, “as well as ongoing concerns for those with a mental illness or substance use disorder,” according to the American Medical Association.

Travis Hayes, 65, holds up a bag of what he says is the synthetic drug fentanyl, across the street from where San Francisco mayor London Breed just held a news conference introducing legislation in curbing the rise of deadly overdoses in the city, at the Tenderloin section of San Francisco, California, U.S., February 27, 2020.   REUTERS/Shannon Stapleton
Travis Hayes, 65, holds up a bag of what he says is the synthetic drug fentanyl, at the Tenderloin section of San Francisco, California, U.S., February 27, 2020. REUTERS/Shannon Stapleton

Marino said while the pandemic certainly intensified addiction issues, much of the blame lies in the fact that those struggling with substance use disorder still aren’t getting the proper help they need.

“I don’t know that anyone was anticipating it, but I think it just shows that we really haven’t learned from our own mistakes in the past,” he said. “2020 has really just exacerbated all of the issues that we have in terms of drug policy and just the way we treat people in our society in general.”

‘Sometimes we reach out in different ways to cope’

It’s no surprise that Americans are looking to cope in various ways amid the pandemic.

A CDC survey in June found that 40.9% of Americans reported at least one adverse mental or behavioral health condition, with 13.3% of respondents having started or increased substance use to cope with stress or emotions related to COVID-19.

(Source: CDC)
(Source: CDC)

“I would definitely say the depression, the anxiety, the uncertainty, the loneliness, the isolation, all of those factors aren’t good for mental health,” Sheila Vakharia, deputy director of research and academic engagement at Drug Policy Alliance, told Yahoo Finance. “What we do when we’re feeling that way is that sometimes we shut down, but sometimes we reach out in different ways to cope. Reaching out to your drug of choice, whatever that might be, is one strategy. People I know have put on a couple of pounds. People are turning to the strategies they know help them manage with their stress and anxiety.”

Along with health concerns, many Americans are dealing with financial instability, as more than 5 million Americans are still jobless as a result of the pandemic and not all are expected to recover.

“A lot of this depression and anxiety is also related to the fact that people have lost their jobs,” Vakharia said. “We’ve got unprecedented rates of unemployment, employment instability, the loss of benefits, or other things that your business might do to employees to stay open. I think people do things to cope with the circumstances that they’re in. People are struggling with all these other forms of instability and confusion and lack of information from the top down about what’s going on, when we’re going to get out of this, what they can expect, and how to stay safe.”

In the month of April, one-third of Americans were unable to make their rent payments, which Vakharia noted as an example of situational-level depression versus individual-level depression.

“Are you supposed to be happy when you lose your job?” she said. “Or when your kids are at home and you can’t make ends meet?”

Dee (L) 29 years-old, who was released from the jail because of the Coronavirus pandemic, smokes a pipe loaded with Methamphetamine, while her boyfriend Sean (last name not given) smokes a cigarette next to the 110 Freeway, during the novel Coronavirus, COVID-19, pandemic in Los Angeles California on May 25, 2020. - On May 22, 2020 a federal judge issued a preliminary order requiring that  homeless people living under Los Angeles freeway overpasses and underpasses, be relocated for health and safety reasons. (Photo by Apu GOMES / AFP) (Photo by APU GOMES/AFP via Getty Images)
Dee, who was released from the jail because of coronavirus, smokes a pipe loaded with meth, while her boyfriend Sean smokes a cigarette next to the 110 Freeway, in Los Angeles on May 25, 2020. (Photo by Apu GOMES / AFP)

Vakharia continued: “There’s a lot of temptation sometimes to individualize mental health, to individualize substance use, and we need to zoom out and remember that people live in social, environmental, and cultural contexts, and those can often dictate the kinds of choices that we make every day, whether those are health-related choices or mental health-related choices.”

Access to health care has also become increasingly difficult due to COVID-19 restrictions. An October 2020 survey from TransUnion Healthcare found nearly six in 10 patients had deferred non-coronavirus-related medical care over the previous six months. That included mental health care and addiction treatment.

“Access to other medical treatment and support systems for these people, things like medicines for substance use disorders, are just not available,” Marino said. “Given the situations of the pandemic, the limited access was further restricted. If you think about the way we treat things like methadone in this country, people have to go in person, wait in line every day. And those things just don’t really work out well during a massive pandemic.”

Nearly half of all patients say the economy has impacted how they seek medical care. (Chart: TransUnion Healthcare)
Nearly half of all patients say the economy has impacted how they seek medical care. (Chart: TransUnion Healthcare)

Calling it an opioid crisis ‘is becoming more and more of a misnomer’

Marino is now worried that these trends will continue to increase in 2021.

“The biggest [concern] is we’re still not implementing things that we’ve known work and can make changes in these numbers that have been around for like 50 years at this point,” he said. “And the other thing is where we’re focusing our energy and our efforts are sometimes just too narrow.”

By this he means calling the overdose crisis simply “the opioid crisis.” Both Marino and Vakharia argued that the problem is far beyond opioids at this point.

“For several years now, we’ve called this an opioid crisis — pinning it on opioids, prescription opioids, heroin, and fentanyl,” Vakharia said. “But actually for the past several reports that we’ve gotten from the CDC, stimulant-involved overdoses are on the rise, and it’s indicative of the fact that people are often using more than one kind of drug at the time of overdose.”

NEW YORK, NY - JUNE 07:  Brian smokes a synthetic drug called K2 on the street in the South Bronx on June 7, 2017 in New York City. Like Staten Island, parts of the Bronx are experiencing an epidemic in drug use, especially heroin and other opioid based drugs. More than 1,370 New Yorkers died from overdoses in 2016, the majority of those deaths involved opioids. The Mott Haven-Hunts Point area of the Bronx borough of New York currently leads the city in heroin overdose deaths. According to the Deputy Attorney General, drug overdose are now the leading cause of death for Americans under the age of 50.  (Photo by Spencer Platt/Getty Images)
Brian smokes a synthetic drug called K2 on the street in the South Bronx on June 7, 2017 in New York City. (Photo by Spencer Platt/Getty Images)

The new CDC data showed that cocaine-involved overdose deaths increased by 26.5%, while psychostimulant-involved overdose deaths, like those involving methamphetamine, increased by 34.8%.

“This idea of it being an opioid crisis or an opioid overdose crisis is becoming more and more of a misnomer and a misrepresentation of what’s actually driving deaths,” Vakharia said. “While fentanyl is an opioid and it’s contributing to a large majority of overdose deaths, cocaine and methamphetamine are involved in more overdoses nationally now compared to prescription opioids and heroin. And those lines flipped.”

Adriana is a reporter and editor covering politics and health care policy for Yahoo Finance. Follow her on Twitter @adrianambells.

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