Opioid deaths surge as pandemic spreads across U.S.

How exactly is COVID-19 affecting the opioid crisis?

Fentanyl warning label

Bags of heroin, some laced with fentanyl, are displayed before a press conference regarding a major drug bust, at the office of the New York Attorney General, September 23, 2016 in New York City.

(Photo by Drew Angerer/Getty Images)
  • Drug overdose deaths hit a record high in 2019, according to recent data from the Centers for Disease Control and Prevention.
  • The pandemic seems to be worsening the opioid crisis, possibly due to users' reluctance to visit hospitals, mental health problems, and disruptions to drug supply.
  • Still, it's too early to know exactly how the pandemic is transforming drug use in the U.S.


Opioid deaths in the U.S. are soaring amid the COVID-19 pandemic. Health experts say the overdose crisis is worsening as states with dwindling revenues cut funding for treatment programs.

At least 35 states have reported increases in fatal opioid overdoses this year, according to a recent report from STAT. Nationally, relapse rates and use of new synthetic opioids are on the rise, while drug overdose deaths have risen by an average of 13 percent, according to data obtained by The New York Times. In Chicago, officials have already logged 773 opioid deaths between January 1 and July 13. That's up from 605 during the same period last year.

Alarmingly, the opioid crisis was already worsening before the COVID-19 pandemic. In 2019, the U.S. logged nearly 71,000 drug overdose deaths, more than half of which were attributed to opioids, according to preliminary data released Wednesday by the US Centers for Disease Control and Prevention's National Center for Health Statistics. That's about a 5 percent increase from 2018.

Facing falling revenues due to economic turmoil caused by the pandemic, some states are cutting funding for treatment programs and other addiction-related services. STAT reports, for example, that Georgia, New Jersey, Florida and Utah have already cut millions in funding for future drug treatment programs.

Meanwhile, nearly half of syringe service programs in the U.S. have reported closures or other service disruptions since the pandemic began, according to a survey from the North American Syringe Exchange Network.

chart showing drug overdose death rates involving opioids from 1999 to 2018

CDC

"Policymakers are faced with impossible choices," Jodi Manz, project director for chronic and vulnerable populations at the National Academy for State Health Policy, told STAT. "Leaders are being put in situations where they thought they had really significant revenue from the prior year, and just overnight were faced with a very, very different revenue situation."

The side effects of the pandemic may be worsening the problem, too. For example, stay-at-home orders may put Americans at higher risk of using or relapsing drugs, especially when you consider widespread job losses.

"Social isolation has always been a huge component of drug overdose risk," Traci Green, an epidemiologist at Brown University who studies drug addiction, told The New York Times. "So much of what we've been trying to do has been completely unraveled."

But perhaps more concerning amid the pandemic is drug users' reluctance to visit hospitals. In Illinois, for example, emergency rooms across Cook County Health have reported a surge in opioid deaths, but no corresponding surge in emergency-room visits for opioids.

A deposit box for used hypodermic needles

A deposit box for used hypodermic needles stands in a park in the South Bronx on March 13, 2019 in New York City.

Photo by Spencer Platt/Getty Images)

"This is extremely alarming because an opioid overdose patient will likely live if given naloxone in the ambulance and opioid overdose deaths in the emergency department are a rare event," Dr. Steve Aks, division chair of emergency medicine and toxicology at Cook County Health, told ABC 7 Chicago.

"Due to the pandemic, we asked individuals to stay at home unless it is an emergency — an overdose is an emergency."

Another reason the pandemic may be exacerbating the opioid crisis is that it's disrupting regular habits and drug supply. For example, cash-strapped users may be taking unusually long breaks between taking opioids, which would lower their tolerance. This would also increase their risk for overdose.

Still, it's still too early to determine exactly how the pandemic is affecting the opioid crisis in the United States.

"Nobody has hard data yet; they just don't," Patrick Trainor, a spokesman for the Drug Enforcement Administration in Philadelphia, told The New York Times.

What the addiction treatment community does know, however, are some basic steps that help to save lives, as journalist Maia Szalavitz told Big Think in 2019:

"I think in order to help deal with opioid addiction, for one we need to have naloxone in every first aid kit. There is absolutely no reason why people who are surrounded by other people should ever die of an overdose. If you are injecting and other people are there—which is the case 50 to 60 percent of the time—naloxone should be there.

"And this is not going to encourage more drug use, because it's an awful experience to get awakened with naloxone, but it will save lives. And so that's one way we can turn the tide on this.

"The other way that I think we can turn the tide on opioid addiction is we really need to provide greater access to drugs like methadone and Suboxone, which is also called buprenorphine."

A landslide is imminent and so is its tsunami

An open letter predicts that a massive wall of rock is about to plunge into Barry Arm Fjord in Alaska.

Image source: Christian Zimmerman/USGS/Big Think
Surprising Science
  • A remote area visited by tourists and cruises, and home to fishing villages, is about to be visited by a devastating tsunami.
  • A wall of rock exposed by a receding glacier is about crash into the waters below.
  • Glaciers hold such areas together — and when they're gone, bad stuff can be left behind.

The Barry Glacier gives its name to Alaska's Barry Arm Fjord, and a new open letter forecasts trouble ahead.

Thanks to global warming, the glacier has been retreating, so far removing two-thirds of its support for a steep mile-long slope, or scarp, containing perhaps 500 million cubic meters of material. (Think the Hoover Dam times several hundred.) The slope has been moving slowly since 1957, but scientists say it's become an avalanche waiting to happen, maybe within the next year, and likely within 20. When it does come crashing down into the fjord, it could set in motion a frightening tsunami overwhelming the fjord's normally peaceful waters .

"It could happen anytime, but the risk just goes way up as this glacier recedes," says hydrologist Anna Liljedahl of Woods Hole, one of the signatories to the letter.

The Barry Arm Fjord

Camping on the fjord's Black Sand Beach

Image source: Matt Zimmerman

The Barry Arm Fjord is a stretch of water between the Harriman Fjord and the Port Wills Fjord, located at the northwest corner of the well-known Prince William Sound. It's a beautiful area, home to a few hundred people supporting the local fishing industry, and it's also a popular destination for tourists — its Black Sand Beach is one of Alaska's most scenic — and cruise ships.

Not Alaska’s first watery rodeo, but likely the biggest

Image source: whrc.org

There have been at least two similar events in the state's recent history, though not on such a massive scale. On July 9, 1958, an earthquake nearby caused 40 million cubic yards of rock to suddenly slide 2,000 feet down into Lituya Bay, producing a tsunami whose peak waves reportedly reached 1,720 feet in height. By the time the wall of water reached the mouth of the bay, it was still 75 feet high. At Taan Fjord in 2015, a landslide caused a tsunami that crested at 600 feet. Both of these events thankfully occurred in sparsely populated areas, so few fatalities occurred.

The Barry Arm event will be larger than either of these by far.

"This is an enormous slope — the mass that could fail weighs over a billion tonnes," said geologist Dave Petley, speaking to Earther. "The internal structure of that rock mass, which will determine whether it collapses, is very complex. At the moment we don't know enough about it to be able to forecast its future behavior."

Outside of Alaska, on the west coast of Greenland, a landslide-produced tsunami towered 300 feet high, obliterating a fishing village in its path.

What the letter predicts for Barry Arm Fjord

Moving slowly at first...

Image source: whrc.org

"The effects would be especially severe near where the landslide enters the water at the head of Barry Arm. Additionally, areas of shallow water, or low-lying land near the shore, would be in danger even further from the source. A minor failure may not produce significant impacts beyond the inner parts of the fiord, while a complete failure could be destructive throughout Barry Arm, Harriman Fiord, and parts of Port Wells. Our initial results show complex impacts further from the landslide than Barry Arm, with over 30 foot waves in some distant bays, including Whittier."

The discovery of the impeding landslide began with an observation by the sister of geologist Hig Higman of Ground Truth, an organization in Seldovia, Alaska. Artist Valisa Higman was vacationing in the area and sent her brother some photos of worrying fractures she noticed in the slope, taken while she was on a boat cruising the fjord.

Higman confirmed his sister's hunch via available satellite imagery and, digging deeper, found that between 2009 and 2015 the slope had moved 600 feet downhill, leaving a prominent scar.

Ohio State's Chunli Dai unearthed a connection between the movement and the receding of the Barry Glacier. Comparison of the Barry Arm slope with other similar areas, combined with computer modeling of the possible resulting tsunamis, led to the publication of the group's letter.

While the full group of signatories from 14 organizations and institutions has only been working on the situation for a month, the implications were immediately clear. The signers include experts from Ohio State University, the University of Southern California, and the Anchorage and Fairbanks campuses of the University of Alaska.

Once informed of the open letter's contents, the Alaska's Department of Natural Resources immediately released a warning that "an increasingly likely landslide could generate a wave with devastating effects on fishermen and recreationalists."

How do you prepare for something like this?

Image source: whrc.org

The obvious question is what can be done to prepare for the landslide and tsunami? For one thing, there's more to understand about the upcoming event, and the researchers lay out their plan in the letter:

"To inform and refine hazard mitigation efforts, we would like to pursue several lines of investigation: Detect changes in the slope that might forewarn of a landslide, better understand what could trigger a landslide, and refine tsunami model projections. By mapping the landslide and nearby terrain, both above and below sea level, we can more accurately determine the basic physical dimensions of the landslide. This can be paired with GPS and seismic measurements made over time to see how the slope responds to changes in the glacier and to events like rainstorms and earthquakes. Field and satellite data can support near-real time hazard monitoring, while computer models of landslide and tsunami scenarios can help identify specific places that are most at risk."

In the letter, the authors reached out to those living in and visiting the area, asking, "What specific questions are most important to you?" and "What could be done to reduce the danger to people who want to visit or work in Barry Arm?" They also invited locals to let them know about any changes, including even small rock-falls and landslides.

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