Overdose deaths were declining. The trend reversed during the pandemic

Nov. 27—Before Covid-19 overshadowed everything, the biggest public health crisis facing local, state and federal governments was the opioid drug epidemic. At one time, it was considered the biggest health crisis of a generation.

But overdoses haven't lessened just because the coronavirus pandemic worsened. It's the opposite; local and national opioid-related deaths have been rising.

Erie County, which had a three-year decline in opioid deaths, saw an upward surge in 2020. And this year, the county appears on pace to meet or exceed 2016's record number of overdose deaths, when 301 county residents lost their lives to drug addiction.

"The pandemic took over and sucked the air out of every room, but here we are now," said Anne Constantino, president and CEO of Horizon Health Services. "We have a crisis of addiction. We also have a crisis of mental health."

As of last week, the county Medical Examiner's Office has reported 274 suspected and confirmed cases of opioid-related drug deaths. That's with six weeks left in 2021.

Meanwhile, the U.S. Centers for Disease Control and Prevention reported that the country has exceeded more than 100,000 overdose deaths for the 12-month period ending in April. That represents a 29% increase from the same period last year.

And similar to Erie County, the rate of deaths began rising steadily in 2020 after stabilizing over the previous two years.

County officials have blamed fentanyl and fentanyl derivatives for many of the opioid-related deaths. The synthetic drug is mixed in with street heroin and, more recently, stimulants like cocaine and methamphetamine. In recent years, fentanyl has been pressed into pill form to resemble legitimate, prescription medication, giving people who buy drugs on the street or the dark web a false sense of security about the safety of the drugs they take, said Cheryll Moore, director of the county's Opioid Task Force.

"There is fentanyl in everything," Moore said, adding that dozens of synthetic fentanyl derivatives lacing opioid drugs are available.

Last year, social isolation and limited access to drug treatment and Narcan were blamed for contributing to the increase in deaths, with more people not getting support or help from family and friends, using drugs alone and dying before help could arrive.

But Dr. Joshua Lynch, a UBMD emergency medicine physician, said shortages in drug treatment staffing and counseling have also played a role this year.

"That's a real problem that I don't think any of us anticipated a year ago," said Lynch, medical director of NY Matters, which links emergency room patients with short-term addiction medication and follow-up treatment with drug treatment programs. "It can't be understated that substance abuse treatment and mental health treatment is incredibly hard to get on a regular day."

Drug treatment advocates said that rescue medication like Narcan masks the drug and alcohol abuse in the community. And with fentanyl being cut into so many different types of street drugs, it's more difficult to keep people safe and healthy.

"We just have a really sad situation here," said Emma Fabian, associate vice president of Evergreen Health Services, which focuses on harm-reduction services for those who are not ready yet ready to end their addiction.

Local advocates have said the lack of progress in treating people with drug addiction has become more frustrating. It has gone from being a high-visibility issues attracting resources and public attention to a back-burner program that rarely gets discussed in the public arena.

Constantino added that the less attention this issue receives, and the more people are able to hide their problems from family and friends, the greater the likelihood that overdose cases will continue to rise.

"When we talk about the real problem, which is addiction and suffering, that I have not seen change at all," she said. "If the same amount of people were suffering, but because of increased isolation and connection — not only to drug treatment programs but to others who could intervene — of course that would raise the deaths."

Constantino said that with bail and criminal justice changes, people who would normally have enrolled in drug treatment to avoid jail time are now bypassing drug treatment programs because they don't face the threat of incarceration. That means fewer people seeking treatment at Horizon facilities, but it also means more treatment spots remain available.

The good news, advocates said, is that if any community can overcome the rise in overdose deaths, it's Erie County, which is relatively rich in drug treatment programs and resources. It also has the expertise to address the problem and advocate for more assistance. Moore said the county is working with other advocates and providers to ramp up outreach and messaging to those who need help.

Lynch also said that local hospitals have expanded telemedicine options so that people who need help with drug addiction and don't want to wait hours in the emergency room can visit virtually with emergency room staff. Both Kaleida Health and Erie County Medical Center have telehealth personnel who can assess patients virtually and have the certification to prescribe a short-term course of Suboxone to prevent withdrawal symptoms, regardless of an individual's insurance status.

These telehealth services are available at mattersnetwork.org/community-resources. In addition Erie County supports a Crisis Services Addiction Hotline 24 hours a day to assist people with information and access to treatment — 716-831-7007. Individuals can also text for the emergency rescue drug Narcan at 716-225-5473.

With the holiday season here, advocates say now is the best time reconnect with struggling family members and friends, and point them toward help.

"Now is the time to reach out to family members, not push them away," Fabian said. "People really need support right now."

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