Pandemic Casts Shadow Over Thriving Epidemic

Summer 2020 has proven to be a deadly season after social distancing restrictions were eased in May. As of July 26, 2020 the United States is leading the world with over 4.1 million confirmed coronavirus cases and 145,982 deaths. While America is fighting the war against COVID-19, a familiar enemy has resurrected in the shadows. The opioid epidemic continues to take the lives of neighbors, friends and loved ones with overdose rates increasing significantly since the pandemic began. 

As of last month, 235 people died from drug overdose in Cuyahoga County and 191 overdose related deaths were reported in Franklin County between January and March. According to The Washington Post, the United States witnessed a 42% increase in drug overdose cases in May. Although not all of the cases were fatal, the data signifies a change in substance abuse behavior that treatment facilities and law enforcement officers must consider. 

What is Addiction? 

“Addiction is a chronic brain disorder, and a medical disease. Addiction is characterized by compulsive harmful behaviors that are continued, despite negative consequences,” said Dr. Martina Moore of Moore Counseling and Mediation Services. “Many addictive substances release the same chemicals in the brain that are associated with the feelings of pleasure, such as sex and eating our favorite food,” Dr. Moore adds.

Johni Fiber, the Director of Clinical Services at Highland Springs Hospital described addiction as “this ritualistic comfort seeking behavior. It’s just that some people go and seek comfort in a way that has a lot of negative consequences,” said Fiber. 

The unpredictability of COVID-19 has increased stress levels. According to the Center of Disease Control and Prevention, stress can worsen the effects of chronic health conditions and mental illnesses. 

“This pandemic is obviously very stressful. People are struggling on multiple levels, they’re struggling with isolation, they’re struggling with financial issues, they’re struggling with fear and anxiety about becoming sick or loved ones getting sick. Our world operates differently and we can’t do the things that we usually do. Change causes stress and whenever there is stress present, someone with an addiction is more at risk of relapse,” explained Johni Fiber, the Director of Clinical Services at Highland Springs Hospital. 

A common misconception about substance abuse is that the decision is voluntary. But as time passes and occasional drug use continues, the brain begins to change. Research has revealed that addiction can cause physical and physiological dependence. Although both are not mutually exclusive, the human body becomes dependent on the substance, making it difficult to function without it.

“When you have substance use disorder, it’s really a chronic brain disorder that feeds off the reward system in your brain. It is so powerful! People don’t believe it, that it causes changes in the brain and takes you over.” 

Fentanyl: The Silent Killer 

   

“When the state shut down, tolerance decreased and people were at a much higher risk of overdosing and dying. When they disrupted the illicit drug supply because of COVID-19, many people were using anything they could get their hands on, including fentanyl,” stated Dr. Leslie Koblentz, the chief clinical officer for the ADAMHS Board of Cuyahoga County. 

Fentanyl is a synthetic opioid that is 50 to 100 times more potent than morphine. It is medically permissible to use fentanyl for severe pain, such as advanced cancer pain. But as of recently the synthetic drug has found its way in heroin and cocaine. 

Clinical Director Johni Fiber analyzed the fentanyl crisis as a supply and demand problem. “People who are selling these substances begin to add it to their drugs to provide a stronger high for substance users. So the problem is nobody really knows what’s in their substances, which leads to accidental overdose,” Fiber described. 

According to the National Institute on Alcohol Abuse and Alcoholism, tolerance is how a person’s body adapts to a drug after prolonged use. Individuals with a higher tolerance level will take more of a particular substance to achieve the same feeling of pleasure. Decreased tolerance occurs for people who have been sober for a while and their body learns to adjust without the substance present. 

At the start of the COVID-19 pandemic, U.S. Customs and Border Protection increased their efforts to lock down the country and seize illegal drugs. From March to May there was a 57% spike in drug seizures compared to the same time last year. With a shortage of drugs available experts noticed two outcomes; substances were being cut and filled with lethal ingredients such as fentanyl and the second being a shift in drug tolerance for opioid users. Both behaviors have been attributed to the rise in accidental overdose cases in Ohio and nationally. 

Maintaining Sobriety 

“I’ve lost a few friends during the pandemic because of heroin overdose,” said Laurie Dever. “It’s just very sad. Everyday you hear that something is killing these people. I keep hearing that there is fentanyl in everything now and that scares me so much. If I don’t continue to do the next right thing, I'm going to go backwards and I don’t ever want to go backwards,” she emphasized.  

Laurie, now eight months sober, battled with her crack cocaine addiction for years. Raised in North Ridgeville Laurie Beavers recalls having a normal childhood.

“My parents were nondrinkers and very devoted to the family. We didn’t really have the family dysfunction that’s often talked about and I grew up with horses,” Dever said. There were two traumatic events that Laurie recognized as influential, which included her older sister leaving home unexpectedly and the death of Laurie’s horse. 

Laurie experimented with different drugs while in college but it wasn’t until 2006 that she was reintroduced to crack cocaine and the addiction completely took over her life. Dever sought the help of family and attended intensive outpatient treatment at Glenbeigh Outpatient Center. After completing her program, Dever was “dry sober” from 2007-2014. Dry sober can be described as not using any drugs or alcohol but still feeling unwell physically and mentally. 

“I met my daughter’s father, who was a regular smoker and I became a regular crack smoker. I was working a phlebotomy job, I had money, I had a car and I had everything. But once I met him, he allowed me to go another way,” explained Dever. 

Laurie continued to battle with her addiction until 2019 when she was hospitalized due to a car accident. “My sobriety date is November 26, 2019,” she said excitedly. “Two days prior my drug dealer and I were going out of town and the car flipped over. I ended up in the hospital to make sure everything was alright. That really was an eye opener and I said that something needed to change.”  

Laurie Dever currently resides in a sobriety home in Richmond Heights where she has the option to stay indefinitely. With the help of her sober sisters, group therapy, a strict daily regimen and sponsor, she is more focused than ever. When asked about the challenges of sobriety during the coronavirus pandemic, Laurie answered that her only struggle was not being able to physically see her children during the shut down. 

“As long as I keep talking about my feelings and expressing how all of this is making me feeI, things have been getting better,” Laurie said. Treatment looks a little different now with the introduction of video conference calling but for the Alcohol and Narcotic Anonymous meetings that have opened up, masks are required and social distancing measures applied. 

Dever encourages those who are currently in recovery to communicate and share their feelings with others. To change their friends, environment and connect with a higher power. Laurie hopes that in the future she will have custody of her two children, working a phlebotomy job while living in a house. “I’m always going to have this disease. The disease of addiction is a daily battle. I only have today and God willing, I will still be sober,” she expressed. 

Where is Hope? 

Addiction is a treatable illness yet people are still dying from narcotic drug overdose. Dr. Nathan Gehlert, the Associate Professor and Department Chair for the Clinical Mental Health Counseling program at John Carroll University believes that in order to find solutions for today, we must study the behaviors of the past. 

“In 2010, the CDC noticed clearly in data that U.S. life expectancy was decreasing for the first time. That is a really worrisome trend for a country and it was strongly correlated with the increase in opioid prescriptions, use and misuse. So, it took a number of years but in 2016 the CDC only focused on three aspects of the trend by limiting opioid access, the amount of opioids prescribed and limiting the amount of time patients are taking the opioid. Unfortunately, what we’ve seen in the last four years is that this hasn’t resulted in a decline in misuse of opioids or impacted the decreasing U.S. life span,” Gehlert exhorted. 

U.S. life expectancy continues to struggle as rates decreased by 0.1% from 2016 to 2017. According to the National Institute of on Drug Abuse, in 2018 67,300 Americans died from drug induced overdose. Out of the 67,300 deaths 31,335 were caused by synthetic narcotics such as fentanyl. Although we’ve seen a decline in drug overdose, deaths involving synthetic narcotics are still rising. 

“What this means is that what we’re doing (as a society) is not working. We’ve gotten better at treatment over the last decade but we haven’t gotten better at all with prevention,” Gehlert continued. Addiction is a disease that thrives from isolation. In 2017, it was published in the Harvard Health Blog that according to scientists and clinicians, addiction is triggered by discomfort. To cope with physical or emotional discomfort, people engage in potentially addictive behaviors.

The next step in potentially solving the opioid epidemic is to research and invest in addiction prevention methods. Dr. Gehlert suggests education initiatives such as emotional resilience, stress reduction, health education and increasing human connection. Research suggests that human adolescence is a prime development stage to incorporate strategic addiction prevention.