Overdose deaths spiked nearly 70% in April and May in Oregon, which already has the fourth-highest addiction rate in the country.
The dramatic rise confirmed the fears of advocates and providers that COVID-19 would worsen the addiction crisis in the state.
The Oregon Health Authority data are preliminary, and public health officials say it’s too soon to draw conclusions. But advocates and providers fear the dramatic rise this spring was not an anomaly and that as the pandemic continues, deaths will also rise.
The pandemic has been especially hard on people struggling with addiction, and it has limited their support programs. Told to stay home and keep their distance from others, patients have had less contact with others, including their peers in recovery groups and 12-step programs that help people deal with addictions. Providers had to cut back on in-person and residential services because of social distancing requirements. Many recovery groups offer services online, which helps maintain some contact. Advocates say only meeting online is not enough.
"If you ask anyone in recovery ‘Do you know someone who has lost their recovery during COVID,’ everyone -- everyone -- will raise their hand,” said Mike Marshall, executive director of Oregon Recovers, an advocacy group for people in recovery.
The Oregon Health Authority calculated the increase by comparing deaths this past May and April to the same period in 2019. The data comes from medical examiners and death certificates.
A total of 137 Oregonians died of overdoses this past May and April, state data show. During that two-month period in 2019, 79 people died. That’s an increase of nearly 60 deaths.
Month-to-month deaths have increased this year too. Sixty people died in April and 77 died in May, a 28% increase.
In 2019, 500 people died of opioid overdoses. That’s an average of nearly 42 people a month.
Opioid overdoses have caused many of the deaths in Oregon. In May, opioid-related deaths accounted for nearly 73% of all overdose deaths, the health authority said.
The health authority said fentanyl and heroin are the most common drugs involved in opioid deaths. Fentanyl accounted for nearly 40% of total overdose deaths in May. Oregon continues to see deaths from prescription painkillers as well.
The health authority data also shows an increase in methamphetamine use. Fatalities tied to methamphetamine and amphetamines accounted for more than 40% of all overdose deaths in May.
Health authority officials said it’s too soon to know how much of the spike is directly tied to COVID-19.
“Until more data become available, it is premature to say how much of the spike in overdose deaths is attributable to the COVID-19 pandemic,” Dr. Tom Jeanne, deputy state health officer and deputy state epidemiologist at the Public Health Division, said in a statement. “However, the realization that we will be dealing with COVID-19 for some time, and other stressors related to jobs, school and social isolation, may increase feelings of anxiety and depression, and that can lead to a harmful level of alcohol or other drug use.”
Professionals and people who have experienced the grips of addiction agree. Garrett Fields, 35, of Portland, has been clean for three and a half years after recovering from an addiction to opioids. In his case, the addiction snowballed out of alcoholism. Opioid addiction also can develop quickly within days.
Fields, also a board member of Oregon Mental Health Consumers Association, said the circumstances of the pandemic can drive increased opioid use as people are isolated and depressed, especially during circumstances like a job loss.
“COVID has been around now since March,” Fields said. “That’s months and months of not working, waiting for unemployment, not being social and locked in your house.”
Even at funerals people have to be socially distanced. People cannot hug. They have to grieve in isolation.
This marks a change in the way people have traditionally coped with grief, said Haven Wheelock, program manager of Outside In, a federally qualified health center in Portland that provides health care and behavioral health services to underserved and homeless people.
"I think there's just a lot of grief and a lot of fear in the community and that fear and that grief compounds what folks are already struggling with," Wheelock said. "It's just constant retraumatization for folks, which is really hard and really sad."
The pandemic has also reduced the availability of treatment. In-person recovery groups have suddenly stopped meeting. Social distancing requirements have forced residential and outpatient treatment facilities to reduce capacity, said Heather Jefferis, executive director of the Oregon Council for Behavioral Health. Residential facility capacity is down an average of 30% to 35%, Jefferis said.
Group meetings and other recovery services have moved online along with other health care services. That helps, but doesn’t always adequately substitute for in-person engagement, Jefferis said.
“There’s a ton of telehealth, but what we’re finding is if you’re more in the throes of your addiction, it’s just harder to engage online for folks,” Jefferis said.
The reduction of in-person services has been dramatic. Before the pandemic, The Alano Club of Portland had about 135 support group meetings and classes with 10,000 visitors a month. At peak times, about 300 to 400 people would be in the 10,000-square-foot facility in a given hour, said Brent Canode, the organization’s executive director.
With social distancing requirements, that’s now down to about 70 people in a given hour.
However, classes and groups are now a hybrid with an online connection that allows others to participate virtually. That means that organization is still serving just as many if not more people, Canode said.
"It certainly doesn't replace the connection you get in person, but we're trying our best to get as close to that as possible,” Canode said.
Canode said online services may not be the best substitute for people in the grips of an addiction, but will help those who are in recovery and need to maintain a social connection.
Virtual options will continue after the pandemic, Canode said.
Even without the pandemic, Oregon’s addiction crisis faces challenges. Advocates have repeatedly called for better access to services and adequate funding for the system.
Oregon needs to look at why people don’t succeed -- even when they receive treatment, said Kevin Fitts, an advocate and executive director of the Oregon Mental Health Consumers Association, a small policy group.
"They fail them over and over again and I don't know why that is,” Fitts said.
This story has been corrected. The Oregon Health Authority stated in its press release that overdose deaths from opioids increased by nearly 70%. In fact, drug overdoses overall increased at that level, not just opioids.