DataHaven
(Opinion)—The opioid epidemic is not simply the sum of individual addictions. It is an economic and social phenomenon, and the Covid-19 pandemic has made the fight against it harder.
Twenty years ago, the opioid epidemic began ruining people’s lives with the very substance that was supposed to relieve their pain. Today, the crisis is far from over.
For New Haven, 2019 was the worst year yet with a record 57 drug overdose deaths, of which 50 involved opioids or opiates. Preliminary reports from January to May show that statewide overdose deaths in 2020 surpassed those of 2019 for every month except May. Last month, we saw 21 non-fatal overdoses in New Haven County over the course of 24 hours.
The story of America’s opioid epidemic is intertwined with mass incarceration and disinvestment in Black communities. According to Connecticut’s Office of Policy and Management, in 2016, 52 percent of people who died from an overdose had been incarcerated at some point in their lives. Incarceration creates an environment of risk for opioid-related overdose that persists long after people are released. This includes trauma, suicidality, disruption of relationships, interruptions and barriers to medical care, and social stigma.
The current investment in the criminal justice system is worsening the opioid crisis. As calls to defund police departments and invest in Black communities reach local and state governments, a long-term redistribution of some of these funds toward combating the opioid epidemic is urgently needed.
For opioid drug users, the Covid-19 pandemic adds crisis on top of crisis. Opioid users may be more vulnerable to health complications related to Covid-19 because of compromised respiratory and pulmonary health. Socially, since opioid addiction is a disease of isolation, the social isolation under the pandemic may cause people to relapse and increases the risk of overdose.
Connecticut’s opioid epidemic has become most acute in our city centers, where Covid-19 has also hit hardest.
The pandemic also presents challenges for therapy clinics and harm reduction programs. Governor Lamont’s executive order to expand Medicaid during the outbreak permitted methadone clinics to continue Medicaid services via telehealth. But this shift to online health care reveals another disparity: access to broadband.
Equitable access to health care will remain far from reach without addressing the digital divide in Connecticut. Increasing support to harm reduction programs, such as syringe exchange centers and naloxone providers, will also be crucial to keep the Covid-19 pandemic from undoing the state’s decade-long effort to curb the opioid epidemic.
Since 2012, Connecticut’s opioid epidemic has become most acute in our city centers, where Covid-19 has also hit hardest. The Connecticut Department of Public Health EpiCenter Syndromic Surveillance System releases mid-year data on emergency department visits. These data, which are preliminary and rely on consistent and accurate reporting from facilities, show that the volume of emergency visits for suspected opioid overdoses in New Haven County has risen in 2020 compared to 2019. Prior to 2020, overdose death rates for the city of New Haven have been higher than the statewide average, but lie below the average for all urban core regions.
According to DataHaven’s newly released publication, “Towards Health Equity in Connecticut: The Role of Social Inequality and the Impact of Covid-19”, opioid overdose deaths in urban areas are commonly attributed to illicit drug use and the surge in the presence of fentanyl in the illegal drug supply. So far this year, the share of fentanyl-involved deaths in Connecticut has been higher than in 2019, continuing a trend of increased fentanyl involvement from over the past six years.
The new report also notes that the reasons why people turn to addictive drugs — specifically opiates — are often related to adverse childhood experiences, experiences in the criminal justice system, inadequate health care, family history, and other social and economic factors. For some, seeking treatment for drug misuse is complicated by mistrust of healthcare providers or fear of law enforcement.
The opioid epidemic is not simply the sum of individual addictions. It is an economic and social phenomenon, affecting people all over the state, and the Covid-19 pandemic has made the fight against it harder. Understanding this, and ramping up our treatment and policy response as a result, can save lives.
John Park is a research assistant at DataHaven, a New Haven-based non-profit organization with a 25-year history of public service to Connecticut communities. Its mission is to empower people to create thriving communities by collecting and ensuring access to data on well-being, equity and quality of life. Some of the content for this article is drawn from DataHaven’s new publication on health equity, and data graphics are edited by Camille Seaberry, a senior research associate.