The COVID-19 pandemic has brought dozens of issues to light, but it also exacerbated a growing problem in the U.S. and in Arizona.
The Centers for Disease Control and Prevention released its annual report on drug overdose deaths in 2020, and the data, perhaps unsurprisingly, set records. The U.S. recorded a high of 93,000 deaths last year, a 29% increase over the 72,000 reported the year before. The 21,000 increase is the biggest jump since the count rose by 11,000 in 2016.
In Arizona, where the state’s proximity to the border provides additional access to illegal substances, approximately 2,644 drug overdose deaths were counted by December 2020, up from 1,981 in Dec. 2019 — a 33.5% increase.
Taylor Zeringue, business development specialist for the Valley-based Buena Vista Health and Recovery Centers, said he’s seen a mix of first-time callers and individuals who relapsed seeking substance abuse treatment throughout the pandemic.
“It’s definitely a mixture of things,” he said. “We definitely see a lot of people who have been through our program before and have had to come back, but I think most of the business that we see is a lot of people coming in for the first time into treatment. I think that’s the majority of it.”
Zeringue said fentanyl is the biggest issue facing addicts and treatment centers right now.
Fentanyl was involved in more than 60% of the overdose deaths during 2020, according to the CDC’s data.
“I’m in recovery myself and so I came from a place where a couple years ago you didn’t see that, ever,” he said of the deadly synthetic pills. “The majority of people that call us with an opiate-use disorder are calling us about fentanyl, and the age of those individuals is younger than probably ever before, and usually with no other co-occurring substances.”
To help combat this issue, Buena Vista offers both in-patient and outpatient treatment services at its two Valley campuses — a 40-bed residential and detox center in Chandler and a 14-bed detox campus in Cave Creek — along with one in Tucson. Most people seeking treatment stay in the program for an average of 30 days, but Zeringue and his colleague, Buena Vista’s Vice President of Sales Randy Clunan, say three to six months are recommended for a full recovery.
“The more treatment, the better,” said Clunan.
Clunan said the combination of fentanyl’s increased hold on the market and the isolation brought by the pandemic made 2020 a difficult year for the industry.
While Maricopa County does not yet have 2020 data, the county counted 1,078 drug overdose deaths during 2019, which was largely attributed to opioids, methamphetamines and alcohol.
“That trend was already there, but the pandemic certainly didn’t help anything,” he said. “We saw it even through the COVID restrictions and everything. I mean we still saw our admissions and our call center, you know the calls coming in, measuring those each month continuing to increase. So we know that folks are struggling obviously through the pandemic.”
Zeringue and Clunan agreed that, while progress has been made in Arizona and the country as a whole on the mental health front, more could be done to help struggling addicts pay for the treatment they desperately need. Without a continuum of care, people are much more likely to relapse.
“So we see a lot of clients that would come to our program that readmit,” said Clunan, who is himself in recovery. “They go out and basically detox, their insurance only pays a certain amount a day, and they go back out on the street really with not much of a toolbox. The shorter the treatment stay, the chances for relapse continue to go up.”
Zeringue, who went to a treatment center to get sober, said “that’s what you have to do for people struggling with substance abuse and alcoholism, they have to go to treatment. That’s the solution.”
Dr. Jasleen Chhatwal, chief medical officer for Sierra Tucson, said the majority of patients she has seen seeking treatment during the past year are doing so after a relapse.
“We have noticed more individuals who, you know, had sobriety for a good amount of time,” she said. “They found it harder to maintain sobriety or relapsed and sometimes relapsed in a fairly dramatic way. I think alcohol has been the most dramatic when we’re noticing that. But we have seen a lot of individuals also with opioid-use disorder, cannabis-use disorder, and many other substances.”
She said when most of the world was shut down, along with in-person support groups, liquor stores remained open as essential businesses, and many stores shifted their alcohol sales to delivery, so gaining access was easy.
Dr. Chhatwal is also concerned by the “increased potency” of opiates finding their way onto the streets, particularly fentanyl either in pill form or laced into other drugs, so life-saving measures don’t always work to combat their effects.
“Over the last few years we’ve started seeing such a surge of fentanyl, which is 100 times stronger or more potent, and even with medication that’s usually used to reverse opiate overdoses, which is called naloxone, the naloxone is just not able to revert the effect,” she said. “We’re trying to even educate our patients that no matter what you’re buying off the street, you just have to know that more than likely it’s laced with fentanyl.”
Chhatwal said much of last year’s increased overdose deaths can be attributed to the isolation of quarantine, and the industry remains concerned about people falling through the cracks.
“Last year made that so much more prevalent, where we were quarantined, not really able to reach out to our usual support,” she said. “We did notice that people who already were struggling with emotional or mental health issues, or having substance use disorders struggled even more because for those individuals usually having some form of community or a place to connect is really important to maintain wellness.”