While drug overdose deaths in the United States declined in 2018, the number increased to record levels in 2019,  especially regarding fentanyl, and may be continuing to increase in 2020 as the coronavirus pandemic surges throughout the country. For today’s COVID-19 Report, PERF interviewed police leaders and a public health professional from different part of the United States and Canada about their recent experiences with opioid overdoses.

Key Takeaways

-- Many factors make this a dangerous time for overdoses. The COVID pandemic has resulted in increased stresses on person with Opioid Use Disorder, including social isolation due to lockdown measures, job losses due to the accompanying recession, and real or perceived reductions in treatment services.

-- It appears that the pandemic has caused increases in overdoses and fatalities in some areas.

-- Public health providers are still working to provide services. In some places, services have been altered, such as offering tele-therapy and home delivery of services instead of visits to a clinic. In other places, services have not been altered, but the public may have assumed they were, due to lockdown measures.

-- Drug trafficking activity appears to have been as prevalent, or even more prevalent, during the pandemic.

Portland, Maine Police Chief Frank Clark:

We’ve Had an Increase in Overdoses, Partly Due to COVID

Our lockdown started the third week in March, and initially we did not see an increase in overdoses. But after that first month, it started to tick back up again. We’ve seen more than 200 overdoses in Portland so far this year, which is a little over where we were last year. In the first half of last year we had about 170 overdoses, and in the first half of this year we had about 182.

It’s hard to attribute it directly to COVID, because we also saw about a 25% increase in overdose fatalities from 2018 to 2019. But talking to folks in recovery and their family members, I think COVID has had an impact. There was the stress of the lockdown, and I heard from family members of people who lost their jobs and had relapses. So anecdotally, I would attribute COVID to a portion of the uptick we’ve seen.

There is also less access to some resources, especially in terms of outreach. We have a substance use disorder liaison in the Police Department, and our folks who do that work and our community partners took a step back during the lockdown. They were trying to do teleconference and distance outreach. Our resources are opening back up and becoming more regularly available, so I’m hoping that will push our overdoses back down.

Roanoke County, Virginia Police Chief Howard Hall:

We’ve Had Increases in Overdoses and Drug Trafficking

We’ve seen a pretty significant increase in 2020 vs. 2019 on both fatal and nonfatal overdoses. We have a population of a little over 90,000 in 250 square miles. Through June, we’ve had 53 overdoses, and 7 of those have been fatal. In all of 2019 we had 50 overdoses.

We started to see increases prior to the pandemic, but we saw the biggest spike in March and April.

In Virginia, the lockdown restrictions started to ease with Phase One in the middle to end of May, and we’re now in Phase Three. We saw a couple fewer overdoses in May, and fewer in June. So in the last couple months we seem to be heading back down, and we’re hoping that will be the trend going forward. Based on the timing, it appears that a spike happened right as everything started to lock down.

The primary thing we did when we started to see this was help public health providers in our area publicize that services were still available. Some providers were able to get waivers for some of their requirements so they could provide virtual services. We wanted to make sure that people who needed services knew that they were still available.

From the drug supply side, we did not see any reduction in drug trafficking activity during the pandemic. We decided we were not going to curtail any of our proactive drug trafficking enforcement efforts, so our regional drug unit continued to do their drug investigations. They reported that drug trafficking was occurring at least at the same level it was prior to the lockdown, and in some cases maybe even a bit more. Some of our detectives reported that some of bigger players in our market didn’t seem to be as cautious as they were before.

Vancouver, British Columbia Police Inspector Bill Spearn:

Our Increase in Fatal Overdoses Apparently Was a Result of Users Being Isolated

In 2019, Vancouver had a 38% reduction in the number of overdose deaths, and British Columbia had a 36% reduction. We still lost nearly 1,000 people from overdose deaths, but our numbers were trending down.

Our provincial government declared a provincial health emergency due to the pandemic on March 18. In January, February, and early March we continued to see a reduction in the number of overdose deaths in Vancouver and throughout the province. But almost as soon as the pandemic was declared, I noticed we went back up to almost one overdose death per day.

Unfortunately, we had some pretty bad months. In June we had 52 overdose deaths, which is the worst month we’ve ever had, and 175 in the province of British Columbia.

Once the pandemic was declared, we started looking at our overdoses weekly and tried to figure out what we were seeing. The one thing that jumped out is that we believe 83% of our decedents since the pandemic began were using drugs alone, with no one else around. We passed that information along to our healthcare partners so they can get the word out.

Visits to supervised consumption sites are down since the pandemic was declared, because they’ve had to allow fewer people inside to allow for social distancing. And our drug checking sites were shut down for a while, and we believe that may have had an effect.

Angie Gray, Nurse Director for the Berkeley-Morgan County, West Virginia Board of Health:

We’ve Had to Scramble to Maintain Services, But Our Clients Appreciate It

COVID caused havoc to our harm reduction program. We went down to essential services, because, as the health department, we were also doing all the case investigation and contact tracing for every positive case.

Our harm reduction clinic usually sees about 50 people in 2-3 hours. When we shut down, we started doing home delivery so people wouldn’t be interacting with each other at the clinic. Some people don’t have a home, and we can’t go to some homes because other people there don’t know our participants are using. So we would meet people at some places in town, such as parking lots.

We were concerned that someone might think we were selling drugs, so a member of our drug task force went undercover to protect our harm reduction staff. He would follow us to those areas, park, and if he heard anything come across the radio he could let other law enforcement officers know it was okay.

We did not stop engaging. Some people got the impression that services weren’t available, but we actually picked up new participants during the shutdown.

We offered participants masks and hand sanitizer to help prevent the spread. They were very appreciative and grateful that we thought of them.

Now that we are operating back on site, we have marked X’s on the sidewalk for distancing. We do temperature monitoring and symptom checks. We limit the number of people allowed in our building at a time. And our recovery resource center has decreased in-person interactions, but they’re offering additional tele-therapy visits.

The opposite of addiction is connection, and isolation impacts the psyche. A pandemic causes a lot of stress and anxiety.

We saw a huge increase in alcohol abuse. Our drug-related crimes were down during the lockdown. Our domestic violence calls were way up. Alcohol was more socially accepted, and people who didn’t usually drink were drinking more. 

The PERF Daily COVID-19 Report is part of the Critical Issues in Policing project, supported by the Motorola Solutions Foundation.

PERF also is grateful to the Howard G. Buffett Foundation for supporting PERF’s COVID-19 work.