Before the pandemic, fatal drug overdoses in Virginia already were breaking records.
As the deadly drug fentanyl often got mixed in with others, users sometimes unknowingly ingested the potent blend and died. Officials in the commonwealth received millions in funding to combat the problem and were making some progress.
But when the coronavirus hit — as with everything it touched — the problem got much worse.
As 2020 closes, it’s proving to be the worst year — by far — for drug deaths in Virginia, said Rosie Hobron, statewide forensic epidemiologist with the Virginia Department of Health’s Office of the Chief Medical Examiner.
For about seven years she’s monitored the numbers, compiling reports about unnatural deaths in the state. She’s never seen anything like this.
As of October, in her most recent report, Hobron estimated there will be 2,053 deaths from drugs in 2020 — most of them opioids, but also cocaine, benzodiazepines, meth and others. The state has never recorded more than 1,626 in a single year.
But she’s worried now that will be a “conservative estimate.”
“No part of the state has been unaffected by this. It’s all over,” Hobron said. “These are real people, not just numbers, and that’s the hardest part.”
In the first quarter of the year, 451 people died of overdoses. In the second quarter that rose to 634. By June, Virginia had already surpassed the total from 2015.
By year’s end, Hobron’s estimate would put the commonwealth more than 420 deaths over last year — which was a record at that time.
Hobron said she’s already received word of 490 fatal drug overdoses for the third quarter, with another 300 cases still open. (The numbers lag a few months awaiting toxicology analysis.)
In the seven cities of Hampton Roads, a total of 203 people had died of drug overdoses by June, 180 of them opioid-related. That’s compared to 303 total in 2019. Norfolk had the most, at 46.
Richelle Burney, substance use disorder program manager for Norfolk-based The Up Center, said the nonprofit has seen a “drastic” increase in calls on the issue. More people are reporting relapses, especially.
“Folks that may have been in short-term recovery or long-term recovery reported they have used again since the pandemic,” Burney said. “We’ve had people struggling with life problems in general, and the pandemic has of course worsened (those).”
Some clients lost their jobs or had hours reduced, she said. A few have lost loved ones to the virus.
Others have reported feeling more isolated, which has led to new or worsening mental health issues at the same time that health care providers are inundated with COVID-19. There are often longer wait times for refilling prescriptions.
Most common is the gap the pandemic has left for the in-person, human connection that is so vital to recovery.
Many of those struggling in Hampton Roads either don’t have the appropriate technology or internet connection to access virtual services, or have struggled to adapt to support groups or treatment through those methods. The Up Center is offering audio calls and in-person accommodations upon appointment.
“The reality of it is that people who had created a routine or schedule for themselves, that’s been disrupted,” Burney said. “Substance use is one way some people cope with that.”
Statewide, the increase started in earnest when restrictions came down in response to the COVID-19 threat.
“As soon as the pandemic hit and we took actions for isolation and containment, a lot of the group support that is imperative for people staying healthy were unable to continue,” said Michael Zohab, state opioid response grant manager for the Department of Behavioral Health and Developmental Services.
On top of that, drug users who previously tried to at least do so around others, with life-saving backstops such as naloxone on hand, were more likely to be going it alone.
“The safeguard of having someone there to dial 911 is not as prevalent,” Zohab said.
To combat the surge, he said state officials have invested heavily in telehealth services and are trying new ways of reaching people, such as a mobile health unit on the rural Eastern Shore that brings providers directly to the population.
It’s not as simple as a vaccine bringing the pandemic to a close. Relapse into addiction, or a stronger addiction, has lasting consequences.
“The increase didn’t happen overnight and it’s not going to go away overnight,” Zohab said, adding he’s concerned the state’s surge in alcohol sales will also lead to problems.
Burney said it’s heart-wrenching to see the statewide numbers. Day to day, what’s impacted her the most is the inability to offer a hug to clients who are emotional and struggling.
“I like people to know I’m here for them,” she said. “People think once we have a vaccine in place … we won’t be dealing with this. But I think we’ll be dealing with the long-term effects of this for a long time to come.”
Those in need of services can reach The Up Center’s intake coordinator at 757-965-8622. You can also contact your local community services board, Zohab said, which can either assist directly or point you to available resources, or independent groups such as Alcoholics or Narcotics Anonymous.