The COVID-19 pandemic has dominated the news since last spring, pushing aside America’s other epidemic — the opioid epidemic — which has only gotten worse in the intervening months.
People who work on the front lines of the opioid epidemic on Cape Cod say isolation caused by COVID-19 lockdowns and social distancing protocols that limit access to 12-step and other meetings are part of what’s driving the increase.
Susan Kinnane of Eastham lost their son Danny Vigliano to an overdose in August. The 35-year-old, whose struggle she said was made worse by the isolation, died alone on the floor of a Brockton MBTA station. Toxicology reports showed ethanol and fentanyl in his system.
According to the Center for Drug Enforcement and Policy at the University of Baltimore, the increase in opioid-related overdoses across the county is substantial. The center runs the only program that collects national data on fatal and nonfatal overdoses.
The Overdose Detection Mapping Application Program (ODMAP) collects real-time overdose data from 49 states, including Massachusetts, which has participating agencies in all counties except Dukes County on Martha’s Vineyard.
In Barnstable County, participants include the Massachusetts State Police and American Medical Response, a medical transportation company that provides emergency response.
More than 40 states, including Massachusetts, that participate in reporting overdose data have reported increases in opioid-related deaths since the beginning of the COVID-19 pandemic.
Falmouth overdoses rise 20%
When pandemic lockdowns began, and social distancing protocols were instituted, 61% of ODMAP-participating counties reported an increase in overdoses. From March 19 to May 19, the data showed a 17.59% increase over the previous year.
A similar trend can be seen in Falmouth. The town reported a 20% increase in overdoses from 2019 to 2020. From March 2019 to December 2019 there were 100 overdoses, compared with 120 overdoses during the same timeframe in 2020.
The number of fatal overdoses remained stable, bucking the national trend. In 2019 there were 11 fatal overdoses. In 2020 there were 10, according to figures provided by Falmouth police Lt. Douglas DeCosta.
But there are big gaps in data collection and reporting methods.
The Massachusetts Department of Public Health keeps track of opioid-related overdose deaths, but there is often a lag in the reporting of that data. Numbers for 2019 is still not complete, but the estimated overdose deaths are projected to decline compared to 2018.
The ODMAP numbers are meant to give up-to-date numbers on fatal and nonfatal overdoses. They are meant to provide real-time numbers, including the locations of overdose spikes. Those spike alerts can prepare emergency responders and hospitals to deal with bad batches of drugs, and help communities to roll out resources to minimize fatalities.
Many police departments on the Cape have to rely on anecdotal evidence of what’s going on as far as overdoses are concerned.
Barnstable Police Department Lt. Michael Riley hasn’t noticed a significant increase or decrease in overdoses since COVID-19 hit, but he said the battle against opioids is the same battle his officers have been fighting for years.
Detecting overdose hotspots
A countywide reporting system being started by the Cape and Islands District Attorney’s office will help, Riley said. The critical incident management system is a software program whose goal is to manage post-overdose cases in Barnstable County.
The project will help police departments document overdose incidents and prompt outreach to the overdose victim and his or her family after the incident. The information will help direct services to those individuals who are at a higher risk of overdosing again. Police and social service agencies that provide substance abuse prevention and treatment services will be able to follow up with individuals after the overdose event.
A majority of Cape Cod police departments have started using the system, according to an email from District Attorney Community Coordinator Tara Miltimore. But it is still in its infancy stages.
Falmouth police and representatives of Gosnold Treatment Center already check on victims of recent overdoses and offer treatment services. Gosnold staff members try to find available beds in a rehabilitation unit when it’s called for.
But COVID-19 has made that a more difficult task.
Rehab beds full
Gosnold has seen an uptick in patients with dual diagnoses, those with addiction and mental health illnesses. It’s not surprising considering the stress people are under due to COVID-19, according to CEO Richard Curcuru.
“We’ve never seen numbers so high needing treatment,” he said. “But with COVID, we’re limited as to what we can do.”
Curcuru cited a 20% to 25% increase in call volume. And though the center has what he calls a “robust” partial hospital treatment program treating patients with dual diagnoses, it has only 50 beds.
Still, their partnership with most police departments on the Cape has been successful. During post-overdose visits, they’ve been able to convince people to continue with some kind of treatment in 70% of the cases, Curcuru said.
What needs to be acknowledged is that addiction is a brain disorder, not a moral failing, Curcuru said.
A large number of people with addiction issues have a co-occurring mental illness.
“We know that’s a precipitant to why people start drinking and using,” he said. “You need specialized treatment. You need an organization that can treat both addiction and mental illness together.”
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