Responding to Drug Overdoses in Times of COVID-19

The national attention is understandably focused on the novel coronavirus at the moment, but America’s addiction crisis has not gone away. We just don’t hear about it that much anymore. There is circumstantial evidence that it is getting worse again after the number of drug overdose fatalities saw a slight reduction in 2018—for the first time in decades.

Now, the COVID-19 pandemic creates serious challenges for people with addiction and for first responders trying to help people experiencing a drug overdose. Treating such patients could expose EMS staff to individuals infected with COVID-19.

Dr. Tim Chizmar of the Maryland Institute for Emergency Medical Services Systems told the Washington Times that first responders now have to take extra precautions when administering naloxone (Narcan), a medication that can reverse opioid overdoses. “Any time they are doing anything, any procedure that might generate an aerosol or droplets coming from a patient, we advise them to put on gowns, gloves, N-95 masks, eye protection,” said Chizmar.

A police department in Indiana reportedly suspended the administration of naloxone due to concerns over the possible transmission of the virus to responding officers. Overdose reversals in Lawrence, Indiana are now left to emergency medical services, according to the police chief of the city near Indianapolis. 

The pandemic has disrupted all kinds of efforts to combat the nation's opioid problem. Walk-in clinics and needle exchange programs have been closed. Community support groups are forced to meet virtually.

In New Jersey, the state’s harm reduction centers are cutting back their hours and in-person consultations are becoming trickier, reported public media organization WHYY. Recovery advocates worry that the COVID-19 pandemic may cause other public health emergencies to worsen while nobody’s watching. “It’s sort of intensifying all of the other things that come along with the overdose crisis,” Caitlin O’Neill, director of harm reduction services at the New Jersey Harm Reduction Coalition told WHYY. 

O’Neill said the increased isolation of drug users from their friends and families—whom she calls “the first of the first responders”—means more people may overdose alone. The Harm Reduction Coalition has started to send naloxone to New Jersey residents in the mail. Ohio, a state at the epicenter of the opioid epidemic, has seen increasing demand for its mail-order program since the onset of the pandemic.

The mail delivery of Narcan may not be enough, though. “County coroners, law enforcement, and emergency responders around the country are reporting spikes in overdose calls and deaths—and they're concerned that's connected to COVID-19,” reported CNN’s Harmeet Kaur earlier this month. 

CBS-affiliated television station WIVB reported that drug overdoses have spiked in New York’s Niagara County north of Buffalo. “According to the Niagara County Sheriff’s Office, the number of drug overdose cases from Jan. 1 to April 6 is 35 percent higher than the same time frame in 2019. The spike could be caused by a number of factors, including the adjustment of methadone clinic hours, decreased availability of methadone or other synthetic treatments for opioid abuse, or a heightened sense of anxiety and job loss.”

Jacksonville’s Fire and Rescue Chief Keith Powers reported a 20 percent increase in overdose calls from February to March.

Federal and state data on fatal and non-fatal overdoses for the past few months are not yet available, while coroners and medical examiners are overwhelmed with cases of COVID-19 and may not have the resources to follow up on overdose deaths, the director of the National Institute on Drug Abuse Nora Volkow told CNN. She predicts that some communities will "absolutely" see an uptick in overdoses. And overdose deaths. Because of social distancing, Volkow said, it's possible that some individuals may not have anyone else around to administer the life-saving medication.