Jesse C. Baumgartner – Research Associate, Health Care Coverage and Access & Tracking Health System Performance, The Commonwealth Fund
David C. Radley – Senior Scientist, Tracking Health System Performance, The Commonwealth Fund
Since COVID-19 first started upending day-to-day life for Americans in March 2020, public health officials have been sounding the alarm about a potential surge in drug overdoses.
Overdose deaths rose during the second half of 2019, and experts feared the pandemic would produce conditions that would further increase overdoses and deaths: economic shock, social isolation and increased mental health distress, and disrupted access to addiction support and medications that require face-to-face visits.
Interim reports from government agencies and researchers have suggested these fears were being realized, with provisional data from the Centers for Disease Control and Prevention (CDC) now further supporting these claims.
Overdose Deaths Spiked After Start of the Pandemic, Driven by Synthetic Opioids Like Fentanyl
Note: Synthetic opioid deaths exclude those from methadone. Specific drug-class deaths are not mutually exclusive.
Data: Final 2016–2019 monthly totals: CDC WONDER; Estimated 2020 monthly totals: Calculations based on National Vital Statistics System Provisional Drug Overdose Death Counts, CDC WONDER.
Source: Jesse C. Baumgartner and David C. Radley, “The Spike in Drug Overdose Deaths During the COVID-19 Pandemic and Policy Options to Move Forward,” To the Point (blog), Mar. 25, 2021. https://doi.org/10.26099/gyf5-3z49
The CDC’s National Vital Statistics System (NVSS) provides monthly provisional data on predicted total drug overdose deaths during the preceding 12 months. The most recent data reflect September 2019 through August 2020. During that period, there were 88,295 predicted deaths, a record high that is almost 19,000 more deaths (27%) than the prior 12-month period.
Using these predicted data in combination with final data from 2019, we estimated monthly overdose deaths from January to August 2020. Our estimates show that total overdose deaths spiked to record levels in March 2020 after the pandemic hit. Monthly deaths grew by about 50 percent between February and May to more than 9,000; they were likely still around 8,000 in August. Prior to 2020, U.S. monthly overdose deaths had never risen above 6,300.
Opioid-related deaths drove these increases, specifically synthetic opioids such as fentanyl. Opioids accounted for around 75 percent of all overdose deaths during the early months of the pandemic; around 80 percent of those included synthetic opioids.
CDC recently published an interactive visualization tool with preliminary weekly estimates of overdose deaths. These data suggest that overdose deaths remained elevated well into the fall before declining toward the prepandemic baseline near the start of 2021. The final 2020 total in the United States could exceed 90,000 overdose deaths, compared to 70,630 in 2019. That would not only be the highest annual number on record, but the largest single-year percentage increase in the past 20 years.
Overdose Deaths Increased in Almost Every State During the First Eight Months of 2020
Note: District of Columbia had an estimated increase of 72%; South Dakota had an estimated decrease of –4%.
Data: Jan.–Aug. 2019 final totals: CDC WONDER; Estimated Jan.–Aug. 2020 totals: Calculations based on National Vital Statistics System Provisional Drug Overdose Death Counts, CDC WONDER.
Source: Jesse C. Baumgartner and David C. Radley, “The Spike in Drug Overdose Deaths During the COVID-19 Pandemic and Policy Options to Move Forward,” To the Point (blog), Mar. 25, 2021. https://doi.org/10.26099/gyf5-3z49
We also estimated how many overdose deaths each state experienced during the first eight months of 2020, compared to overdose deaths during the same period of 2019.
Overdose deaths increased in almost every state; 24 states and the District of Columbia had an estimated increase of at least 30 percent, and the overall U.S. total increased by 33 percent.
States like West Virginia and Kentucky have long been at the heart of the opioid epidemic, and that region is still reporting some of the largest proportional increases. Recent research has also highlighted the growing impact of fentanyl and overdose deaths within states farther West. Arizona, California, Colorado, Illinois, Texas, and Washington all experienced increases above 35 percent during the first eight months of 2020; Colorado recently reported record overdose deaths during full year 2020.
President Biden campaigned on a platform to address the opioid crisis through a public health approach that includes expanding funding and resources, reforming the criminal justice system, increasing insurance coverage, and widening access to medication-assisted treatment (MAT) and mental health care. His administration has already faced early pressure to make it easier for providers to prescribe buprenorphine — a key component of MAT — during the pandemic.
One policy tool that can address multiple objectives is Medicaid expansion. Data continue to show the positive impact of expansion on coverage, MAT access, and mortality outcomes for substance-use patients.
By simply expanding Medicaid, nonexpansion states like Florida, Georgia, Tennessee, and South Carolina could access significant federal financing in their push to help an ever-growing number of people in need. These four states all experienced overdose death increases above 30 percent during the first eight months of 2020.
Utilizing Medicaid also decreases the reliance on annual discretionary funding to support siloed treatment programs, which has proven to be unsustainable in the fight to reduce drug overdoses. Policy experts recently argued for restructured financing of substance-use treatment through “mainstream public and private insurance programs” like Medicaid that allow states to reliably “pull” down funding as their needs increase.
But in the absence of further financing reform, federal discretionary funding has quickly increased to meet the growing crisis. The December 2020 funding package included $4.25 billion in mental health and substance-use emergency funding; the recently passed American Rescue Plan (ARP) will provide an additional $3.5 billion for block grants in these same areas. President Biden recently announced $2.5 billion to further support states.
Combined with ARP’s significant financial assistance for state and local governments, the targeted substance-use funding will likely be critical for struggling addiction-treatment providers and government agencies that account for a significant percentage of overall substance-use treatment funding. Many have had to contend with tighter budgets related to the pandemic’s economic impact.
How Can Central Florida Treatment Centers Help?
We are here to help you and your loved ones. Go to https://methadoneworks.net/locations to find the closest clinic to you.
Data and Methods
The Centers for Disease Control and Prevention’s (CDC’s) National Vital Statistics System releases monthly provisional predicted overdose death totals from the preceding 12 months across different drug types. For example, the August 2020 predicted total represents overdose deaths occurring between September 1, 2019, and August 31, 2020. These predicted totals tend to lag by six to eight months and are usually 2 percent to 3 percent higher than the final U.S. annual death totals eventually released by the CDC. The agency also releases state-level provisional data.
In the first exhibit, the January–August 2020 individual month estimates are based on calculations using the CDC’s final 2019 monthly data and its 2020 provisional 12-month predicted totals — these estimates are not confirmed by the CDC. To account for the typical overcount in national-level provisional predicted deaths, we discounted the 12-month predicted totals during 2020 by the percentage difference between the final 2019 U.S. annual overdose death total and the December 2019 12-month predicted total (provisional totals are typically about 2.5% higher, depending on the drug overdose death type).
In the second exhibit, state estimates for overdose deaths between January and August 2020 are based on calculations using final 2019 monthly data for each state and the August 2020 provisional predicted 12-month total. To account for potential differences in state-level provisional predicted deaths, we adjusted the 12-month totals by the average percentage difference between a state’s final annual totals and its December 12-month predicted totals from 2015 to 2019.
Here at Central Florida Treatment Center your safety is our number one priority. We have partnered with the Department of Children and Families in order to provide Narcan, a life saving medication used in cases of overdoses. You may come to our location if you are in need of Narcan as well as other agencies across the state. By searching isavefl.com you can find agencies that provide this to the community for free or at a low cost. Providing tools and resources to community members in active addiction is one of the ways we can limit overdoses and help individuals find the proper treatment that they need in order to regain sobriety.
If you search Methadone in any major search engine you will find copious amounts of information on the subject. Some of the information could be considered myths and some could be legitimate. There is extensive research available to the public about the pros and cons of Methadone Maintenance Treatment and why people should or should not choose that treatment option. As an MAT professional for over three years, I’m here to say that every treatment option has its benefits and risks however, the main goal of every patient should be to find what treatment option works best for you and your unique situation. The evidenced based options available to a client when suffering from opioid addiction are MAT via Methadone, Vivitrol, or Buprenorphine, Detox Facilities, and Intensive Outpatient Psychotherapy. Despite all of these being viable treatment options, one may be better for you than the other based on various reasons. Therefore, I highly recommend contacting agencies that provide these treatment options and allowing trained professionals to assess and discuss possible interventions for your addiction. Here are some scenarios in which Methadone might be the best option for you: • Individuals who have been addicted for over a year and have been unable to stop or decrease use on their own • Individuals who have tried detoxes and left AMA or relapsed once returning to the community • Pregnant women who are still suffering from their addiction • Anyone who has been taking Buprenorphine for at least three months and continues to use opiates despite dosage changes and discussions with your doctor • Patients who have been in pain management who no longer qualify or who have been discharged due to abuse The greatest part about fighting addiction is that it’s a fight you CAN win. You may not win every battle but, if you work hard enough and take the help that is offered, you can surely win the war.
Sincerely, Your local methadone advocate
Addiction is a complicated chronic disorder that combines psychological and physiological dependency….Read More
Opioid treatment programs continue to respond to the evolving needs of our patients throughout the first wave of this epidemic. These developing responses can be viewed as inflection points or stages. The first stage, beginning six or seven weeks ago, represented the initial shock to the system with conservative decision making. This gave way to a more adaptive responses through more flexible policy making at federal and state regulatory levels in addition to changing program policy.
The second stage represented increasing adaptability as more take-home medication was provided in addition to curbside administration of medications and providing families or friends of patients with take-home medication, following patient consent.
Without any question, this epidemic has provided different challenges to the OTPs. On the one hand, if OTPs were overly conservative in providing take-home medication to patients, there would be increased risk of infection. On the other hand, if the OTPs provided too much additional medication to clinically unstable patients, there would be additional risk for potential overdose and diversion.
This is why we discussed this balancing in our Association’s initial guidance to our field, which was released on March 20, 2020.
There were the initial complications, including the assurance that there would be an adequate supply of medication as OTPs began submitting larger than normal orders of medication. Fortunately, this challenge was quickly resolved through the DEA and pharmaceutical manufacturers. There has been no interruption in the supply of needed medication for OTPs.
OTPs were also experiencing difficulty in obtaining personal protective gear and SAMHSA was extremely helpful in providing a letter on March 25, 2020, which helped free up some supplies. Additionally, the White House Office of National Drug Control Policy also provided a letter to the field on April 23, 2020 and that has also been helpful in getting protective equipment to OTPs since there continues to be challenges in obtaining masks and other protective equipment. I am grateful to have the support of these federal agencies in providing guidance to our field as OTPs remain open as essential medical facilities.
We are now facing a new, third stage and I anticipate that there will be greater reports of patient and staff infection and mortality. We will begin collecting such information over the next several weeks in conjunction with our policymaking partners. There will come a time where we will be better able to understand what went right and what did not, and we will come to know how OTPs acted in response to the needs of our patients.
The dust has yet to settle but it is important to acknowledge the incredible work of the staff working in OTPs in addition to expressing gratitude to the patients, who continue to put their trust into the work of our treatment programs during such an extraordinarily challenging time. I realize that some programs may have been slow to react to the initial shock of the first wave and I believe that that there has been an evolution of thoughtful responses. There will be many people to thank in the coming months as the initial phase of this epidemic comes to an end and AATOD will continue to provide guidance to the field as we learn more.
For the time being, I am deeply appreciative of the work of the OTPs and other substance use treatment programs throughout our country and other nations. I am also grateful for the coordination of the federal and state agencies, which have jurisdiction in these areas.
In good health,
Mark W. Parrino, M.P.A. – AATOD President
Written and posted May 1, 2020, can be found on the AATOD web page at http://www.aatod.org
As a drug addict committed to recovery, you may experience shame and disappointment if you relapse. The truth is, relapse is a normal part of recovery that if handled properly will not ruin your journey to lifelong sobriety.
Normal Doesn’t Mean Inevitable
It’s important to understand that just because drug relapse is common doesn’t mean it has to or should happen. It’s possible to achieve sobriety the first time. Avoid using the fact that relapse is normal to justify returning to addictive behaviors.
How to Handle Relapse
If you do relapse, the first thing to do is not beat yourself up. Shame and discouragement only further drive your drug addiction to escape the pain. Instead, use relapse as a learning opportunity. Ask yourself if you really are ready to give up your drug addiction, and if not, what is holding you back. To succeed, you need:
- A strong motivation
- Recovery tools
- Professional help
- A support network
The work begins internally with honesty and surrender. You have to accept that total abstinence may be the only possible way you can never relapse again.
You must learn how to navigate difficult emotions and be committed to reaching out whenever you feel triggered instead of thinking you can do it alone. There are people and programs waiting to assist you. To learn more about relapse and recovery, call Central Florida Treatment Centers, Inc. in Orlando 407-843-0041.
Whether it’s residential or outpatient, when evaluating specialists and programs, everyone’s needs are going to be different. However, the lengthier and intense the drug use, the longer the treatment will be.
Proper Medication Combined With Therapy
The use of the correct medication coupled with therapy has shown to be highly effective. For instance, someone addicted to heroin often needs withdrawal medication and intense therapy.
Addressing the Addiction and a Possible Psychological Disorder
It’s relatively common for someone with a substance problem to also be struggling with a psychological issue, such as:
This type of integrated treatment has also proven to be successful. You may be referred for additional services for assessing or treating possible psychological conditions.
When it comes right down to it, the best treatment will almost always include individual therapy and often group therapy. Many programs provide plenty of both.
Your counselor will work with you to address any mental, emotional, or spiritual blocks to recovery thereby helping you make a behavioral action plan that fits your needs and desire to change. Throughout the process, you will be assisted in implementing behavioral and cognitive changes benefiting your quality of life.
Techniques Most mindfulness experts teach that the mind is the root of all suffering. As more professionals guide individuals to go inward, more people dealing with addiction will be able to burn out their destructive thought patterns through the fire of observation.
If someone you love struggles with an addiction, you know it can be difficult to determine how to best help. However, even if you don’t quite understand what your loved one is experiencing, there are a few things you can do to talk effectively to someone with addiction:
- Prepare yourself. Think about what you want to say before talking with your loved one. You should also prepare yourself by trying to understand that addiction is a disease and that even though you want to save your loved one, it’s not all up to you.
- Be open. Try to be kind, but very honest about how the addiction affects you and others in your loved one’s life. It is important for addicts to understand how their actions can hurt more than just themselves.
- Keep your cool. It’s natural to get emotional while talking about such a difficult subject as addiction, but try to stay calm and avoid belittling your loved one, even if he or she gets angry or upset. Try to maintain a discussion rather than letting the talk turn into an argument.
- Try to show empathy. Avoid getting angry or sounding judgmental. Your loved one’s addiction can be very frustrating, but both of you will likely be better off if you work hard to show empathy and understanding.
It may be difficult, but it is worth taking action to help an addict take steps toward recovery. Call Central Florida Treatment Centers, Inc. in Orlando 407-843-0041 to learn about additional resources for addicts.
If you have a harmful addiction you want to break free of, then you will need professional help. While you are going through a treatment program, there are things you can do on your own to ensure you stick with your decision.
Build a Support Group
Surround yourself with people who believe in your well-being. You would not want to hang around people who are going to encourage you to pursue your vices. Let loved ones know you are seeking treatment, and you will likely find people are more than willing to help.
Develop New Hobbies
Many addicts feel encouraged to continue their habits because they need something to fill them time. Develop other hobbies that take your mind off the addictive behavior. This can be anything from jogging to volunteering at a local shelter.
You probably have triggers that entice you to give into the addictive habit. Before quitting, you want to identify these triggers. Triggers can be anything from places to people. Write them down, so you know exactly what they are. Once you are on the path to recovery, actively take steps to avoid them.
Fighting an addiction can be tough, but with the right mindset, you can do it. To learn more about the treatments available, call Central Florida Treatment Centers, Inc. in Orlando 407-843-0041.
The struggles and demons of addiction and recovery can be stressful and painful for the person as well as their family. The road to recovery may surely be hard, but it is necessary for one to become healthy and have the quality of life you desire once again. These are some important steps to follow:
The most important step is to acknowledge that your disease of addiction exists. One must be aware that the problem is causing harm to your body, relationships, employment, behavior or other issues. You are seeking solutions to fix the problem instead of making excuses.
Recovery cannot be done alone. It is important to find professionals, such as Central Florida Treatment Centers, to work with you step-by-step through the recovery process. Recovery may include individual/group therapy, medication as well as counseling to make the needed mental, emotional, spiritual, and behavioral changes.
Build a Support Group
It is Important to be around individuals or a group that will make a positive contribution to your treatment and recovery. Find like-minded people, as well as be around family and friends who will not allow you to relapse into poor habits that contributed to your addiction. This may include removing yourself from people that you enjoyed being around in the past that may trigger additional drug use.
Fight Through Relapse
Of course, relapse is not ideal. However, it is important to remember and use what was learned during treatment as well as continuing to follow the steps of your recovery to get back on track. Healing is a continuous process.
If you are in Central or South Florida and want to start your addiction recovery, contact Central Florida Treatment Centers at one of our six locations. Your recovery begins here.
Recovering from an injury or suffering from chronic pain due to an underlying medical condition will require some pain relief. While many people choose to manage their pain through physical therapy and holistic practices, others will turn to prescription medications. Although shocking for some to learn, opioid pain relievers are the most common of all medications prescribed by doctors. Prescription painkillers are effective for man patients, but they can lead to dangerous addictions. Unfortunately, the U.S. Centers for Disease Control and Prevention recently reported deaths from opioid poisonings have tripled within the last 20 years. If your spouse is currently taking opioids for pain relief and showing one or more of the following signs, they require help for their addiction.
Lack of Motivation
Before starting the painkillers, your spouse may have considered work a priority, getting up each morning to head out for the day. While taking the opioids, your spouse may have lost all motivation to work or complete normal daily tasks.
Addicts will also lose interest in the home and work life. They may stop caring for the house, lawn, pets, and children and call in sick to work. Your hard-working, motivated spouse may seem to shut down physically.
If your spouse is currently taking painkillers and missing work or school, forgetting important tasks, or neglecting themselves or your family, they may be abusing opioids.
Everyone experiences sleepiness and fatigue during a day. However, if your spouse is constantly tired and drowsy while on prescription painkillers, they may be abusing the medications.
Pay attention to any patterns of drowsiness and fatigue during the day. Droopy eyes, slurring words, and nodding off during the middle of the day are common issues that occur during the peak effect of using opioid medications.
Your spouse may also close off emotionally while abusing prescription painkillers. These drugs induce feelings of loss that can cause your spouse to isolate themselves and display signs of depression.
Your spouse may spend time alone in the bedroom or the front of the television. They will decline invitations to social events, choosing to spend their time alone or with individuals who are also abusing drugs.
Opioid abusers also lose all interest in favorite activities, such as sports, gaming, and hobbies. A decreased libido is also common in drug addicts so that you may notice a change in your sex life.
This isolation will affect relationships between your spouse and family, friends and children. In many instances, the drug addiction will end relationships.
Changes In Appearance
If your loved one is addicted to painkillers, they may show physical signs, as well. One of the most common signs that your spouse is on drugs is a change in their pupils.
In bright light, the pupils will become smaller or constrict. In dark spaces, the pupils will become larger. This involuntary reaction occurs in an attempt to restore your vision when experiencing changes in light and color. If your spouse’s pupils are constricted even in dimly lit areas, they are most likely using opioid drugs.
Most drug addicts will stop eating, resulting in a dramatic weight loss that affects not only their appearance, but also their overall health and wellness. This unexplained weight loss is another sign that your spouse may have an addiction that requires treatment.
Lastly, addicts may forego simple grooming tasks. Your spouse may stop shaving or showering. You may notice they are wearing dirty clothes while having greasy hair and body odor.
Opioid addiction is a serious problem that requires immediate help. By understanding the signs of a potential addiction, you will know when it is time to seek help. For help restoring your spouse’s physical and emotional health, contact one of the Central Florida Treatment Centers today.