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How the pandemic is complicating America’s addiction crisis

According to preliminary data, drug overdoses killed nearly 72,000 Americans in 2019, a record high. Now, it appears that 2020 is on track to be even worse, as the U.S. has witnessed a startling rise in overdoses during the pandemic. William Brangham reports on how increased isolation, economic uncertainty and reduced access to care have exacerbated American addiction -- with deadly consequences.

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  • Judy Woodruff:

    Drug overdoses killed nearly 72,000 Americans last year, a record high, according to preliminary data released last week by the Centers for Disease Control and Prevention.

    It now appears that 2020 is on track to be even worse, as the nation has seen a startling rise in overdoses just in the last few months.

    William Brangham examines what could be behind these disturbing numbers.

  • William Brangham:

    In early April, like so many Americans, 31-year-old Sara Wittner was struggling with the new realities of life during the pandemic. So, she called up her dad, Leon.

  • Leon Wittner:

    When the pandemic started, she asked if she could come live with us, because she wanted that family support. She knew that the worst thing for her to do during this pandemic was to sit at home alone.

  • William Brangham:

    I spoke with Leon, and Sara's sister, Grace, via Skype near their home in Broomfield, Colorado.

    They told me that Sara had struggled with addiction for eight years. It started when she was prescribed opioids after she had surgery on her ear in 2012. But prior to the pandemic, she'd seemingly turned a corner. She was working at a local health association, and was planning her wedding in the fall.

  • Grace Sekera:

    I wasn't as worried about Sara now than I was about her in the past.

  • William Brangham:

    The family says, Sara completed multiple treatment programs in recent years, including 30 days of in-patient treatment in January. She was also regularly attending Narcotics Anonymous meetings.

  • Grace Sekera:

    In addition, she would just be able to call a friend and go get coffee and have that one-on-one connection. And that was extremely helpful to her.

    So, all of those things combined, I think, really helped her sobriety. And then that was completely gone when the pandemic hit.

  • William Brangham:

    Sara was also told there would be a delay in her medically assisted treatment. She was taking monthly shots of Vivitrol, which is a drug that helps block people's cravings for opioids.

  • Leon Wittner:

    She normally had a 30-day appointment to have the Vivitrol shot, which is what the time that it really is effective for.

    And, because of the pandemic, they pushed all the appointments out, and her appointment ended up being at 45 days, instead of 30. And that…

  • William Brangham:

    So, normally, she would get a shot every month, pretty regularly, every 30-day window.

  • Leon Wittner:

    Yes. Yes.

  • William Brangham:

    But then the pandemic stops that normal process?

  • Leon Wittner:

    Yes.

    It added 15 days onto that process, and that 15 days were a tough 15 days for her.

  • William Brangham:

    That delay, her dad says, led to Sara relapsing.

    On April 16, one day before her next Vivitrol shot Sara was found by her sister Grace unresponsive in her bedroom, a syringe in her hand. Sara died.

    Her dad believes it was an overdose of fentanyl, the powerful synthetic opioid.

  • Leon Wittner:

    She passed away on Thursday morning. And the real unfortunate piece for us is, her doctor's appointment for the shot was Friday.

    So, it was like she was going to make it to that last — that one last time, I will be fine, and then I will get to the doctor, and I will be OK.

  • William Brangham:

    Tragically, Sara Wittner's story is becoming more common across the U.S.

    While overdoses were already on the rise before the start of the COVID-19 pandemic, the public health crisis is only making matters worse. Drug-related deaths have risen, on average, by 13 percent so far this year, according to data collected from both local and state governments.

    And the American Medical Association recently reported that 39 states have seen a spike in opioid-related overdoses. In some places, like Cook County, Illinois, which includes Chicago, opioid overdose deaths have doubled since last year.

    In nearby DuPage County, they are up by about a third, according to coroner Richard Jorgensen.

  • Richard Jorgensen:

    When I looked through these deaths, overwhelmingly, these were people that lived alone. They were having financial difficulties, marital difficulties, previous problems with addiction, or mental health problems.

    So, these are the very needy of our society. And what do they need? They need community.

  • Dr. Caleb Alexander:

    Addiction is a disease of isolation, and no one chooses to have addiction any more so than someone chooses to have diabetes or multiple sclerosis.

  • William Brangham:

    Dr. Caleb Alexander is a professor of epidemiology and medicine at Johns Hopkins Bloomberg School of Public Health. He says another effect of the pandemic has been a massive disruption to the illegal drug market.

  • Dr. Caleb Alexander:

    If you think about the ways that the pandemic has ground the economy to a halt, that's occurred in the illicit drug markets as well.

    So, for example, it's decreased the transport of drugs across borders, but it's also disrupted local drug markets and introduced much greater uncertainty regarding what substances are what, and how individuals that do have opioid addiction can find those.

    And this is one of the reasons that the increased mortality rates that many states have reported due to fentanyl are so concerning.

  • William Brangham:

    Alexander says, in normal times, a disruption in the illegal drug market would likely help funnel more people into treatment.

    But for many facing substance abuse disorders, access to treatment has also been disrupted by the pandemic.

  • Chuck Ingoglia:

    Because of social distancing, you can't have as many people. In an inpatient facility where you may have had two or three people to a room, now you only have one, or in some of the group situations, you're also having much smaller groups.

  • William Brangham:

    Chuck Ingoglia is the president of the National Council for Behavioral Health, which represents more than 3,000 treatment organizations around the country.

    Ingoglia says fewer patients has meant less revenue this year, and more than 40 percent of the organizations he represents could be out of money in six months.

  • Chuck Ingoglia:

    And at a time when more people will be experiencing depression, anxiety and/or substance use disorders, it's the last thing we need to do, is to lose facilities.

  • William Brangham:

    President Trump has often cited both the rise in suicides and drug use as a reason to open up the economy quickly.

  • President Donald Trump:

    We have to get our country back. People are dying the other way, too. When you look at what happens with drugs, it goes up. When you look at suicides. I mean, take a look at what's going on. People are losing their jobs.

  • William Brangham:

    But of the roughly $3 trillion in relief funds that Congress has given out since the beginning of the pandemic, only a fraction of 1 percent has been designated for mental health and substance abuse treatment.

    Back in March, the federal government relaxed some of the barriers around the prescription and dispensing of the most commonly used medications to treat opioid addiction.

    For example, methadone clinics can now prescribe up to four weeks of the medication at a time, rather than requiring daily visits.

  • Jen Cutting:

    I can get you that information, so that maybe can make things a little bit easier for you.

  • William Brangham:

    But for those on the front lines of the addiction crisis, the toll gets worse every day.

  • Jen Cutting:

    I probably personally know of 11 people who overdosed in the last three months.

  • William Brangham:

    Jen Cutting is in recovery from heroin and methamphetamines, and now works as a certified peer recovery coach in Upstate New York.

    She says, both the pandemic and the government's response to it has upended life for many of the people she cares for.

  • Jen Cutting:

    It's a cluster, to be quite frank. And you go, and you take people who are already closed off and operate in a very, very small circle, and then tell them they can't even have that circle.

    And they're like, and on top of it, here's $1,200 bucks, and see you later. Bye.

  • William Brangham:

    This is the unemployment or the government's — the check people are getting.

  • Jen Cutting:

    The stimulus. The unemployment and the stimulus all came at one time. You have people who are struggling with their sobriety.

    You gave them a boatload of cash and told them to stay in their home and don't do anything. So, imagine if the entire country was on a diet that couldn't eat chocolate and then, all of a sudden, they were putting chocolate out on the street.

  • William Brangham:

    Back in Colorado, Leon and Grace Wittner say they have been shocked at how many people have reached out to them with similar tragic stories.

  • Leon Wittner:

    The numbers of people that I have come in contact with that have lost a loved one to either overdose or suicide during this pandemic is staggering.

  • William Brangham:

    Are you convinced that, if it were not for this pandemic, that Sara would still be alive today?

  • Leon Wittner:

    Had she of just gotten her shot at 30 days, she would still be planning her wedding with Grace right now. She'd be at her job working.

    It's no one's fault, but we have to find a way to fix that, because it's a terrible loss of an amazing person.

  • William Brangham:

    The Wittners say they plan to hold a funeral for Sara this Saturday in Broomfield, Colorado.

    For the "PBS NewsHour," I'm William Brangham.

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