SAFE GC Coalition: Overdose Increase Amid COVID & Policy Options

A recent Commonwealth Fund report discusses the spike in drug overdose deaths and policy options to reverse this devastating issue. 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 as overdose deaths spiked after the start of COVID driven by synthetic opioids like Fentanyl. 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.

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, estimated monthly overdose deaths from January to August 2020 showed 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 still around 8,000 in August. Prior to 2020, U.S. monthly overdose deaths had never risen above 6,300.

The 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 two decades. Additionally, 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.

President Biden campaigned a public health approach to the opioid epidemic that included expanding funding and resources, reforming the criminal justice system, increasing insurance coverage, and widening access to medication-assisted treatment (MAT) and mental health care. 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. Researchers maintain 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.

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.

The Commonwealth Fund is a private U.S. foundation whose stated purpose is to "promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable and the elderly." For more information please visit www.commonwealthfund.org.

The SAFE Glen Cove Coalition is conducting an opioid prevention awareness campaign entitled. “Keeping Glen Cove SAFE,” in order to educate and update the community regarding opioid use and its consequences. To learn more about the SAFE Glen Cove Coalition please follow us on www.facebook.com/safeglencovecoalition or visit SAFE’s website to learn more about the Opioid Epidemic at www.safeglencove.org.