While it may feel like COVID-19 has upended everyone’s lives and shifted other issues to the side, the reality is that crises such as the opioid epidemic are still raging. As a result, drug overdoses have actually increased during the past year in the Houston area, according to first responders.
A Growing Crisis
UT Health Professor of Emergency Medicine and Biomedical Informatics Dr. James Langabeer has been tracking calls to first responders for heroin overdoses since 2018 through a group he launched known as HEROES, or the Houston Emergency Opioid Engagement System. When the group first started tracking 911 calls connected to opioid abuse, there was an average of 60 calls per month. That number went up to 80 per month in 2019, and it increased again to 90 per month in 2020.
Over the three-year period that HEROES has existed, the number of calls has increased 50%. At the same time, the number of people dying from overdoses has also increased.
Worsening Mental Health
The lifestyle changes and rising unemployment created by COVID-19 have resulted in increased stress and a surge in depression. The National Center for Health Statistics (NCHS) partnered with the Census Bureau for a survey in December 2020 that found more than 42% of respondents nationwide reported symptoms of anxiety or depression that month, an increase from 11% in 2019. The increased levels of anxiety, isolation, and uncertainty all have the potential to cause relapse in someone in recovery.
In fact, across the country, states have seen an increase in overdoses. The CDC recently reported more than 80,000 overdose deaths in 2020, significantly higher than the year before. According to Forbes, if overdose deaths hit 90,000 nationwide, this would be the sharpest year-to-year increase the country has witnessed in 20 years.
Texas is no exception to the rule. Between June 2019 and May 2020, Texas witnessed a 50% increase in overdose deaths related to man-made opioids, including the powerful painkiller fentanyl. Experts attribute the increase to the rise in social isolation and a lack of access to treatment resources for people struggling with opioid addiction.
In fact, some experts are calling the convergence of the COVID-19 pandemic and the opioid crisis a major threat to public health. Researchers at Texas A&M say that COVID-19 has made the opioid crisis worse for several reasons, including:
- Individuals are more likely to take drugs alone and have little access to help in the event of an overdose
- Family members and friends of addicted loved ones may not have access to drugs like Naloxone that can reverse overdoses
- Social distancing requirements and “shelter in place” mandates make it harder for individuals to access treatment
- Members of the general public are less likely to help someone who is overdosing in a public place out of fear of catching COVID-19
As Texas A&M clinical professor Joy Alonzo noted, “If you are alone and have no access to your support network, you are at much greater risk of relapse, and if you start to use alone, you are at greater risk of an overdose.”
Community Response To The Opioid Crisis
While area addiction treatment providers work hard to reach as many individuals as possible, community groups step in to fill the void left by the opioid crisis.
In addition to conducting research into the region’s opioid overdoses, the HEROES group also provides free services to individuals who have survived a past opioid overdose.
Led by the UT Health system with funding from the Texas Health and Human Services Commission and the Substance Abuse and Mental Health Services Administration (SAMHSA), HEROES acts as a “first line of defense” for individuals struggling with opioid addiction.
The program provides medical screening and a consultation with a doctor, then creates a recovery plan featuring medication-assisted treatment, behavioral therapy, and peer support groups. Individuals enrolled in the program can track their progress on a mobile app and receive personalized coaching as they continue their recovery.
Currently, HEROES has enrolled more than 300 people in the Houston area who have experienced severe opioid use disorder or an opioid overdose.
HEROES is also supported by the Houston Fire Department, which has seen a more than 300% increase in opioid-related emergency calls since 2017. The department reports that one out of every four of these emergency calls ends in a fatal overdose.
In 2019, Houston supplied the department with $2 million in funding to equip every vehicle with Narcan, the emergency opioid-blocking drug that can help first responders treat opioid overdoses more quickly. The department also partners with HEROES to enroll individuals in the free recovery program.
Statewide Response To The Opioid Crisis
As increasing numbers of Texans struggle with opioid addiction, the state is taking aggressive action to try to help turn the tide.
Texas Attorney General Ken Paxton recently unveiled the results of a lawsuit against consulting firm McKinsey in which Texas joined with 47 states to challenge the company’s opioid marketing practices.
McKinsey ultimately settled the lawsuit for more than $500 million, resulting in $38 million for Texas which will be used to fund local addiction treatment programs on the state level.
The state has also put additional funding and resources into educating people about the dangers of opioid addiction. The Texas Department of Health and Human Services recently launched an educational website intended to help people understand why opioids can be so addictive, as well as steps to take to lessen their risk.
The site is part of a broader program known as the Texas Targeted Opioid Response, which is funded in part by SAMHSA. The program focuses on key areas to help Texans navigate the opioid crisis, including:
- Programs for individuals to safely throw away expired or unused opioid medications
- A statewide system to allow medical professionals to better track patients who have been prescribed opioids
- A plan to distribute a higher amount of Narcan and other opioid reversal drugs to Texans across the state
- Plans to increase the availability of addiction treatment programs through workplaces and clinics
- More access to treatment programs in hospitals, as well as access to peer support programs, sober living opportunities, and help for first responders
How Opioids Affect the Brain and Body
Also known as narcotics, common opioids include morphine, codeine, hydrocodone (Vicodin), fentanyl, oxycodone (OxyContin, Percocet), and heroin.
The human brain contains receptors designed to bond with opioids. The body naturally produces pain-relieving chemicals which act on these receptor sites to temporarily reduce painful sensations in the body. Opioids can also bind to these receptors and mimic the same response, blocking the perception of pain as well as causing temporary feelings of euphoria and well-being. They may also cause other, more negative side effects like nausea, confusion, and drowsiness.
To continue to experience feelings of pain relief and well-being, people abusing opioids need to take more and more of the drug. If they try to stop taking the opioid, they may experience a range of withdrawal symptoms such as anxiety, muscle aches, irritability, insomnia, runny nose, nausea, vomiting, and abdominal cramping.
Signs of Opioid Abuse
A person struggling with opioid abuse may not show signs of addiction immediately. Signs that could indicate that someone has a physical addiction to opioids include:
- Job loss, money problems, or other hardships
- Trying to stop or cut down on opioid use but not being able to do so
- Making mistakes at school or on the job because of using opioids
- Harming relationships with family and friends because of opioid use
- Developing a tolerance and needing larger amounts of opioids to get high
- Having strong cravings for opioids
Treating Opioid Abuse
The most effective way to treat opioid addiction is through a whole-patient approach that includes counseling, behavioral therapy, and, when appropriate, medication-assisted treatment.
Counseling and behavioral therapy help with recovery by showing the individual how to change the attitudes and behaviors related to their opioid abuse. Such therapies can also enable them to create and build healthy life skills and provide support to stick with their treatment regimen. Counseling can come in the form of individual or group sessions, as well as cognitive-behavioral therapy (CBT), which teaches coping skills and ways to recognize and stop negative patterns of thinking and behavior.
Many individuals who seek help with opioid addiction turn to residential drug treatment programs that offer housing and treatment services. These types of programs can be residential, hospital-based, or outpatient. All provide support from peers, as well as other types of counseling and interventions to help treat opioid addiction.
In some cases, individuals may qualify for medication-assisted treatment for their opioid addiction. Medications that can help treat opioid addiction include methadone, buprenorphine, and naltrexone. Methadone and buprenorphine act on the same targets in the brain as other opioids without also making a person feel high. As a result, these medications help decrease withdrawal symptoms and cravings.
Naloxone is used to treat opioid overdoses. It is safe to take these medications for long periods of time under the care of a doctor. If someone is using these medications to treat their opioid addiction, they should not stop taking them without the supervision of a medical professional.
If you or someone you love needs help with addiction, the licensed professionals at Into Action Recovery can help. Our multidisciplinary staff works closely with each client to develop a customized plan for overcoming opioid addiction that prepares them for long-term sobriety. This targeted treatment addresses each client’s individual needs, identifying the tools and resources that can lead them to continued success.