The COVID-19 pandemic disrupted almost every area of normal life in the US. It had a host of side-effects that impacted the nation and society in various ways. Some of these were unsurprising – the consequences of reduced economic activity, job insecurity, and restrictions on freedom of movement were all to some extent predictable. Few could have foreseen that the pandemic would also cause a spike in drug overdose deaths, and help spread one of the nastiest synthetic opioid drugs, fentanyl, across the US.
Yet, this is what happened. As the world emerged from the pandemic, the number of drug overdose deaths hit, and then surpassed, the 100,000 mark for the first time ever. Furthermore, the geographical distribution of opioid overdose fatalities changed too. Whereas fentanyl had primarily been affecting the eastern half of the country – causing an exponential rise in overdose deaths but also a heightened interest in opiate rehabilitation and treatment including Motivational Enhancement Therapy– it spread to other areas that had thus far been largely spared the drug’s infiltration.
The pandemic created conditions such as economic pressure, social isolation, as well as anxiety around employment, health, and the virus itself, that proved very challenging for a great many Americans. These conditions drove some people to start using drugs, forced already active drug users to change their habits, and adversely affected the mental health of both.
But how did this pave the way for fentanyl to spread its tentacles across the whole country?
In This Article
Drug Supply Availability
As a consequence of the pandemic, the supply of illegal drugs in general was considerably disrupted. With increased numbers of people seeking drugs and less drugs available, there was both more demand than ever and a shortage of supply, leading to an inevitable hike in prices.
For dealers, who needed to keep their distribution channels active and their stock circulating, restrictions at interstate borders, not to mention stay at home orders, made moving drugs of any kind around difficult. Bulkier drugs became particularly problematic, because they could not be so easily illegally shipped or mailed.
For consumers, the result was that their usual drugs were no longer available, or at least not in the quantities they wanted. In the face of dwindling financing resources, covering the cost of their drug habit became challenging also.
The spread of fentanyl can largely be explained by the above two points. Illegal drug suppliers began to resort to fentanyl, which can be easily transported in small quantities, as pills for example. It is also 50 times more potent than heroin, so they needed far less of it to supply large numbers of clients. The practice of adding fentanyl to other drugs increased dramatically.
From the buyer’s perspective, fentanyl, or other illegal substances containing it, were both readily available and cheaper. From a transactional perspective, it was a win-win situation for both parties.
It would, however, be an oversimplification to blame all increased use of illegal substances directly on the pandemic. Similarly, the rise in overdose deaths can not be explained solely by the spread of fentanyl.
Other Contributing Factors to Increased Overdose Deaths
The pandemic helped fentanyl spread to drug users across the country. Its increased availability and low cost meant more people began using it – some knowingly, but many unaware. Indeed, a great many people who purchase illegal drugs ultimately have no idea what they are putting into their bodies, since anything can be laced with fentanyl. Either way, as a result, more people were developing an opioid use disorder (OUD), while others were worsening their pre-existing drug habits. However, other factors also played a role in record high overdose fatalities.
Many people took drugs while alone. With no one else around, there was nobody to call 911, far less administer naloxone, a life-saving medication which reverses the effects of opioid overdose. Many community-based projects or support centers for sufferers of substance abuse interrupted their services. Local clinics began prioritizing COVID patients. Many people became anxious about going to their medical provider for fear of contracting the virus, including people needing help for their drug habits. In-person support group meetings were suspended indefinitely, and certain harm-reduction services put on hold. Let us not forget the stigma which, for many, is still attached to SUDs (substance use disorders).
The pandemic deprived a great many people of activities which contribute to their physical and mental well-being. Some began to replace the face-to-face social interaction and physical exercise they no longer had access to, with alcohol or drugs.
In short, the pandemic created overall conditions conducive to a slump in the mental health of the nation. The Centers for Disease Control and Prevention found that as early as June 2020, 40% of US adults reported struggling with their mental health. In addition,13% said they had either started or increased substance abuse. With a greater demand for illegal drugs and less of the usual ones available, fentanyl simply filled the gap.
Greater Access to Treatment as the Way Forward
OUD is one of the most difficult conditions to recover from, because of the intense withdrawal symptoms opioid users experience when they stop using their drug. The quickest way to treat these symptoms is to take more drugs. Having spread across the nation, fentanyl is not going to disappear overnight. People will continue to take opioids that contain it, until they have easier access to better options. Medication-assisted treatment with medications like buprenorphine and methadone, which combat withdrawal symptoms, needs to become more widespread and sustained. A shift towards telemedicine has helped in this regard, but long-term treatment depends on patients being able to meet with their medical provider.
Peer support, most often in the form of recovery support groups and recognized as essential in lasting recovery, is now readily available online too. Helping OUD sufferers find appropriate help and ensuring it continues until they are able to take responsibility for their own recovery, is what will help stem the circulation of fentanyl on our streets.