Just because the Covid-19 coronavirus pandemic has taken center stage since early 2020 doesn’t mean that the opioid-use crisis has simply disappeared. In fact, it’s been quite the opposite. Since the pandemic started, the opioid-use crisis has gotten worse, much worse. Provisional data posted on Wednesday by the U.S. Centers for Disease Control and Prevention (CDC) showed that drug overdose deaths overall reached a new record high. During a 12-month period from May 2020 to April 2021, over 100,000 people died of drug overdoses in the U.S. That was a 28.5% increase from the prior 12-month period. But not all of the trends have been doom and gloom. There have been some promising signs, particularly in Pennsylvania and Michigan. But more on that later.
Back to the doom and gloom for a moment. While drug overdoses can be caused by different things, over 75,o00 of the over 100,000 overdose deaths were due specifically to opioid use. And over 64,000 of deaths were due to synthetic opioids such as fentanyl. Over the past several years, opioids have been constituting greater and greater percentages of drug overdoses overall. From May 2020 to April 2021, synthetic opioids comprised 64% of all drug overdose deaths, which was a substantial increase from the 49% in the 12-month period prior.
“The overdose epidemic is one of the worst public health crises we’ve ever faced–254 Americans die every single day from drug overdoses,” said Michael R. Bloomberg, founder of Bloomberg LP and Bloomberg Philanthropies and the World Health Organization (WHO) Global Ambassador for Noncommunicable Diseases and Injuries in a statement. “It’s tearing families apart across the country, and we need bolder, nationwide action, especially from the federal government – but we can’t afford to wait until that happens.”
As I covered previously for Forbes, in 2017, U.S. President Donald Trump did declare the opioid crisis a national emergency. But in the subsequent years, others criticized the federal government of not doing nearly enough. For example, in an opinion piece for Bloomberg news, Bloomberg wrote, “the opioid epidemic is now a full-blown national crisis, yet the federal government continues to dawdle.” Newsflash, “dawdle” is not a positive word. Then the Covid-19 pandemic happened and people may have forgotten what was and was not happening with the opioid crisis.
Of course, it would be easy to blame the Covid-19 coronavirus pandemic alone for the rise in opioid-use overdose deaths. Heck you could try to blame the pandemic for a lot of things like why you only have 200 rolls of toilet paper in your closet rather than a thousand. But it’s not as if everything will turn into sunshine and unicorns once the pandemic subsides.
Again, the pandemic did not create the opioid-use crisis. Instead, like a gigantic vacuum cleaner that sucks, the pandemic uncovered and perhaps worsened a lot of underlying existing problems in society that did not get enough attention and were not fully addressed prior to 2020. “The pandemic resulted in social isolation,” explained Kelly Henning, MD, Public Health Program Lead at Bloomberg Philanthropies. “Outreach was a lot harder to do. A lot of people faced economic hardship and mental health hardship, which accelerated use of substances.”
There have been some progress and hope, though, when it comes to the opioid crisis over the past few years. Various individuals, organizations, and state governments essentially gave up waiting for the Trump Administration to take more action and took their own initiative to tackle the opioid crisis. For example, as I covered previously for Forbes, in late 2018, Bloomberg Philanthropies launched a $50 million initiative to help address the country’s opioid crisis along with Vital Strategies, the Pew Charitable Trusts, Johns Hopkins University and the CDC through the CDC Foundation as partners. The initiative would cover up to 10 different states in U.S. over a three-year period. Pennsylvania followed by Michigan were the first two states in the fold.
“It’s consisted of evidence-based interventions, working with law enforcement,” Henning described. “It has included developing communications strategies, to reduce stigma and improving access to treatments. Each state is now doing more than 20 projects.” Reducing stigma is important because while other health and medical conditions may garner sympathy and more assistance, as Henning explained, “If someone has an addiction, people scatter.” Imagine being hit by a truck and others saying something like “well that’s what happens when you do this walk-outside-and-cross-the-street type of thing.”
Bloomberg Philanthropies has so far provided $10 million to Pennsylvania. This has helped support seven staff members, allowing them to focus exclusively on the opioid crisis. These have included those embedded in the State’s health department, department of corrections, and department of drug and alcohol programs and in Philadelphia’s behavioral health department and office of criminal justice. Bloomberg Philanthropies has provided $10 million to Michigan as well. This has helped support five staff members in the State’s health department, regulatory agency, and department of corrections. Additionally, both states have benefitted from expert technical assistance from the initiative to help design and implement data-driven policies. The key word here is “data-driven” and not “gut-driven”, “seat-of-the-pants-driven” or “saw-a-post-on-Facebook” driven.
Data-driven approaches tend to get positive results. Both states have seen wider distribution of naloxone, which is used to rescue those who have overdosed. There was a 28% jump in the distribution of this medication in Pennsylvania from 2018 to 2019. Michigan now has a new first-of-its-kind online portal to provide naloxone via mail order, resulting in 148,387 free kits distributed in 2020. Both states now offer greater access to medical treatment for opioid use disorder, especially in prisons. Both states now have enhanced preventive services such as more syringe exchange programs. In 2020, while overdose deaths were up 16% in Michigan and Pennsylvania, these increases were significantly lower than the approximately 30% average increase seen nationally.
“In Michigan, we have taken concrete action to invest in healing and recovery,” said Michigan Governor Gretchen Whitmer in a statement. “We’ve expanded access to naloxone, set up the Opioid Task Force to address racial disparities of the opioid epidemic, created a statewide Recovery Community Collective to elevate voices of lived experiences and expand recovery supports, and expanded treatments and syringe service programs.”
These promising results have prompted additional investments by Bloomberg Philanthropies. On November at the Fourth Annual Bloomberg American Health Summit 2021, Bloomberg announced that Bloomberg Philanthropies will making an even greater investment of $120 million over five-years as part of the Overdose Prevention Initiative. This will include an additional $4 million each for Pennsylvania and Michigan. Plus, five additional states will each receive $10 million in support. Henning described this investment in the following video from the Summit held by Bloomberg Philanthropies and the Bloomberg American Health Initiative at the Johns Hopkins Bloomberg School of Public Health:
“Bloomberg Philanthropies is expanding our work to confront the crisis, by building on the data-driven approach we’ve taken in Pennsylvania and Michigan, where we’ve made some important progress,” said Bloomberg in a statement. “We will now begin working in five more states: Kentucky, New Jersey, New Mexico, North Carolina, Wisconsin. We know we can save lives from this crisis, and we will.”
Again, there’s that word “data-driven.” Instead of being blinded with science, with apologies to Thomas Dolby, science can help open eyes and guide the way for public health strategies. And one of the silver linings to the pandemic has been increased attention to public health. “The pandemic has increased an appreciation for public health strategies,” Henning said. So maybe the pandemic taking center stage will help other ongoing problems reach the stage as well.