While COVID-19’s devastating toll has taken center stage over the past year, another health crisis has quietly raged on.
Nationally, opioid overdoses have accelerated amid the pandemic’s daily life disruptions. In Washington state, overdose deaths increased by 38% in the first half of 2020 compared to the same period the previous year, according to the Department of Health.
Even more locally, those same alarming trends are also playing out, said Amy Hill, an opioid outreach specialist with the Snohomish County Human Services Department.
“The bottom line is that the social connection just isn’t there,” she said. “Not having any support is really traumatic.”
Nationwide, overdose deaths were already on the rise in part because of synthetic or illicitly manufactured drugs like fentanyl, a powerful opioid. In Washington state, for example, fentanyl has been found in counterfeit pills that people may confuse as prescription opioid pills.
The pandemic’s added stressors only deepened the crisis. Social isolation is not only a threat to mental wellbeing but physical health, too, experts say. If someone begins to overdose alone, there’s no one to intercede and prevent death with the life-saving medicine naloxone.
Struggling to connect
As one of her roles, Hill reaches out to people who have survived an overdose and helps connect them with recovery services. She has found clients in homeless camps. Others have been recently incarcerated. Many were estranged from their families and the connection with another human was vital to their recovery efforts.
Before the pandemic, she would often meet clients at a cafe. She’d buy them a cup of coffee, listen to their story and explore the available treatment options together. On some occasions, Hill would sit next to clients and wait while they called for an appointment. If they encountered frustrations – like long hold times – she’d be there silently supporting them.
“Sitting with someone and going through the process together is really important,” she said. “And with the pandemic that’s been taken away.”
Over the past year, Hill was still able to reach out to some clients by phone, but it hasn’t been the same. As the pandemic stretched on, she got more creative and met people in a parking lot or a park, though that also posed a challenge in the colder, rainy months.
Despite the pandemic’s isolation, there have been some moments of hope. She pointed to one client who has now hit the four-month marker of being clean and sober, after a long, grueling journey. He’s now off the streets and living in a clean and sober house where he’s helping with landscaping and contributing to the daily chores.
“It’s really great to see his motivation looking for employment and wanting to do good,” she said.
The pandemic’s impact has extended to families of people struggling with opioid addiction as well, said Edmonds-based counselor Lara Okoloko, who works with families impacted by addiction. While some may assume parents send their adult children away in hopes of “getting better,” the reality is more complicated, she said.
Pre-pandemic, individuals would often come and go from their parents’ homes. Some clients allowed their grown children to live with them – even as they struggled with drug use—because they wanted to keep an eye on them and support them through what’s often a long and complex recovery process.
Suddenly, though, those interactions posed a threat to older parents’ own health and wellbeing.
“Families might feel differently now,” she said. “I help them figure out what boundaries work for them and their families. That’s much more complicated than a blanket declaration, telling them to go away.”
Locally, families have gotten creative over the past year as they’ve tried to balance supporting their loved ones with protecting their own health. Some have sectioned off a separate part of the house for their grown child or put up a tent in the yard while others arranged motel stays after potential COVID-19 exposures.
Still others had to make the tough decision to separate completely, she said, explaining their thought process: “I can’t risk my own health. You need to stay somewhere else.”
For some people who struggle with opioid addiction, the slower pace of pandemic life has had unexpected benefits, Okoloko said.
“While some have had a terrible time, for others, it’s been an opportunity to slow down and find stability for the first time,” she said.
Isolated at home, often with parents nearby, they’ve been able to create stable routines that incorporate treatment medications. The reprieve from the stress of daily life has provided an opportunity to focus on recovery.
Another unexpected benefit of pandemic: virtual therapy. People who couldn’t find a nearby therapist with openings can now access someone elsewhere in the state.
Meanwhile, treatment providers are continuing to work, both virtually and in-person. For some, a virtual appointment option might present less of a barrier than going in-person. Plus, family members can sit in the room for support during a videocall intake process.
Looking back over the past year, Okoloko sees some opportunities in times of upheaval, some of which might continue once the pandemic subsides.
“At this point, it feels more like a mixed bag with positives for some and negatives for others,” she said.
— By Kellie Schmitt
This article is part of an ongoing series exploring the impact of coronavirus on the life, work and health of South Snohomish County residents. If you or someone you know has a story to tell, please email us at firstname.lastname@example.org. For other stories in this series, click here.
For more information and resources on opioid overdoses in Washington state, check out www.stopoverdose.org.