While the world eyes the death count from COVID-19, the number of fatal drug overdoses in the United States in 2021 crept up to the highest point ever recorded, according to statistics released by the Centers for Disease Control and Prevention (CDC).
Almost 108,000 people died after overdosing on drugs that year, with about two-thirds of the deaths stemming from the presence of fentanyl or another synthetic opioid.
“We have watched the number of overdose deaths climb for a number of years, but once COVID hit – negatively impacting mental health, in-person treatment, recovery support and harm reduction efforts – the rates just skyrocketed,” said J. Craig Allen, MD, FASM, vice president of addiction services for the Hartford HealthCare Behavioral Health Network and medical director of Rushford. “In addition, travel restrictions may have pushed suppliers to turn to the more easily transported and toxic synthetic opioids, which are being added to an ever-expanding range of drug products.”
The CDC data noted that the death toll in 2021 was almost 50 percent higher than in 2019, with 14,000 more people dying of an overdose in 2021 than in 2020.
“This trend should be alarming to everyone,” Dr. Allen said, noting that the frequent addition of fentanyl is worsening the situation for people seeking drugs on the street.
Concerted and collaborative efforts to address drug use are needed to turn the trend, work Allen said might take years but demands aggressive action now. At Hartford HealthCare, he said ongoing efforts to identify and engage people in care include:
- Medication Assisted Treatment Close to Home (MATCH) program, which taps a combination of medication and therapy to help people in recovery from addiction to opioids, alcohol or other drugs.
- Meriden Opioid Referral for Recovery (MORR) that stems from a partnership with the Meriden Police Department to bring services and support to people in the community struggling with addiction and mental health.
- Tryccyle, a free mobile app people can download and use for support and to check in with care providers.
- Recovery Support Specialists (RSSs), people with personal lived experience with addiction who are trained to support those interested in seeking help. Additional support comes from coaches through the Connecticut Community for Addiction Recovery (CCAR).
- A new residential treatment program, The Ridge, opening soon in Windham.
There are also new initiatives developing as part of the system’s Zero Opioid Overdose Deaths focus, such as:
- Standardizing safety planning and risk reduction efforts for people with opioid use disorder (OUD). Using EPIC and MyChart, harm reduction strategies are being integrating into existing safety plans in each patient’s electronic medical record. All providers working with patients at risk of overdose can access this template using a “smart phrase” during documentation. Patients will receive a printed copy of these strategies at discharge and they can also access them electronically through MyChart.
- Introducing motivational interviewing modules to help providers better connect with patients struggling with opioid and other substance use disorders.
- Enhancing patient and family education around naloxone in the emergency department. With the support of a Hartford HealthCare grant, Jimmy Choi, senior scientist of the Institute of Living (IOL) is launching a pilot program at Hartford Hospital to teach patients about naloxone and hopefully increase the number who fill prescriptions for the life-saving medication once they’re released. Naloxone can be given to reverse the effects of an overdose in an emergency.
- Expanding identification and medication intervention for patients with OUD in our psychiatric inpatient units and emergency departments. Through the “Changing Pathways” project, Backus and Windham hospitals, in collaboration with Beacon Health, will undertake work that mirrors what is already being done at the IOL, to induct patients onto MOUD and transition them to MATCH or other community providers.
Rushford, Dr. Allen added, is also applying for a grant from the Substance Abuse and Mental Health Services Administration to help expand opioid treatment access and support opportunities.
“While we never stopped offering care during the pandemic, people were understandably more reluctant to come into medical facilities. That and the increased use and potency of fentanyl has driven the death rate up to unprecedented levels,” Dr. Allen said. “Through innovative programming, access to naloxone and the involvement of people with lived experience, we will continue to address overdose and OUD.
“With the help of our first-responder partners, we are meeting people where they are to prevent overdoses and, when needed, help reverse them as we connect people with proven treatment to help them recover.”