Overdoses In The Media

Over the past month w­e have witnessed the devastation that alcohol and other drugs have caused for so many families. First it was Harry Brandt, age 24, a young and upcoming model and son of supermodel  Stephanie Seymour, who died in an accidental overdose of prescription drugs.  According to news reports, Harry was no stranger to the perils of abusing alcohol and other drugs and had been scheduled to enter a behavioral health center yet died before that could happen. From the outside Harry once had everything, fame, wealth and popularity from the inside he was alone and in isolation. Harry is not the first nor last silver spoon child who has fallen prey to the perils of substance abuse

Then we learned that Britt Reid, the 35-year-old outside linebackers coach for the Kansas City Chiefs and a son of the head coach Andy Reid, told police officers he had “two or three drinks” and Adderall before he was involved in an automobile crash on a Thursday night that left a child with life-threatening injuries, according to a search warrant filed in Jackson County, Mo., circuit court.

The crash occurred just days before the Super Bowl in Tampa, Fla., on Sunday where the Chiefs, the reigning N.F.L. champions, played the Tampa Bay Buccaneers. The Chiefs flew to Tampa on Saturday, but Britt Reid did not.

Finally, on Feb. 8, OWN TV host Dr. Laura Berman mourned the death of her 16-year-old son.

The relationship and intimacy therapist confirmed to USA Monday that her teen son Samuel died on Sunday from anaccidental overdose of fentanyl-laced Xanax at their family home in Santa Monica, California.

“Our son Sammy was a beautiful soul who left us way too soon,” Berman said in a statement provided by her husband, Samuel Chapman. “Our hearts are broken for ourselves and for all the other children that are suffering during this pandemic.”

Berman first shared the news of her son’s death on Instagram Sunday, writing that her son got “the drugs delivered to the house” in an “experimentation gone bad.”

This tragic death spurred my colleague and fellow clinician and interventionist, Heather Hayes to write an excellent blog on teen isolation. The post explores the impact of isolation, the ease with which kids can order drugs online through such platforms such as Snapchat, and the toll that takes on so many families lives.

Overdoses in the Community

The truth is that over 83,000 drug overdose deaths occurred in this past year in the US alone. While overdoses were already increasing preceding the novel COVID-19 virus, these numbers suggest an acceleration of both increased usage as well as overdose deaths during the pandemic.

The disruption of daily life due to Covid-19, the loss of social connection and the rise in online media, as well as the rise in online purchasing of mind-altering substances and ease of home delivery has exacerbated the situation.

My home state of California saw 7,121 deaths reported as drug overdoses in May 2020 12 month-ending period. The national number at the same time was 79,251. This is part of a skyrocketing rise, with overdose deaths in California up 26.8% in the period between June 2019 and June 2020. Nationally, in that same time frame, deaths were up 21.3%.

“It’s a wave and it’s not done cresting,” said Konrad Franco, a researcher at CHPS. “I don’t think the general public really understands the scope of the epidemic,” said Franco. “If you look in individual counties’ data and in all of 2020, 3 times more people died in San Francisco [of drug overdoses] than they died of COVID.”

Causes of Drug Overdose

One of the main causes of the trend is an increase in the use of fentanyl in California, a drug where a single misstep in the dosage can lead to an overdose, said Dr. Aimee Moulin, behavioral health director at the Emergency Department at U.C. Davis and a co-principal investigator with the California Bridge Project. Fentanyl is a synthetic opioid similar to morphine but about 100 times more potent.

“In the past, we have been very heavy on stimulants, methamphetamines predominantly with heroin kind of in the background, and that has shifted dramatically towards fentanyl over the past year,” said Dr. Moulin.

Fentanyl is also killing a lot of young people according to Dr. Moulin. Those aged 20-34 years old died more from fentanyl overdoses than from other types of drugs.

“The frightening thing is how young these people are, the folks that are using fentanyl are young,” said Dr. Moulin. “We’ve had some teenagers overdose recently. So, when you look at these numbers and you see that spike up there, these are people and they are young.”

This increase in the use of fentanyl may not, however, be a result of overprescribing of opiates by doctors. Franco says California has actually seen about a 25 percent decrease in prescriptions since 2015. The pandemic however is expected to have caused an increase in the rise in overdose deaths.

Mental Health in the Pandemic

The CDC also reports an increase in mental health issues, increased substance abuse, and suicide ideation during the pandemic.

The pandemic has been disruptive in a lot of ways. People have moved, people have lost their jobs, so your usual source of care gets disrupted. Plus the social stressors, people who were previously in treatment, [their] clinics were closed, lost their insurance, so that disrupts their treatment and often precipitates relapse.

The sheer magnitude of the Covid-19 crisis is hard to fathom. Besides loss of life and loss of income, the immense stress and trauma of the pandemic and the resulting economic recession has negatively affected many people’s mental health and created new barriers for people already suffering from mental illness and substance use disorders.

During the pandemic, about 4 in 10 adults in the U.S. have reported symptoms of anxiety or depressive disorder and many adults are reporting specific negative impacts on their mental health and well-being, such as difficulty sleeping (36%) or eating (32%), increases in alcohol consumption or substance use (12%), and worsening chronic conditions (12%), due to worry and stress over the coronavirus.

Key Takeaways of the Pandemic

  • Young adults have experienced a number of pandemic-related consequences, such as closures of universities and loss of income, that may contribute to poor mental health. During the pandemic, a larger than average share of young adults (ages 18-24) report symptoms of anxiety and/or depressive disorder (56%). Compared to all adults, young adults are more likely to report substance use (25% vs. 13%) and suicidal thoughts (26% vs. 11%). Prior to the pandemic, young adults were already at high risk of poor mental health and substance use disorder, though many did not receive treatment.
  • Research from prior economic downturns shows that job loss is associated with increased depression, anxiety, distress, and low self-esteem and may lead to higher rates of substance use disorder and suicide. During the pandemic, adults in households with job loss or lower incomes report higher rates of symptoms of mental illness than those without job or income loss (53% vs. 32%).
  • Research during the pandemic also points to concerns around poor mental health and well-being for children and their parents, particularly mothers, as many are experiencing challenges with school closures and lack of childcare. Women with children are more likely to report symptoms of anxiety and/or depressive disorder than men with children (49% vs. 40%). In general, both prior to, and during, the pandemic, women have reported higher rates of anxiety and depression compared to men.
  • During the COVID-19 pandemic, concerns about mental health and substance use have grown, including concerns about suicidal ideation. In a survey from June 2020, 13% of adults reported new or increased substance use due to coronavirus-related stress, and 11% of adults reported thoughts of suicide in the past 30 days. Early 2020 data show that drug overdose deaths were particularly pronounced from March to May 2020, coinciding with the start of pandemic-related lockdowns.

Mental distress during the pandemic is occurring against a backdrop of high rates of mental illness and substance use that existed prior to the current crisis. Prior to the pandemic, one in ten adults reported symptoms of anxiety and/or depressive disorder. Nearly one in five U.S. adults (47 million) reported having any mental illness. In 2018, over 48,000 Americans died by suicide,3 and on average across 2017 and 2018, nearly eleven million adults reported having serious thoughts of suicide in the past year.

For Our Future

This trend will not disappear after the pandemic has ended either, said Dr. Moulin.

“I think we’re going to have a lot of digging out to do,” said Dr. Moulin. “Next year when we’ve vaccinated everybody, we will still be digging out from this.”

While the world is now starting to get vaccinated and things are opening up, we have a tremendous amount of work to do to address the problems associated with the increase in mental health and alcohol and other drug problems. Jobs, housing, public health campaigns along with making counseling and behavioral services available to everyone must be a priority.

Let’s all join in the solution.