The nation has seen it before: During previous economic downturns, more people died from opioid overdoses, but fewer people entered treatment for heroin addictions.
“There’s likely much more use of substances that we’re not capturing right now, either in hospitals or emergency rooms or jails,” said Gary Tsai, interim director of Los Angeles County’s division of Substance Abuse Prevention and Control. “There is a lot of concern that pent-up cases will materialize once our communities reopen. I think that’s a very real risk.”
The toll of opioids has been increasing in California over the past two decades. More than 4,386 people died from drug overdoses during the first nine months of 2019, about half from opioids, according to the state’s preliminary count.
The “collision of epidemics” endangers people who use drugs on multiple fronts. They face increased risks from respiratory infections if smoking and vaping drugs has damaged their lungs or if opioids suppress their breathing.
But the virus’s social-distancing measures also tear the fabric of medical care and social support for people who use drugs, Nora Volkow, director of the National Institute on Drug Abuse wrote in a recent paper.
“Feeling irrelevant, feeling that no one cares for you, is probably one of the most devastating feelings a human being can have,” Volkow said in a recorded video conference. It can “increase dramatically the risk of taking drugs, and, if you are trying to stop taking drugs, it increases that risk of relapse.”
Weeks before Breanna Dixon overdosed in Fontana, Crystal Acosta in Oakland said she was thinking of quitting drugs, and 60-year-old William Smith was relapsing in Los Angeles.
Acosta, 33, who first took heroin when she was 11, lived in a tent with her partner as the pandemic intensified. She fears what she’ll do if drugs become scarce, struggles to stay safe on the streets and worries about their son, who lives with his grandfather.
“When you do heroin, you get sick and it’s bad when you don’t have those drugs,” she said. “I’ve been thinking about getting clean, just to not have to deal with that.”
Acosta said she had been treated with methadone, which can help reduce cravings and symptoms of withdrawal. But it was expensive to travel to a clinic on the bus, so she stopped going.