Over 93,000 Americans died of drug overdoses in 2020, an increase of nearly 30 percent from the previous year that set a record, the Wall Street Journal reported on Wednesday, citing new CDC data. “That is a stunning number even for those of us who have tracked this issue,” Brendan Saloner, of the Johns Hopkins Bloomberg School of Public Health, told the Journal. “Our public health tools have not kept pace with the urgency of the crisis.” The presence of fentanyl in the drug supply has helped drive the increase of fatal overdoses, and the pandemic itself may be another factor.
It’s difficult to measure the real impact of isolation, or the psychological burden imposed by mass illness and death. Social-distancing requirements and shuttered schools, churches, and workplaces stranded individuals in their homes for months and kept people apart. That was necessary, but without the usual support networks in place, people with substance-use disorders may have become uniquely vulnerable to drug abuse. The economic circumstances created by the pandemic may have also cut people off from medical care, disrupted treatment, or deprived them of the stability they needed to avoid falling into risky behaviors.
Like all public-health matters, however, overdose rates are complicated and are influenced by multiple factors. So-called “deaths of despair,” which include drug- and alcohol-related deaths and suicide, had been rising before the pandemic occurred. A massive economic downturn was unlikely to help reverse the trend. Nevertheless, experts have pointed out that there are other factors at work. In a January interview with NPR, economist Anne Case, known for her groundbreaking work on deaths of despair, cautioned against settling on the pandemic as a primary explanation for rising overdose deaths. “There’s this horribly dangerous, deadly drug on the market that is responsible for this explosion of drug overdoses,” she pointed out at the time.
Fentanyl is significantly more dangerous than heroin, as the Journal points out. When mixed into the drug supply, people may consume it without realizing it’s present and the results can be deadly. The Journal states that “57,550 people died of overdoses from synthetic opioids, primarily fentanyl, an increase of more than 54% over 2019,” according to the CDC. ” What’s more, people likely used drugs in isolation during the pandemic, lowering the odds someone could revive them in case of an overdose. The trend highlights the need for more effective policy solutions at the state and federal levels. The entire pandemic provided a deadly lesson in the need to invest more heavily in public-health infrastructure; rising overdose rates argue that drug use, too, belongs under the same public-health rubric. Instead, drug users are often subject to a kind of moralizing, abstinence-only sentiment that shapes punitive drug policy. Drug users deserve more from policy-makers — and so does everyone else.
While deaths of despair don’t fully explain rising overdose deaths, the necessity of a better social safety net ought to be obvious. Society is tentatively taking initial steps back toward normalcy, but full recovery is impossible unless we scrap the pre-pandemic status quo for something more egalitarian. People need stability, whether they use drugs or not; that means stronger rights for workers, and a more expansive welfare state. Social contact helps, but it can only accomplish so much. Despair demands radical change.