Thursday, April 23, 2020

OD Deaths Versus COVID Deaths

 Early on, I wondered when this was all over, if we would say, we did all this disruption and in the end, fewer people died of COVID than accidental overdoses in our state.

Well, this week COVID has blown past substance use deaths. As of yesterday there were 1554 deaths in Connecticut is just a little over one month versus 1200 OD deaths in a year.  Nationwide COVID deaths at 47, 034 still lag annual OD deaths at 67,000, though they will likely catch up and surpass.  I don’t mean to compare loss of life from one to the other. They are both tragic.

I also wonder how many more deaths there would have been in our state had our governor not put into place social distancing and business and park closures. Even with that Connecticut is one of the hardest hit states in the nation both in terms of sheer death numbers (6th) and the high mortality rate (6.9%-2nd). Currently our cases are doubling every 11 days.

Connecticut COVID-19 Statistics

United States COVID-19 Statistics

None of this means we should stop paying attention to substance use deaths, which may likely accelerate due to the COVID epidemic for the following reasons

1. Decrease in out-reach services that have been shuttered or have reduced hours.

2. Decreased availability of Naloxone.

3. Disruption in drug supply lines leading to bad mixtures or people buying from unfamiliar dealers

4. Increased stress can lead to increased substance usage.

5. Isolation can lead to people using alone without a rescue partner.

6. People being released early from jail with decreased tolerance.

7. People who are COVID positive may have decreased respiratory reserves making them less likely to survive an overdose.

8. Loss of work and health insurance can lead to substandard care or failure to seek care.

9. Stimulus checks could cause binge drug use leading to fatal overdose.

10. EMS protocols that out of COVID precautions, now(in some areas)  forbid or restrict use of bag-valve mask ventilation to assist people who are not breathing or ventilating ineffectively.

One of my jobs is to read every day the Statewide EMS overdose reports that are called in daily to our poison control center. The stories continue to be heartbreaking. Patient released from jail, found dead the next day with syringe in arm. Child finds parent dead in bathroom, doing CPR on EMS arrival. Young man found dead in hotel with empty heroin bags around him. Homeless person and known heroin user found dead in vacant building. Young woman found dead in upstairs bedroom by parents when they came in to say goodnight.

Whether a death in a nursing home, in an ICU or behind a building, we are family in Connecticut and in America.

We are all in this together.