As Dr. Avery explains, from its earliest days the pandemic provided multiple risk factors for a worsening substance-use epidemic.
“You could see the writing on the wall,” he says. “Social stress, mental health stress, financial stress, isolation, and the sudden closure of treatment clinics — all these problems conspired with the existing opioid epidemic to create an escalating perfect storm.”
The CDC found that drug overdose deaths nationwide jumped more than 29% between 2019 and 2020, and that more than 100,000 people died of overdoses between April 2020 and April 2021 — the highest total since the opioid crisis first took hold in the 1990s. Several other grim statistics also made history during this time span — most notably, record-setting highs for overdose deaths tied to stimulants like cocaine and illegal fentanyl, a synthetic opioid 50 to 100 times more powerful than morphine.
Even before the pandemic, a wave of synthetic opioids was fueling the epidemic by contaminating the drug supply. And with heroin, cocaine, and even prescription medications like Xanax still being laced with fentanyl and fentanyl-like products, deaths in 2020 from synthetic opioids alone (57,614) well surpassed the number of overall opioid overdoses in the previous year (49,860).
The global health crisis then spurred new substance usage, especially among at-risk groups. Dr. Avery suggests that those with a family history of substance use were most vulnerable, and that traumas linked to the pandemic also played a role. Widespread lockdowns, job loss, and the death of loved ones took their toll, with the steepest climb in overdose deaths occurring from April to May 2020.
“Everywhere you turned, there was another stressor,” says Dr. Avery. “All our methods of coping were taken away — we couldn’t go to the gym, we couldn’t go outside, we couldn’t talk to family or friends, we couldn’t have our social gatherings. So the easiest escape for a lot of people became substances.”