Vol. 256 May 15, 2021 The Other Pandemic

 

“If you look at the number of lives lost, we have a public health disaster
going on in parallel with the COVID epidemic.”
-Miriam Komaromy, MD, Director of the Center for Addiction, Boston Medical Center. (1)

 

 

Remember the other pandemic? In Massachusetts alone 2104 people died from opioid overdose in 2020. That is more deaths than the “peak year” of 2016. “Massachusetts was in a steady decline of opioid deaths before the coronavirus pandemic hit.”  Supposedly the isolation, stress, and fear during the pandemic triggered increased drug use and social distancing prompted more people to use drugs alone, an additional risk of overdose deaths. Perhaps fear of COVID infection kept addicts aways from treatment centers (congregate care settings). Some treatment center censuses dropped by 25 – 40%.

92% of these overdose deaths in whom toxicology analysis was performed were associated with synthetic fentanyl. Cocaine was detected in 43% of the overdoses.

As we are now accustomed to reading with many other medical statistics, there are marked racial/ethnic disparities. In 2020 the overdose death rates ( deaths per 100,000 population) of Black men surged the most, up 70% compared to the State overall overdose death rate increase of 5%.  Hispanic men’s overdose death rate did not increase, but they continue to have the highest rate of overdose deaths in Massachusetts. In fact these opioid death rate disparities follow the same patterns of COVID illness rates for these populations. The opioid overdose death rates varied considerably among towns, apparently unrelated to any demographics.

The story was worse in the rest of the nation. The CDC (you’ve heard of them haven’t you?) reports that the national increase in opioid overdose deaths in 2020 was 30%, obviously much worse than Massachusetts’s overall rate of 5%. Analysts credit the lower rates in Massachusetts to its responses during the COVID  pandemic:  1) increased distribution of opioid-reversing naloxone (Narcan), 2) loosened regulations allowing methadone recipients to take their doses at home, and 3) permitting the filling of other anti-addiction medications over the phone.

Unfortunately we have no vaccine against opioid overdose. . . nor against gun violence, another epidemic . . . and no Fauci to give us advice on how to reduce both.

MEANWHILE . . .

Moderna is preparing for the next twist in the original pandemic by testing three different options of a single-dose booster (yes, you knew that was coming, didn’t you?) against COVID-19 variants. It could be a reduced (1/2) dose of its current vaccine, a new vaccine specifically developed against the variants, or a 50/50 mix of new and old. They are hoping for FDA approval to use the booster in the fall, if enough clinical testing data is available by then.

Like the label “gate” which seemed to be added as suffix to all sorts of erupting political crises, the word  “pandemic” seems to be following the same path as it is being being applied to some of our non-infectious fears. Two days before the Colonial Pipeline was shut down by hackers demanding a ransom to supply the unlocking computer code, the former Head of Cybersecurity at the Department of Homeland Security testified to Congress that “ransomware has brought the world to the cusp of a pandemic of a different variety.”

Q.E.D.

  1. Felice Freyer, Boston Globe, May 13, 2021, pg.1
  2. Amanda Kaufman, Boston Globe, May 13, 2021, pg. D 1

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