‘Lost in your own hell’: As pandemic recedes, worsened opioid epidemic persists
MINERAL POINT, Wis. – The COVID-19 pandemic overshadowed and worsened a deadly epidemic that touches so many in the country.
The challenges of the pandemic drove many to substance use, whether it was a new habit or an old one.
‘I had no one to talk to’: COVID disrupts usual support system
“I had a really bad life until moving here,” said Shaun Jaco, sitting on a swinging bench outside his Mineral Point home. “I never had friends like I have up here.”
It took a change of scenery and a new support system for his life to look brighter.
“I never want to see a kid have to go through what I go through,” Jaco said. “My little brother’s dad was extremely abusive to all of us.”
When he was a kid, it was hard to see the way through the darkness. He left at 12, tried heroin for the first time while homeless in Atlanta, got into meth, and eventually spent 13 years in prison away from his children.
“I was choosing drugs over them,” Jaco said. “I hate saying that.”
He loves talking about his recovery. He’s gotten used to giving public talks, even participating in an Iowa County documentary, ever since he got clean for his kids and came to Wisconsin.
He credits his parole officer, along with another unlikely friend.
“I’ve never been friends with a cop,” Jaco said.
“When having a tough time, a guy that’s been in prison for a lot of his life, where did he come? He comes up and sees me,” said Michael Peterson, jail administrator with the Iowa County Sheriff’s Office.
Things got tough for Jaco again in 2020, during the pandemic and following his mother’s death.
COVID-19, a dark cloud for many, hung especially heavy over people whose positive relationships kept them sober.
“I had no one to talk to,” he said. “They want you to sit at home and be lost in your own hell.”
Jaco was looking for some kind of meeting or service one night in the winter, but everything was closed.
“Every building is closed because of social distancing,” Jaco said. “So I get high and I overdose.”
Jaco, worried he’d lose his family again, felt alone. Statistics tell another story.
Substance use, opioid overdoses up
In Iowa County, Peterson said EMS response to overdoses is steadily climbing, from a total of 8 in 2018 to 15 already this year. None of those represent deaths.
“It’s scary because it’s an upward trend,” Peterson said.
According to the Wisconsin Department of Health Services, Dane County opioid deaths jumped from 105 in 2019 to 123 in 2020.
Statewide, DHS data show opioid deaths topped 1,000 for the first time ever in 2020, with preliminary numbers showing 1,226 such deaths. That’s up more than 300 since the previous peak in 2017.
The month with the most opioid deaths, May 2020, corresponds to one of the first months of the pandemic in Wisconsin. Each month since July 2019 has had above average opioid deaths.
Sauk County data show an increase in drug overdose deaths overall, rising from 13 in 2019 to 21 in 2020.
“We all have been affected, and one overdose death affects an entire community of people,” said Sara Jesse, a community health strategist with the Sauk County Health Department. “I think it is due, in part, to the isolation caused by the pandemic, but also to drugs we’re seeing in the community.”
The majority of deaths in Wisconsin in 2020, 1,051, were attributed to synthetic opioids such as fentanyl.
This impacts emergency calls, as well. Dane County Emergency Management statistics show a 23% increase in in EMS calls for suspected opioid overdoses in 2020.
The administration of naloxone, the drug that brings people back from opioid overdoses and saved Jaco’s life, has gone up since 2019. So far this year, 511 naloxone doses have been administered, compared to a total of 876 in 2020 and 727 in 2019. When comparing naloxone administration January through June each of those years, the county has seen a 54% increase since 2019.
Fitch-Rona EMS has an increase in naloxone use as well, recently starting a Leave a Dose Behind program to leave the life-saving drug with patients and/or their families following an overdose.
“While the highest volume of EMS responses to suspected opioid overdoses over the past three years took place between March and July of 2020, the sustained increase began as early as fall of 2019,” said Eric Anderson, a data analyst with Dane County Emergency Management. “This demonstrates that drug-involved overdoses have always been an issue of concern, and the COVID pandemic magnified challenges in accessing and engaging in treatment and recovery services.”
The Madison Police Department reports that they responded to slightly fewer overdose cases and confirmed and suspected deaths in 2020 compared to 2019, though they clarified that police don’t respond to all overdose calls.
“The pandemic really worsened things considerably,” said Dr. Mike Repplinger, an associate professor of emergency medicine at the UW School of Medicine and Public Health. “A lot had to deal with the joblessness, homelessness, strains on relationships, isolation — all of which lead people who cope with those challenges by using. Not surprisingly, they ended up using more.”
Repplinger said at UW Health, the average number of yearly overdoses has gone up 15% each year for the past four years.
“We need to get people connected to care, and a lot of clinics, as everyone knows, were shut down during the pandemic,” he said. “There were virtual visits if you were lucky.”
Telehealth isn’t for everyone, including Jaco.
“I don’t know how to do no telehealth or Zoom,” he said.
But virtual options are what recovery organizations like Safe Communities in Madison were left with.
‘The world is on fire’: Recovery specialists adapt to changing landscape
“We were already in the middle of an epidemic before the pandemic hit, a whole big mountain that rose up,” said Tanya Kraege, the certified peer specialist program manager at Safe Communities.
Doing their best to climb that, peer recovery coaches are now working on a return of in-person services mixed with virtual options, which can improve accessibility, especially for those with transportation barriers.
“As bad as it’s been, still a lot of positives have come out of it,” said Joseph Galey, a peer support specialist.
Galey said the pandemic did make it harder for many to engage in recovery and treatment. He also noted an increase in fentanyl-laced substances as people traveled less and secured whatever substances they could.
“Even for myself, a person in recovery, things got to the lock-down phase, and I started struggling,” he said.
Even with the pandemic receding, the opioid epidemic sits tall in its wake.
“I can hardly go on Facebook these days without seeing another person we lost in our community,” Galey said.
While Kraege doesn’t think the pandemic was the only contributing factor to increased substance use in 2020, now that the worst is over, people may be coming to terms with feelings buried during the pandemic.
“The team here is getting slammed,” Kraege said. “People are struggling. The world is on fire.”
Kraege said with calls doubled, increased funding is needed more than ever. Just as important, she said, is reducing stigma
“This is a human being who more than likely has a long history of trauma,” she said.
“This is a chronic disease,” Repplinger said. “The reward pathway is hijacked.”
It’s not just opioids. Dane County Emergency Management reports a significant increase in EMS responses to suspected alcohol or substance use emergency calls in 2020, at an 18% increase over 2019.
“While the first half of 2021 has not seen a sharp increase like 2020, the frequency of these emergencies have remained high,” Anderson said.
Timely resources can be tough to come by, especially rurally and in places such as Iowa County.
“I died that night when I overdosed,” Jaco said.” And I (had) to wait now to be seen.”
“It’s not how hard you fall, it’s how you bounce back,” Peterson said.
Jaco has done just that, happy again to share his story of recovery.
“To see him going back to church, being the best dad he can be, it’s just a great feeling,” Peterson said.
“It’s way more rewarding than jabbing myself with a dirty ass needle,” Jaco said. “I’m on TV now and I’m not in a high speed chase. That’s amazing.”
He’s focusing on the bright points in life, able to see them clearly with his family by his side.
“Now I’m diving in head first, absolutely loving it,” he said.
Monarch Health opened in Madison last year to provide alcohol and opioid treatment services within a business day of a referral.
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