Alabama had 980 drug overdose deaths in 2020, an increase of about 27% from pre-pandemic 2019, according to preliminary numbers from the Alabama Department of Public Health.
State Health Officer Dr. Scott Harris said he didn’t have a complete explanation for the spike in overdose deaths, but it’s likely the pandemic contributed to it.
“People had difficult economic times, they had social isolation and just being out of their normal activities,” Harris said. “And I think public health and other health care interventions were probably sidelined a bit because everyone was focused on COVID.”
Separately, there were 793 suicides in 2020, according to information obtained from death certificates. That’s slightly fewer than the preceding three years, but Harris cautioned that the 2020 numbers are preliminary and could increase. The same is the case for the overdose information. It takes 10 months to a year to finalize numbers, including ongoing death investigations and data on deaths of Alabamians in other states, Harris said.
And some deaths attributed to drug overdose may have been suicides, he said.
“We certainly had fears that the numbers (of suicides) would increase because of issues related to mental health issues that are tied to the pandemic,” Harris said. “But really, still, no matter how you look at it ... almost 800 suicides is just not acceptable.”
The Alabama Department of Mental Health has several programs aimed at addressing drug abuse and preventing suicide. Spokeswoman Malissa Valdes-Hubert said department leadership is aware of the spike in overdose cases during the pandemic.
“We are very concerned about the increase in overdoses seen in the last year,” she said. “To address high substance use and in specific areas of our state, the treatment and recovery committee of the Alabama Opioid Overdose and Addiction Council has created new strategies and programs. Through our department, state agency partners and local providers, we can reach individuals where they are, with the right care and treatment.”
The department is also adding overnight help to the peer-to-peer suicide hotline anyone can access at 1-844-307-1760.
Harris is a co-chair of the Alabama Opioid Overdose and Addiction Council, the group tasked with finding ways to reduce opioid-related deaths in the state.
“I think we’ve heard across the nation that opioid problems are rearing their head again after we thought we had made some progress with the issue before the pandemic,” Harris said.
Alabama’s increase in overdose deaths mirrors a national trend, according to information from the Centers for Disease Control and Prevention. The nation saw a 29% increase in drug deaths between November 2019 and November 2020.
In December, the CDC said overdose deaths were already increasing in the months preceding COVID-19, but the pandemic likely accelerated those deaths.
“The disruption to daily life due to the COVID-19 pandemic has hit those with substance use disorder hard,” then-CDC Director Dr. Robert Redfield said in December. “As we continue the fight to end this pandemic, it’s important to not lose sight of different groups being affected in other ways. We need to take care of people suffering from unintended consequences.”
Synthetic opioids, primarily fentanyl, appeared to be the primary driver of the increases in overdose deaths, the CDC said.
Of the 980 recorded drug deaths in Alabama in 2020, 581 were opioid-related.
The drug deaths were mostly among white Alabamians. Forty-eight percent were white men; 28% were white women.
Last year, medical leaders began sounding the alert on an increase in drug deaths.
“The work of public health and the Opioid Council is to continue to address that,” Harris said about the increase. “We still have a long way to go to get out of the opioid epidemic even while we try to get out of COVID.
“… It’s not a problem that we can implement a single solution to … . It will require long-term changes to many different aspects of our society in the way that we deal with people who have substance abuse issues and the approaches taken by law enforcement and corrections and the approaches taken by mental health and public health.”
Looking back, forward
Late last month, a new commission responsible for analyzing how the state responded to the pandemic and making suggestions for handling future emergencies met for the first time.
Co-chair Sen. Tim Melson, R-Florence, said the commission will be looking at how to better provide services should the state ever see another situation like 2020. Looking at the suicide and overdose deaths will be part of the commission’s work. Maybe these numbers are a fluke, he said, “but we need to be prepared for the future.”
“As the (world) population grows and we have more and more interaction, this type of thing could become more frequent than we’re expecting,” Melson said Thursday. “We need to be looking for answers and not just looking for someone to throw under the bus.”
Harris also said that as more 2020 data becomes available, more impact of the pandemic will be seen.
“We know, for example, that the childhood vaccination numbers plummeted during the pandemic because parents just weren’t taking their children for their routine checkups and regular medical care and if school wasn’t meeting in person you know there wasn’t always the urgency to get them vaccinated,” he said.
“We’ve also heard from a lot of providers that a lot of cancer screenings were deferred so many women may have avoided their mammograms or pap smears that they otherwise would have gotten just because we had a pause on elective health care services for a while and people just weren’t seeking out health care environments if they can help it for a lot of different reasons.
“I don’t know what the effects of that are going to be in terms of the magnitude of the problem, but I think it’s definitely a problem.”