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"An Unintended Consequence": Overdoses Spike In Clark Co. After Pandemic, Lockdowns

Shooting heroin

A still from the 2016 WTIU documentary "Finding the Fix: Heroin's Hold on the Heartland." The documentary explores the epidemic of heroin and opioid abuse and addiction in the Midwest, specifically along the shared Ohio, Indiana and Kentucky borders. (WTIU/WFIU News)

For the last four years, Lisa’s Monday evenings went the same.

She would hop in her car, make the 30-minute drive to Jeffersonville and unlock the large red doors of St. Paul’s Episcopal Church to prepare the cafeteria for weekly recovery meetings.

“I open up the church for our meetings, I make the coffee, I get everything ready. But that’s to make sure I’ll be here. That’s to force it on me,” she said.

Lisa’s been in recovery for the last nine years – by the time she made it to recovery in 2011, she’d “used just about everything.”

“I was never aware that [drugs] were the problem. They were always the solution,” she said.

Weekly group meetings became an integral part to maintaining her sobriety after a lifetime of substance abuse. But they stopped in March after Gov. Eric Holcomb issued a “stay at home” order to slow the spread of the coronavirus.

“I was due to celebrate my nine years [the week the state locked down],” Lisa said. “That Friday, they called and said that everything was being shut down. I was due to celebrate on Monday, and it really hit me hard. It was all kind of symbolic for me.”

Lisa Camacho
Lisa sits in the St. Paul Episcopal Church cafeteria for the first time since the pandemic started. "I was due to celebrate on Monday, and it really hit me hard. It was all kind of symbolic for me,” she said. (Adam Pinsker, WTIU/WFIU News)

It has been a lot of work, but Lisa has stayed sober through the pandemic. For many others in the area, though, that hasn’t been the case.

“We were down about 40 percent, as far as overdose deaths and ER visits for overdose,” said Dr. Eric Yazel, Clark County’s Health Officer. “And then once COVID hit, you saw that trend right back up again.”

By the end of April, the month’s overdose events were up by over 150 percent. May then saw the most overdoses since the county started keeping track of the data roughly a decade ago. And with about two months still left in 2020, the number of overdoses in Clark County has already surpassed last year’s total.   

“If it was me and I was still in active addiction, and that was what I needed to make me okay, the pandemic would be an excellent justification for that,” Lisa said. “It’d be an excellent reason. And so, I'm not surprised. Because that's kind of the way our minds work, you know?”

Counties across the state have reported overdose increases. Indiana Drug Czar Doug Huntsinger said before the pandemic, Indiana was a success story – the state was seeing overdose deaths decrease by twice the national average.

“Indiana was positioned really well to begin to really see some of our numbers decline,” Huntsinger said. “The pandemic, of course, has had a huge impact on people with substance use disorder, and we've seen a 79 percent increase in our overdose events at emergency departments. We've also seen a 63 percent increase in EMS naloxone administrations.”

Lisa said many recovery groups, including her own, moved their meetings online at the start of the pandemic and other options, including literature and treatment centers, have been available and stayed open. She’s been more reliant on her sponsor and friends and takes comfort in knowing that they’re still there and still clean.

“I have felt at times overtaken by all what's going on out there in the world, the pandemic and everything else that's going along with it,” she said. “But I can always go back and return to that foundational stuff and do what I have been taught to do.”

Maintaining those relationships has been essential for Lisa, as her own family has lost someone to addiction over the pandemic.

“They had opportunity to go to as many meetings as they could,” she said. “They had all the support in the world. And they – I guess they just sort of started to have some questions and drift away a little bit. And they found themselves doing what we do. And they overdosed, and they died.”

Dr. Yazel will tell you that not having those personal connections and stability that come from group meetings, employment and just regular life has likely heightened feelings of isolation and hopelessness already on the rise because of COVID.

“It's absolutely an unintended consequence [of the pandemic and lockdowns],” he said. “And that's one thing I say, is some of these public health decisions we make, we can't do them in a vacuum. Because my philosophy, at least locally here [as county health officer] has been to kind of stay in the middle – if you're too aggressive [staying open], you're probably putting people at unnecessary risk. But if you’re too conservative, the things you're trying to protect – some of that fallout outweighs what you're trying to protect in the first place.”

COVID-19 has been responsible for 65 Clark County deaths since March; unintentional overdoses have killed 41 people in that same timeframe.

The county’s overdose numbers have begun to level off a bit and many groups have gotten back to holding smaller in-person meetings.

“The big silver lining I take is the fact that even though our overdose activities increased, our death rate has not increased as much. And so that tells us that some of our programs are effective,” Dr. Yazel said.

One program that stayed open was the county’s syringe exchange program. That’s especially important because in 2015, neighboring Scott County was the epicenter of an HIV outbreak that was spurred by intravenous drug use. It also affected Clark, which has already had 159 heroin overdoses, its most since 2017. 

“Certainly anytime you see an increase in that activity, it does lead to concerns that you'll have increased HIV or other IV drug use-related infections and things like that, that are going to start popping up the next 6 to 12 months,” said Dr. Yazel. 

READ MORE: As Expiration Date Approaches, Scott And Clark County Tout Effectiveness of Needle Exchanges

Clark County’s Board of Commissioners voted to extend the county’s syringe exchange program in August. Among other things, the program provides drug users with clean syringes and a safe place to dispose of them.

But the needle exchange is set to expire in July of 2022, along with the state law that allows the programs to operate. Dr. Yazel says the exchange program is critical to keeping potential HIV cases down, and hopes that when it’s all said and done, this will be another example for state officials to see the effectiveness of syringe exchange programs. 

“COVID-19’s effects on the opioid epidemic [and] substance use disorder, it just shows how fragile this environment is. Anything that kind of shakes the societal norms that we have, and you go right back to the [peak] 2016 numbers. And that's what we saw.”

As for meetings at St. Paul’s, Lisa says she’s not sure when and if they’ll start back up again.

“Without seeking out recovery on a regular basis, staying connected and using my sponsor, using other people in recovery to really talk about what's going on inside of me, it would be a very good chance that I would end up going, ‘How did I get here again?’” she said. “When I go back to [visit] Indianapolis, I'll find out where the meetings are, if they're already going on. And I'll wear my mask and do what I got to do. Because I don't want to have to live in that hell again.”

 For the latest news and resources about COVID-19, bookmark our Coronavirus In Indiana page here.

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