Fatal overdoses in Lancaster County soared to 146 in 2020, a 40% increase from the previous year that officials are attributing to COVID-19.

Lancaster Joining Forces, which was formed in 2017 with the mission to reduce deaths from opioids and heroin, said the pandemic has ushered in many of the triggers for addiction and relapse including mental health distress, social isolation, changes in daily routines and access to treatment and support services.

“We had been tracking the numbers all along and sensed that they were going to be higher than in the recent past,” said Alice Yoder, executive director for community health at Lancaster General Health and co-chair of Joining Forces. “Yet seeing the final numbers is heartbreaking because these are people behind these numbers.”

The county recorded its most overdose deaths in 2017, when 168 people died. That number fell by 36% to 108 the following year, and the downward trend continued in 2019 when 104 people died.

Then the pandemic hit.

“We made a lot of progress as a community in 2018 and 2019 with Joining Forces by aligning everyone working on this issue around a common set of data, metrics, and goals,” said Lancaster County Commissioner Chair Josh Parsons. “It had a big impact on reduction of opioid related deaths. That work has continued but has been more challenging to do during COVID.”

Not a surprise

Lancaster County District Attorney Heather Adams said the higher overdose numbers weren’t a surprise “given the circumstances of the pandemic and challenges it presented.”

She said many counties in the state have reported a similar increase they also have attributed to the pandemic.

From 2019 to 2020, overdose deaths in York County increased 45% — from 139 to 201 — according to its county coroner. Over the same two years, fatal overdoses increased 25% — from 28 to 35 — in Lebanon County, and 2% — from 126 to 129 — in Berks County, according to the coroners’ offices in those counties.

Recent preliminary data from the Centers for Disease Control and Prevention showed more than 81,000 fatal overdoses were recorded in the 12 months ending in May 2020. It was the highest number of overdose deaths ever recorded in a 12-month period, it said.

While the CDC noted overdose deaths were already increasing in the months before COVID-19, it said the latest numbers suggest an acceleration in fatal overdoses during the pandemic.

In 2020, the Lancaster County Drug Task Force seized a total of approximately 5,885 bags of heroin and fentanyl, according to Adams. County Coroner Dr. Stephen Diamantoni said fentanyl was the substance most commonly found in fatal overdose cases in 2020.

Despite the government ordered shutdown, law enforcement continued to perform its role in reducing and targeting the illicit heroin and fentanyl supply coming into the county, Adams said. In addition, she said, reducing the supply of illicit drugs is not the only measure that law enforcement can take.

“My office will continue to support diversion programs, like the Second Chances program and our specialized drug treatment courts that are designed to reduce the demand for these drugs,” she said.

When asked if the increase in drug overdoses could be considered a trend, Yoder said recovery is supported by relationships and social contact, and those have been altered by the COVID-19 pandemic.

“The logic would be that once people are vaccinated and the pandemic reduces its effects on people, and we have more in-person connections, all of that would help those struggling with substance use disorders,” Yoder said. “It would be gradual, but the expectation would be that the numbers would decrease.”

Pandemic exacerbating struggle

Monitoring the trends is essential to better understand and respond to drug addiction, and collaboration, experts agree, is essential for success in preventing drug overdose deaths.

“We are all dealing with the mental and emotional effects of the pandemic, but not all have the necessary skills and resources to cope with it,” said Kate Ramsey, Retreat Rehabilitation Center clinical director for Lancaster County.

One of the dangers, Ramsey said, is that the way addiction can affect the brain has made the pandemic particularly challenging for those with substance use disorder.

“We are looking at individuals who relapse and start using again but are susceptible to overdose because their tolerance to these drugs has fallen sharply and that could be lethal,” she said.

However, isolation is the one things that experts point to as a major contributor to the rising number of fatal overdoses.

“One of the things that encourages success in the recovery process is the sense of community and building social support,” said Joi Honer, Retreat Behavioral Health alumni services director.

“Individuals who are receiving treatment services for drug addiction need personal connections … we all do,” she said. “But many of them are struggling because of the isolation associated with the pandemic. They can no longer go to their 12-step group meetings in person, they can’t spend time with friends, and if they overdose no one is there to help.

The need to expand prevention and response activities is important.

“The pandemic is just exacerbating the struggle because access to care is many times limited,” Ramsey said. “Some facilities are closed due to COVID-19 protocols or are limiting who they can see so that has aggravated the situation.”

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