'Two pandemics’: Drug overdoses spike, stretching help even further

The social isolation and stressors of COVID-19 have made the opioid crisis even more precarious — and deadly

A woman puts supplies into a paper bag.
Sue Purchase packs a sharps container into a paper bag that is destined for someone using drugs on Dec. 31 at the offices of Harm Reduction Sisters in Duluth, Minn. Other items that may accompany sharps containers in these paper bags are needles, cotton swabs, tourniquets, condoms, Narcan and more.
Derek Montgomery for MPR News

When all the data is in, 2020 is likely to be the deadliest year in American history for drug overdoses. Preliminary federal and state numbers show that the COVID-19 pandemic has made it harder for people who use drugs to stay alive and healthy. It's also taxing the advocates and organizations who work to keep them safe. 

Sue Purchase is based in Duluth, Minn., but she’ll deliver safe injection supplies and the overdose antidote naloxone to people as far south as Pine County and all the way north to the Canadian border. 

She’s been working in the field of what’s called “harm reduction” for decades, trying to meet people who use drugs where they’re at, and help them be as safe as possible. The stakes have always been life and death in this field. But Purchase said the pandemic and social distancing have made the opioid crisis even worse. 

“People are shut in,” Purchase said. “What's going to happen if you're using alone and you overdose? There's nobody to save you.”

Boxes filled with supplies.
Boxes of supplies ranging from sharps containers and condoms to needles and Narcan await distribution on Dec. 31, 2020, at the offices of Harm Reduction Sisters in Duluth. Sue Purchase runs the organization that aims to make drug use safer, which results in fewer overdoses, less disease spread and better outcomes for people who will be using drugs.
Derek Montgomery for MPR News

Looking at a graph of fatal overdoses for the first half of 2020, you see the line start out in January about even with the year before. But as the pandemic drags on, the 2020 line lifts off. And by early summer, the total drug overdoses are already 30 percent higher than at the same time the year before. There’s not yet fatal overdose data for the rest of 2020, but advocates like Purchase expect numbers to be bad. 

“Overdose numbers have increased, they're skyrocketing up here,” Purchase said of northern Minnesota. ”We have two pandemics on our hands, and people need to respond to it accordingly.”

Before COVID-19, people who use drugs could find places in northern Minnesota offering safe supplies — no questions asked. But many of those facilities have since shut down or restricted their hours. Purchase said that shortage of supplies has put people in even more danger of diseases like HIV and hepatitis. 

Notes written on a black board.
Needed supplies are tracked on a board inside the home office of Sue Purchase.
Derek Montgomery for MPR News

“A syringe is cheap … to start with, and you get one good shot if you're lucky,” Purchase said.

“Can you imagine doing that for months on end with multiple people? Because that has been the norm in northern Minnesota.”

The Steve Rummler Hope Network distributes more than 10,000 naloxone kits across the state every year with the help of groups on the ground. Executive director Alicia House said COVID-19 has shifted attention from the ongoing opioid overdose epidemic, even though people are struggling even more as they lose jobs and homes.

“Especially around the summer, when, you know, not only COVID was going on, but also the racial disparities and tensions going on around the George Floyd in Minneapolis, and there were a lot of people displaced,” House said. “We were getting quite the uptick in requests from communities in harm reduction.”

In the Twin Cities, Jack Martin is among those working to get safe supplies to people who use drugs through the group Southside Harm Reduction. Martin said the increase in people living outside, or in tent encampments, has made the overall situation for displaced people even more challenging.   

“We really see the value in the ‘housing first’ model where people ... have time to focus on things besides where they’re going to eat, where they're going to sleep, how are they going to not feel sick from withdrawal?” Martin said. 

And the burden doesn’t fall across the state equally. Numbers from the Minnesota Department of Health show that African Americans in the state are more than twice as likely to die of a drug overdose than whites. And that American Indians are seven times more likely. Those disparities have just been increasing for a decade, and Martin said it’s clear that the losses have taken a big toll on communities that they’ll be dealing with for a very long time. 

But there is at least one positive that comes along with the economic collapse that accompanied the pandemic, Martin said.

“There are more volunteers to do the work on the streets because so many people lost jobs or were furloughed,” Martin said. “We definitely see and really appreciate all these glimmers of hope, which largely revolves around people really having this deep desire to look after each other.“

At least once a week, Marissa Bonnie can be found handing out supplies like safe injection kits, naloxone and hand warmers on Bloomington Avenue in south Minneapolis for Southside Harm Reduction. Other days, she’ll do outreach at encampments or other places outside where people have been living. 

People stand at tables that line a sidewalk.
Outreach tables set up to help provide services on Bloomington Avenue in Minneapolis.
Courtesy of David Glanzer

“A lot of places closed down; services have ended or are limited,” Bonnie said. “Just to be able to use the bathroom and wash your hands has been less accessible.”

Bonnie pulls a cart behind her over icy sidewalks, using a grabber to pick up any discarded syringes. She chats up people — and not just about drug use, but about their families or favorite sports teams. She said the public shouldn’t forget that “drug users are people.”

“With the overdoses, it's not just data, those are people's lives,” Bonnie said. “Those aren't just numbers, they are people who have families and a life, and cares, and love — it is absolutely heartbreaking.”

Although lots of volunteers and advocates have pitched in from different organizations, Bonnie said the systems aren’t offering much help to people, and so advocates are left to do the best they can with what they have. But it feels, she said, like there’s never enough. 

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