Amid rising hospitalizations and deaths related to the novel coronavirus, drug abuse experts and advocates say that another crisis is also emerging: Deaths from drug overdoses have reached a record high.
According to the American Medical Association (AMA), more than 35 states have "reported increases in opioid-related mortality" since the pandemic began. The Overdose Detection Mapping Application Program (ODMAP), a surveillance system that provides near real-time suspected overdose data nationally, reported more than 60% of participating counties experienced an increase in overdose submissions, with an observed 17% increase in suspected overdose submissions when comparing the weeks prior to and following the end of state-mandated stay-at-home orders.
For mothers Lisa Mahoney and Amy Sutton, the crisis hits close to home: They both lost their adult children to drug overdoses during the pandemic.
Sutton said that her son Brian, 30, who had been in recovery for about a year when the pandemic hit, had been an active member of several support groups, which were no longer able to meet due to restrictions on gatherings. Many communicated online and over the phone.
"Self-isolation is always a risk with addicts," she told TODAY. "They will tell you that whenever an addict starts to self-isolate or withdraw from the group, that should always be a (red flag). Whether it's alcohol, narcotics, opiates, whatever, they need to have people around them who can read the signs. If they self-isolate, nobody knows what's happening. Nobody can see, nobody can hear."
Brian passed away on June 17, after a "one-time relapse," according to Sutton, a situation that experts say is relatively common among drug users in recovery. Their tolerance may have changed due to a period of not using drugs, so a dose that they might have been able to handle before could lead to an overdose.
Dr. Sarah Wakeman, an addiction medicine specialist at Massachusetts General Hospital in Boston and the medical director for the hospital's substance use disorders initiative, told TODAY in early May that she believed the pandemic would result in increased rates of overdose and relapse.
"So much of people getting well is often about connection with other human beings and people who care about them and their sense of identity and feeling loved and valued," she said. "(Social distancing and isolation) is hard for all of us, and particularly challenging for people who are actively using or people who are very early in recovery."
Lisa Mahoney, 57, who lives in Massachusetts, said that her son Jonathan, 27, had a prior diagnosis of schizoaffective disorder, a chronic mental health condition characterized by symptoms of schizophrenia-like hallucinations or delusions, and symptoms of a mood disorder (mania and depression). He had a support team that included a clinician and an addiction specialist, but he was unable to communicate with them or attend meetings. He died of an overdose in late April after purchasing drugs with a friend, Mahoney said.
"The pandemic just increased the isolation," she said, adding that she believed the isolation made her son more willing to go out with his friend than he might have otherwise been. "It made the secrecy that goes around drugs even worse."
There are more concerns that just isolation: Experts worry that the stress of the pandemic itself, the shifting job market and financial insecurity could all lead to drug use or relapses.
Samantha Arsenault, the vice president of treatment initiatives at Shatterproof, a national nonprofit organization based in Connecticut focusing on reversing the addiction crisis in the U.S., called the situation "incredibly heartbreaking."
"There's obviously an increase in fear and isolation, which are factors that exacerbate substance use and are incredibly challenging for someone with an active substance use disorder to process and manage without assistance in the first place," she said. "But there's also more difficulty in accessing treatment of things like medication and therapy."
Mahoney said that the trauma of losing her son was compounded by not being able to hold a regular funeral service.
"You couldn't have a wake or a funeral," she said, through tears. "... We could only have 10 people in the funeral home ... It would have been too hard. It would have been too hard to stand there for a couple of hours for one or two people. It just didn't seem like it was a possibility."
While the family was eventually able to hold a small graveside service later in the year, as restrictions loosened, she said that the grieving process had been disrupted and slow — and again, the isolation of the pandemic has taken its toll.
"It's just been 90 days," Mahoney said. "The first Mother's Day, the first Father's Day, the first Fourth of July, which was his favorite holiday. It's just been really painful and isolating. You can't really see anybody, you know? It's been hard not to see anybody."
Sutton said that if there was any "silver lining" to the pandemic and the timing of Brian's death, it was that her family was able to have at least some services in their home state of Pennsylvania in late June.
"The funeral parlor had 25% capacity, so people just moved through, but at least we had that opportunity," Sutton said.
She has been involved in multiple forms of therapy since her son passed.
"I feel like my heart has a hole in it that's never going to fill," she said. "It was shock, at first ... I refused to take any medications to deal with it, I didn't want to forget a detail. I remember going through the motions, having people take me by the hand and lead me to where I needed to go and what I needed to do. It's a shock, it's surreal. It's the most heart-wrenching experience that I can ever imagine."
Now, she's trying to share her son's story and help others who are battling addiction.
"My son, so badly, wanted to beat this," Sutton said. "He so badly wanted a life and a family, and he wanted his friends to have the same. My son's (legacy) will live as long as I can help somebody else defeat their battles ... We have more of our kids dying of these overdoses every single day. We’re losing our babies, we’re losing our kids and we’re losing our loved ones. We need to fix it. If one person can be saved, if one mother can be saved from the pain of losing their child, it’s worth my time."