Opioid epidemic: 2021 was deadliest year for drug overdoses in the U.S.

Nearly 108,000 Americans died of drug overdoses last year, a nearly 15% increase from the previous record set in 2020, according to estimates by the Centers for Disease Control and Prevention.

The numbers are provisional, yet experts warn they point to a trend of rising overdose deaths, meaning the nation’s opioid epidemic may be far from over. Although the causes are likely myriad, the ongoing COVID-19 pandemic seems an obvious culprit to many.

“Coming out of isolation into perilous-feeling times has made it challenging for people to feel OK,” said Dr. Jennifer Plumb, co-founder of Utah Naloxone, an advocacy group that helps distribute kits that can reverse overdoses caused by opioids. “Substance use on some level is a way to try to cope … it’s a way to get away from the things that are bothering you. I have — in my personal opinion — no doubt that in this time, people have been looking for ways to feel better about themselves, about their lives, about the world. And it’s been challenging.”

Plumb said she has seen anecdotal evidence of the trend continuing into 2022, with a “pretty decent uptick” in the number of overdoses and overdose reversals in Utah.

“I had, unfortunately, a day earlier this week where I heard about four overdose deaths. I’ve never had that happen before,” she said.

Did the pandemic end Utah’s positive trajectory?

Prior to the pandemic, Plumb said Utah was actually one of a few states with a decrease in overdose deaths. Thanks to messaging, public awareness and the availability of naloxone, Plumb said she had hoped the state was on its way toward significantly reducing the problem.

Naloxone is a drug that — if administered timely — can reverse the respiratory depression associated with opioid overdoses, which can be fatal.

High-profile lawsuits against the Sackler family — who founded Purdue Pharma, the maker of OxyContin — have also helped change the public perception of the opioid epidemic and those suffering from addiction.

“In the beginning, the education and awareness piece was enormous, helping people understand that although we have this image in Utah — of ourselves — that everything’s fine, everything wasn’t fine,” Plumb said.

Still, she said the problem of overdoses and substance abuse is more structural, and the pandemic exposed a variety of social vulnerabilities that could have made individuals more likely to abuse.

“Naloxone is by no means the cure here, it’s just the strategy to keep people alive. No one can get better if they’re dead, so we have to keep them here,” Plumb said.

Now that the easy part is done, she said the state needs to focus on fixing the chronic, long-term factors that lead to addiction and abuse in the first place.

“I think we’re going to face a little bit of a challenge, because we now need to take the deeper, harder steps of looking at our resources. The earlier steps were successful, but they were just the start,” Plumb said.

A holistic model of care

Plumb called substance abuse an “equal opportunity destroyer,” but she pointed out that risk factors such as homelessness, poverty and lack of quality medical care can all make a person more likely to suffer from addiction. That’s why a clinic in Salt Lake City is opening a new substance use recovery center, aiming to provide high-level care to underserved communities.

Sacred Circle Healthcare is owned by the Confederated Tribes of the Goshute Reservation and provides a variety of services to Native Americans and those covered by Medicaid. The clinic is a one-stop shop for medical, dental and mental health care, making services easily accessible to patients with transportation or time hurdles.

The recovery center, which opened Friday, will be able to provide a “safe and sober space,” said recovery director Scott Smid, where patients can work with therapists, in groups or simply take refuge from the stresses of life at home or on the streets.

“We want to have folks be able to just chill,” Smid said. “In some of their home environments, the folks that we serve are more triggered than anything. Even for the non-user, if we had to go into the lives of some of these folks who are substance users, we might end up using as well. Not just their physical spaces, but their emotional and mental spaces as well, there’s so much trauma.”

Chief financial officer Matt Judd said Sacred Circle is unique because of its roots serving the Native American community, and patients will benefit from professionals who prioritize long-term success over short-term results.

“Their healing ways are holistic in nature, in that they want to solve the problem and not just put a bandaid on it,” he said. “We want to provide them with a solution — not just a stop-gap fix — but a long-term, lifelong solution.”

Sacred Circle’s recovery center, located at 660 S. 200 E. Suite 250 in Salt Lake City, will be open Monday through Friday, starting at noon.

‘Every bridge has been burned’

In addition to better health care and treatment, Plumb believes the best way forward is to address the root societal issues that lead to addiction in the first place, and that can start with removing the stigma around substance abuse.

“It’s very easy to fall on that, ‘Oh, that population’ mentality, and we simply cannot do that any longer,” she said. “Those are the folks that things have gotten so bad for them. Every bridge has been burned. Every connection to their family or friends or society has slipped away from them and they end up really far down. Well, behind them, there’s a whole pipeline of people who could end up there if their life gets that out of control.”

“It isn’t just the people that are camped out under a viaduct or in a camper in a park,” Plumb continued. “It’s our entire society. I don’t know many people who don’t have a connection one way or another to addiction and overdose.”

Critically, Plumb said the criminal justice system needs to take further steps to move away from criminalizing lower-level drug crimes, or nonviolent crimes in general.

“If you’re a person in recovery and your life is going in a better direction, but you have a criminal record,” trying to rent an apartment or get a job is going to be much more difficult, Plumb said. “You’re not going to be able to take those next positive steps. ‘So, great, I’m not using substances, but what am I supposed to do now?’”

Rather than arresting someone for drug use or shoplifting related to substance use, she suggests taking them to get health and mental health treatment so they can avoid a detrimental blemish on their record.

She knows that’s not popular with everyone because of the inclination to “penalize” those who commit crimes, but says that thinking is misguided.

“That’s not working,” Plumb said. “We’ve been doing that since Nixon’s war on drugs, thinking, ‘Hey, if we punish them harder it will go away.’ The war on drugs is really just a war on people and it hasn’t worked.”

Plumb praised Utah’s recent Clean Slate law — which automatically expunged some minor criminal records — as a “great protection” for those who might be prone to addiction because they aren’t able to get their feet underneath them.

It’s not just government’s problem to solve, though, Plumb said. Employers, landlords and others need to stop viewing addiction as a moral failure and instead as something people of all backgrounds can fall victim to.

“What does it mean to hire somebody who had drug paraphernalia charges 10 years ago?” she said. “To me, it means they’ve made it 10 years without stumbling back into that space — that person should be celebrated. But for that person, what it actually means is they don’t get that job, they don’t get that apartment, they can’t get that loan. There’s this bigger kind of rebuilding that needs to happen.”