Editor’s Note: This story originally appeared in the January 2022 edition of the Daily Universe Magazine.
Patrick Alverson has been sober for about six years. When the COVID-19 pandemic started and in-person meetings were canceled, a friend of his started a daily Zoom meeting for people in recovery.
“Without this support group during the pandemic, I wouldn’t say I would be in a horrible place, it would suck even more,” he said.
But Alverson also knows people who have relapsed or struggled with drug addiction during the pandemic. He thinks it’s because of people’s isolation.
“One of the things I hear in recovery is that the opposite of addiction is connection,” he said.
There was a 29.4% increase in the number of drug overdose deaths nationwide between 2019 and 2020, according to the Centers for Disease Control and Prevention. In Utah, overdose deaths increased by about 7% between 2019 and 2020, according to preliminary data from a Utah Drug Monitoring Initiative report released in October 2021. However, an earlier report from the Department of Utah Health, released in January 2021, said there has been no increase in drug overdoses during the pandemic.
Opioid Abuse in Utah County
Gabriela Murza leads the HEART initiative at Utah State University Extension in Utah County. The HEART initiative partners locally and nationally to address the opioid epidemic and other public health issues, according to the State of Utah HEART Extension website.
Murza said it’s difficult to fully understand how the COVID-19 pandemic has affected drug-related deaths in Utah because the most recent data is usually a year or two behind.
“2020 data for the state came out recently. And just in general, Utah County is sort of following a similar trend to Utah State, and also the United States,” she said.
Murza made a presentation to the Utah County Commission in June about the opioid epidemic in Utah and the HEART initiative. Murza told the commission that the rate of opioid use disorder in Utah has gone down.
“Then 2020 came and everywhere the numbers went up; they have increased when it comes to opioid deaths,” she told the commission.
The HEART initiative operates in nine Utah counties, including Utah County, which have higher rates of opioid abuse and deaths related to opioid use. Carbon and Emery counties have the highest rates of opioid overdose deaths in the state, according to the Utah Department of Health.
Changes in opioid prescriptions
Alverson lives in Orem and was first prescribed an opioid after emergency gallbladder surgery when he was 16. He had previously used other substances, such as alcohol and marijuana.
“They (opioids) didn’t do anything for me at the time,” he said. “My first opioid addiction came when I was 21 when I hurt my back.”
Alverson said he was prescribed 30 milligrams of oxycodone when he was 16 and 80 milligrams of oxycontin when he was 21. After his back surgery, he started getting prescriptions from several doctors.
“I was able to ‘shop’ so I can go to a doctor to get a prescription and go to another doctor and get another prescription,” he said. “One prescription will be paid for by insurance and the other prescription will have to be paid for in cash.”
Around 2013, some of Alverson’s friends told him that “doctor shopping” was getting riskier, and Alverson said his insurance stopped covering his opioid prescription, so it was too expensive.
Over the past decade, several laws in Utah have been passed to address the opioid epidemic. For example, HB 175 “Prevention and Treatment of Opioid Abuse”, adopted in 2017, requires that “substance prescribers receive training in a nationally recognized opioid abuse screening method “. HB 50 “Opioid Prescribing Regulations,” also passed in 2017, limited the number of days an opioid can be prescribed to a patient.
But after Alverson couldn’t get prescription opioids, he started using heroin.
“I had never used heroin before 2014,” he said. “Plus, heroin is so much cheaper and much more potent than synthetics.”
According to the National Institute on Drug Abuse, approximately 80% of people who have used heroin first abused prescription opioids.
Alverson said he suspects more people have turned to illicit drugs, like heroin, during the pandemic as many doctor’s offices have been closed or seen fewer patients.
The Drug Watch Initiative’s 2020 annual report includes preliminary data from the Utah Medical Examiner’s Office on drug-related deaths. The report shows that for the first time in 20 years, prescription opioids were not the drugs most commonly implicated in overdose deaths.
Methamphetamine was the most common drug implicated in fatal overdoses in 2020 and fatal fentanyl overdoses increased 125% from 2019 to 2020 according to the Utah Drug Monitoring Initiative report. Fentanyl is a synthetic opioid but is several times more potent than other opioids, according to the CDC. Non-prescription drugs can be mixed with fentanyl. Murza said the rise in fentanyl-mixed opioids has played a significant role in the increase in opioid-related deaths.
“People just don’t know what they’re buying. They don’t know if it contains fentanyl,” Murza said. “Fentanyl on its own is quite potent, so mixing it with something else that is also potent is not a good thing.”
Alverson said most of the people he knows who use opioids didn’t get them from a doctor’s office.
“You can buy more drugs on the street than in a doctor’s office,” he said.
Murza said that although there have been legislative changes, there is still a lot of stigma surrounding opioid addiction. She said in talking to people in Utah, the biggest misconception she’s seen is the idea that if someone has an opioid use disorder, they’re to blame. of his addiction. Murza also said she prefers the term “opioid use disorder” as opposed to “opioid addiction.”
“A person is not their addiction, a person is not the challenge they face,” she said. “The most important thing is to help people understand that there are humans behind any challenge, anything someone is going through.”
To help humanize the issue, the HEART Initiative has created a digital library collection that features stories from Utahns impacted by the opioid crisis.
Nathan Ivie, a former Utah County Commissioner, told the Daily Universe that another misconception in Utah County is that only certain types of people are addicted to opioids.
“It’s non-discriminatory, it affects a lot of people,” he said.
Ivie’s mother had knee replacement surgery and was prescribed a heavy narcotic. He said she battled depression before the surgery, and the narcotics not only took away the physical pain, but also helped ease the emotional pain.
“It led to addiction. We found out when she got out of it, she had withdrawals,” he said.
She had her other knee replaced a few years later and had a similar problem. Except this time, Ivie and some of her family members told her doctor about her mother’s experience during her last surgery.
“What happened that second time was kind of the same, we had to take them off,” he said. “We had to strongly regulate her medication, she again suffered withdrawal.”
But Ivie said he didn’t think his mother would have considered herself addicted to the drug because she was just taking what she was prescribed.
“Utahns, especially members of the LDS faith, are taught to trust authority figures, aren’t they,” he said. “And so if the doctor says to do that, that’s inherently okay.”
Alverson underwent another back operation in 2017 while recovering, and he said it was the first time a prescribing physician had spoken to him about how addictive opioids could be. The doctor also told her about her recovery, what medications might be right for her, and the dose.
“They only gave a week’s worth of medication and not the whole month,” he said. “If my previous doctors had done what this doctor did while I was recovering, it would have been a huge help.”
Alverson wants more people to know about and have access to naloxone or narcan, drugs that can reverse an opioid overdose and said there are many unnecessary deaths from overdose.