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One city struggled with a drug addiction crisis.  Then came COVID-19

HUNTINGTON, West Virginia (AP) – Larrecsa Cox walked past the used tire store, where a young man had collapsed days earlier, the syringe he had used to shoot heroin still clenched in his fist.

She walked over to her house in the hills outside of town. The man had been resuscitated by paramedics, and Cox leads a team on a mission to find all overdose survivors to save them from the next.

The man’s mother stood in pink slippers in the rain to meet her. People are dying all around her.

“The people I have known all my life since I was born, you need both hands to count them,” she says. “In the last six months, they’ve been gone.”

While the COVID-19 pandemic has killed more than half a million Americans, it has also quietly ignited what was before it one of the country’s biggest public health crises: drug addiction. The Centers for Disease Control and Prevention estimates that more than 88,000 people have died from drug overdoses in the 12 months ending August 2020 – the latest figures available. This is the highest number of overdose deaths ever recorded in a year.

The devastation is an indictment of the public health infrastructure, which has failed to tackle the dueling crises of COVID-19 and drug addiction, said Dr Michael Kilkenny, who heads the department of Cabell County Health, which includes Huntington.

At the same time, Kilkenny said, disruptions in healthcare have exacerbated the collateral consequences of drug use – HIV, hepatitis C, deadly bacterial infections that bite the flesh to the bone and cause people in their twenties to undergo surgeries. open heart. There were 38 HIV infections linked to injection drug use last year in the county of less than 100,000 – more than in 2019 in New York City.

Huntington was once the ground zero for the drug addiction epidemic. On the afternoon of August 15, 2016, 28 people overdosed in four hours in Huntington. Connie Priddy, a county emergency medical services nurse, describes it as their “judgment day.”

In 2017, the county had an average of six overdoses per day. Some companies have changed their bathroom bulbs to blue – making it harder for addicts to find a vein.

They couldn’t ignore it anymore. The county got two grants and chose Cox, a paramedic, to lead a team of addiction specialists, church leaders and police who roam the county, hunting down people with overdoses. “Faced with addiction? We can help you, ”reads the sticker on the side of the Ford Explorer.

If the people they find are ready for treatment, they bring them there. If they aren’t, they give them the anti-overdose drug naloxone, and other supplies to try and help them survive in the meantime.

A whiteboard in their office lists the names of clients they’ve introduced into treatment – about 30% of those they are able to track down. After two years, the county’s overdose calls fell 50%.

The federal government has honored Huntington as a model city. Other places have come to study their success.

The first few months of the pandemic have been calm, said Priddy, who coordinates the team and tracks their data. Then came the month of May. There have been 142 EMS calls for overdoses, almost as many as in their worst crisis.

By the end of 2020, Cabell County’s EMS calls for overdoses were up 14% from the previous year.

“It makes us sick,” Priddy said, but colleagues from other counties told him their peak was twice as high.

The CDC estimates that nationwide, overdose deaths increased by nearly 27% in the 12-month period ending August 2020. In West Virginia, fatal overdoses increased by more than 38%.

Report after report arrived at Cox’s desk. In October, she saw the name of a woman she knew well and lost her breath: Kayla Carter.

Carter had a bright mind for math and worshiped the stars. Her family always thought she would grow up to work for NASA.

Instead, she was addicted to opioids by the time she turned 20.

“We went through hell,” said her mother, Lola.

Carter has overdosed dozens of times. At 30, she was already walking with a cane that she painted in her favorite color, pink. The infection roamed her body. She had hepatitis C and HIV.

In 2018, HIV started to spread among people who inject drugs here. Kilkenny said the county has stepped up testing, treatment and the needle exchange program that offers clean syringes to drug addicts, recommended by the CDC. The cases have calmed down.

But they still increased.

As Huntington tries to fend off the damage caused by the pandemic, Priddy said he feels their own state is working against them. The state legislature is pushing a bill to strictly limit needle exchange programs, citing the dangers of discarded syringes.

Syringe programs have been the subject of decades of scientific study. The CDC describes them as “safe, effective, and economical” – they don’t increase drug use, studies show, and they dramatically reduce the spread of HIV.

Priddy sent his lawmaker a pleading message that if they restrict needle exchange, many more will die.

Carter was hospitalized last summer with endocarditis, a heart infection caused by the use of dirty needles. Her parents stood by her bedside and thought she was 100 years old. They cried all the way home.

She was drug-free when she was released from the hospital. She gained 30 pounds. She said she was sorry for everything she missed: babies born, birthdays, funerals. They thought she was back.

Then she stopped taking calls. Her mother went to her apartment and found her dead on the bathroom floor.

They are still waiting for the medical examiner’s report, but his father Jeff, a retired paramedic, would rather never see him. It gives her comfort to think that she died of complications from her surgeries, not that she relapsed and overdosed.

Now the box of his ashes is in their living room. His mother talks to them every night, then cries to fall asleep.

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