Opioid crisis lingers amid coronavirus

Health officials concerned about shift away from reforms, scrutiny of drug companies

WARREN -- As COVID-19 still lingers in the Mahoning Valley and across the globe, another epidemic continuing to hit hard is the opioid crisis and the overdose deaths that accompany it.

While many people were stuck at home during Ohio's quarantine, there seems to have been an uptick in accidental overdoses, said April Caraway, executive director of the Trumbull County Mental Health and Recovery Board.

"The opioid epidemic certainly continues to plague our state and our nation. During the stay-at-home orders, urban centers in Ohio have experienced increased overdoses due to an abundance of fentanyl on the streets. Fentanyl is being added to street drugs including heroin, methamphetamines and cocaine," Caraway said.

Fentanyl is a synthetic opioid that is stronger and more deadly than other manufactured opioids like heroin and morphine.

"I believe that Trumbull County did not have a spike in overdose deaths during the COVID-19 stay-at-home time because our first responders continued to carry and administer Naloxone and this saved lives," Caraway said. "This is just one more reason we should all thank our police officers, EMTs and firefighters who played a major role not only in keeping us safe during the COVID-19 lockdown, but also in saving so many lives through administering Naloxone."

Naloxone is an opioid overdose reversal drug administered nasally. It can be obtained by anyone who seeks it through Project DAWN, administered locally through the Trumbull County Combined Health District by calling 330-675-2590, Option 3, for an appointment.

Caraway said she agrees with a local chiropractor, Dr. Patrick Ensminger, "that prescription opiates should only be considered after safe, effective non-pharmaceutical approaches have been exhausted," but "while abuse of opioids can lead to dependence and addiction, there are still valid reasons that pain medications are a necessary part of many people's lives just to manage their pain and help them to function throughout their day."

A member of the Ohio State Chiropractic Association Opioid Task Force and of the Eastern Ohio Chiropractic Society, Ensminger said doctors in the country still are overprescribing opioids, which are much more addictive and dangerous than other options and do nothing to correct chronic issues -- they only mask the pain.

Although accidental overdose deaths this year and last aren't as high as previous years, the problem remains for several reasons, including obstacles created by insurance companies for alternative treatments such as high copays and deductibles, treatment limits and limited physician choice.

Added to those obstacles, Ensminger said the coronavirus is shifting attention away from reforms and scrutiny the opioid crisis placed on drug companies.

"Drug companies, vilified by the public and media and prosecuted for their role in promoting opioid use as safe and non-addictive, are breathing a huge sigh of relief as the focus of our nation shifts to coronavirus. Many of them are being hailed as heroes and saviors as they work to develop a COVID vaccine. The vacuum of oversight and criticism may lead some big pharma executives to consider returning to those huge profits gained from promoting cheap and easily accessible prescription opioids to physicians and patients," Ensminger said.

With an increase in telemedicine because of the virus, Ensminger said he is concerned about a possible increase in prescription writing, "as this represents an easy solution for the doctor without physical contact with their patient.

"Our American physicians are certainly well meaning and have helped us through this current pandemic heroically, but they are limited by the tools of their trade and when it comes to pain, that tool is medications including, in many instances, opioids. They have greatly cut back on opioid prescribing following the explosion of the opioid epidemic in the past decade," Ensminger said. "They continue, however, to prescribe opioids beyond their safe-intended use of relief for patients with terminal conditions such as cancer and those suffering from trauma and immediately after surgeries. They continue to prescribe opioids to patients with more minor pain conditions such as low back pain, and sports and work injuries."

While no one knows how long the coronavirus will remain a concern, the opioid epidemic has been plaguing the country for a decade.

"Some estimates place the overall death toll from coronavirus at 150,000, or roughly one in 2,000 Americans. For the opioid epidemic, it has recently come to light that the death toll may be much higher than originally believed. Many coroner's reports have cause of death simply listed as 'drug overdose' meaning that death will not be included in the opioid epidemic totals. Newly revised fatality estimates taking this into account put the opioid death totals over 600,000. That's over four times the likelihood of dying from coronavirus," Ensminger said.

Ensminger said efforts are still needed to reduce the amount of legal and illegal opioids circulating in society to prevent addiction and overdoses, as many in the country came together to reduce the spread of the virus.