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Pandemic’s Changes In Illegal Opioid Supply Create New Overdose Risks : Shots

A patient arrives to pick up medication for opioid addiction and is given hand sanitizer at a clinic in Olympia, Wash. The pandemic is changing the distribution networks and supplies of street drugs across the U.S., authorities say.

Ted S. Warren/AP


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Ted S. Warren/AP

A patient arrives to pick up medication for opioid addiction and is given hand sanitizer at a clinic in Olympia, Wash. The pandemic is changing the distribution networks and supplies of street drugs across the U.S., authorities say.

Ted S. Warren/AP

As the country went into quarantine in March, many of Joseph DeSanto’s opioid-addicted patients in Orange County, Calif., told him their supply was drying up, because drug dealers in the area were worried about a border shutdown, and were retreating to their hometowns in Mexico.

“So we lost a lot of our larger dealers that supplied the smaller dealers,” says DeSanto, an addiction specialist.

But within days or weeks, many of his patients had found new sources of heroin and pain pills, with dangerous results: “When they had to use another dealer, they would be getting a different strength, so they weren’t really sure of how they should measure it and how much they should use, so we started seeing a lot of overdoses and a lot of overdose deaths in the first couple of weeks of the pandemic,” DeSanto says.

There is no national data yet on the pandemic’s impact on drug supply and overdose rates in the U.S., but experts in addiction and law enforcement say availability and prices of illegal drugs have changed in different areas of the country. And as drug users adjust to new patterns of use, that’s creating a patchwork of new overdose risk as well.

The availability of street drugs varies by region, says Uttam Dhillon, acting administrator of the Drug Enforcement Agency. Methamphetamine has increased in price in most areas as supply apparently decreased, and cocaine and heroin have seen a similar uptick in price.

Much of this is due to travel restrictions.

Dhillon says some of the normal transit routes, through Asia or South America, have shut down. He also points to dramatic decreases in car and foot traffic to and from Mexico, the main source of America’s heroin.

“The ability of these drug-trafficking organizations to move across the Southwest border we believe may be having an impact,” Dhillon says. Increased police presence, and stay-at-home orders have also discouraged dealers and buyers from meeting in public, he says.

That appears to have affected demand for the street drugs in Cambridge, Mass., where, according to Jack MacEachern, opioid supply remains pretty dry.

“No one’s out on the street; it’s just not out there,” says MacEachern, who runs a Salvation Army residential drug recovery program there.

He says it’s not just that dealers aren’t getting shipments; their customers also can’t get money to buy them. “If you have a dope habit and, you know, the way you hustle — make your money — is shoplifting, well, stores are closed,” he says.

MacEachern, who has been in recovery from opioid addiction for two decades himself, says relapse and overdose rates near him have decreased — at least for now.

A decreased supply of drugs might sound good. But it also increases the risk of overdoses in the future, especially as many states reopen for business.

During the lockdown, the Recovery Centers of America, based in King of Prussia, Penn., saw an influx of lower-income patients unable to buy opioids, who then sought treatment to avoid painful withdrawal, says the treatment chain’s chief medical officer, Heidi Ginter.

People who reduced their use of opioids may be at especially high risk if they start using again.

“We may see additional potency of drug available on the street and then people whose tolerance has changed, based on what they’ve been using” Ginter syas. “So we’re pretty fearful about that.”

That concern has led to talk of increasing distribution of Naloxone, a medication often also referred to as Narcan, which is used to try to reverse an overdose.

Elinore McCance-Katz, who heads the Substance Abuse and Mental Health Services Administration, supports such measures, but also points out that the virus has also complicated the ability to treat people with Naloxone.

“In some areas, first responders such as law enforcement do not want to administer Naloxone because they’re afraid of being exposed to the coronavirus,” she says. “I found that very concerning because the option is that the person dies.”

She says her agency is now sending training teams into communities to help them safely administer the Naloxone while also managing the risk of virus exposure.

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Chris Christie Pushes for Reopening, Says Americans Have to Accept More Coronavirus Deaths

Former New Jersey Gov. Chris Christie said on Monday that the American economy needs to reopen quickly and that tens of thousands of more Americans may die from the novel coronavirus, insisting that Americans are “gonna have to” accept that.

Speaking to CNN correspondent Dana Bash on her The Daily DC podcast, Christie—who now works as an ABC News contributor—pushed for the reversal of stay-at-home orders in order to open up businesses and ramp up economic activity.

Confronted with recent models that now show that as many as 135,000 Americans will die due to decreased social distancing amid the pandemic, Christie essentially threw up his hands and said there really wasn’t a choice.

“Of course, everybody wants to save every life they can—but the question is, towards what end, ultimately?” Christie said. “Are there ways that we can thread the middle here to allow that there are going to be deaths, and there are going to be deaths no matter what?”

Echoing previous comments he’s made that the country cannot wait to reopen the economy, the former Trump transition team member asserted that “we’re going to destroy the American way of life” if people don’t immediately get back to work.

Bash then asked the ex-governor if the public could accept reopening following reports that a White House model is now projecting a daily death toll of 3,000 by June 1. 

“They’re gonna have to,” Christie bluntly replied. “We’re in the midst of a pandemic that we haven’t seen in over 100 years. And we’re going to have to continue to do things.”

Asked how he would tell the American public about the need to reopen if he were the president, Christie responded: “The message is that the American people have gone through significant death before.”

“We sent our young men during World War II over to Europe, out to the Pacific, knowing, knowing that many of them would not come home alive,” he said. “And we decided to make that sacrifice because what we were standing up for was the American way of life. In the very same way now, we have to stand up for the American way of life.”

About half the states have begun to reopen public spaces and their economies in recent days despite cases growing in many areas and the confirmed U.S. death count from coronavirus approaching 70,000. President Donald Trump, who has called for states to “LIBERATE,” casually conceded during a Sunday Fox News town hall that the final death toll could reach 100,000 after claiming just a few weeks ago that it would be half that number.

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