Wellness Wednesday: Amid rise in overdose deaths, help is available

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A candlelight vigil for victims of substance use disorders.
A candlelight vigil for victims of substance use disorders in New York City, 2017. (Spencer Platt/Getty Images)
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Joseph Lee on the opioid epidemic
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Earlier this month, the Minnesota Department of Health put out a report that says drug overdose deaths increased 31% during the first half of 2020, as compared to the first half of 2019. Substance use disorders can affect anyone, but they are preventable and can be treated. It's okay to need help.

To discuss this, Joseph Lee, medical director for Hazelden Betty Ford's Youth Services, joined Jill Riley once again on The Current's Morning Show.

Every Wednesday morning at 8:30 CST, Jill connects with experts and local personalities for some real talk about keeping our minds and bodies healthy — from staying safe in the music scene, to exercising during a pandemic, to voting and civic engagement. Looking for more resources and support? Visit our friends at Call to Mind, MPR's initiative to foster new conversations about mental health.

Joseph Lee, medical director of Hazelden Betty Ford's youth services.
Joseph Lee, medical director of Hazelden Betty Ford's youth services. (courtesy Hazelden Betty Ford)


When I read that number — 31% — I was absolutely blown away.

Yeah. It's a very concerning number for public health, and it'll be really interesting to see what kind of measures we take to prevent that into the future and what happens next year when these statistics come around. There are many variables pushing this, and it's a convergence of a number of troubling things happening in our society now — including COVID — that have unfortunately caused us to lose a lot of lives.

According to the data, it looks like the numbers are really being driven by an increase in synthetic-opioid-involved deaths.

Yes. On the surface, that's certainly one of the most concerning variables. Many of you have heard all kinds of news about the opioid epidemic, and in recent years the opioid epidemic has shifted from the use of pain medications that are standard from clinics and hospitals, and heroin, to synthetic opioids called fentanyl. These fentanyl tablets and pills are generally coming from various clandestine labs and dealers are using them on the streets.

What's changed in the fentanyl story, however, is that while potent and causing many overdoses, just a couple years ago people were using fentanyl and then shocked that they had accidentally taken it when they went to the emergency room and the urine drug screen showed fentanyl, they were shocked. These days, people kind of know that the fentanyl or the pain medications they're taking are fake. They know that these are what the kids call "pressed pills," but they continue to use fentanyl. So there's a thriving market for counterfeit pain medications in the form of fentanyl out there, and it's driving a lot of these deaths.

To hear that — knowing what it is and still doing it — clearly there's a lot of education that needs to be done to really drive home the point of just how dangerous these drugs are, because you don't know what level of strength you're getting. Is that a way to put it?

Yeah. I think in a time of COVID, what you've seen is just the raw power of some of your substance use disorder, which we call addiction. You've seen people in COVID time drinking more, using more substances all the way around with an awareness that they're not doing so hot...and I think that goes double for opioids. People have some awareness that they're playing roulette, basically, but their addiction is so powerful that they're willing to take a chance. They try to take a quarter pill or just a sliver, they try these things that are not scientifically safe, and a lot of people are passing away, unfortunately.

How can people get help during the COVID-19 pandemic?

Access has been difficult. The government has been trying hard to make medications for opioid use in particular accessible for people, but people have lost jobs. They're scared to go outside. They have less health insurance coverage. Many clinics have closed down. Mental health and addiction services are stigmatized services, and that stigma lives in the financial realm as well in that we don't have the resources of a typical hospital for PPE and masks and all the testing.

As a large nonprofit, Hazelden Betty Ford, we do, but a number of our partnering clinics do not. So the access issue has been a concerning one, both in people being afraid, losing resources and not knowing where the on-ramp is, and just not having enough services out there because they've been ravaged by the COVID epidemic.

As if there weren't enough barriers before. But there are places that people can go when it comes to getting treatment. I wonder, for anyone listening that knows someone who's struggling through substance use disorder, how can people support someone, or maybe approach them with a conversation?

If you're concerned, in this epidemic, with someone's substance use disorder, I would ask that you be positive but have the courage to really care for their lives and have a conversation with them. And for those people who have some concerns and want help, they can call our number, you can go to the state website where there are resources for addiction services...one kind of silver lining through all this is that we've been very creative in how we deliver services. Virtual care services are available for you, so you can roll out of bed and sit on your couch with your coffee and talk to your doctor or your therapist. You can get medications in new and novel ways. We are trying whatever we can to meet the need, so the on-ramp has definitely widened for people. You can find your place in getting help.

We're hearing more about opioid emergency response: whether it be something to counteract the effects, whether it's timing. What are we learning more when it comes to saving people's lives?

Prior to COVID, we knew that the foundations of opioid use disorder and treatment — not all addictions, but opioid use disorder specifically — was using medications both to reverse overdoses, in the form of Narcan, and medications that save lives. Continued medications, in the form of methadone, buprenorphrine, injectable naltrexone. These are medications that people use, and have the science to back them, and they show that lives can be saved. With COVID, there are a few wrenches thrown in that puzzle in terms of access to medications. The market of fentanyl has been evolving. So as a treatment community, we have to continue to be creative to come up with new solutions and easier ways for people to get help. Emergency response services are definitely part of that picture.

As far as age groups go, it looks like [the opioid epidemic is] really affecting those from 25 to 34.

Yeah. We've known for a very long time that addiction is generally a developmental issue, that most people between their late teens and mid-20s develop a substance use disorder. So kind of in the 20s ballpark is when people use the most substances, they use most heavily, they have the highest risk, in many cases, and so it's not surprising that the spike in deaths is in that population.

I wonder about the question of prevention. What could improve in that area, in your opinion? I think most of us grew up learning about drug prevention programs, but where has the gap been there?

There's certainly a need for more intervention and deploying resources for younger people, for families, in communities. I think COVID has taught us a lesson about our health care infrastructure. Just like when you look at people, with COVID you've seen that not everybody is affected the same. Many people who are disenfranchised, marginalized, on the front lines who have jobs where they can't take off or isolate...these people have been affected disproportionately. And to use that metaphor in health care, systems that have been plagued by stigma — mental health and addiction services in particular — have also been disproportionately affected in terms of their resources and ability to help people. So I hope that after COVID, we really take a hard look at how health care is deployed; where there's really the right measure of equity; and we correct the issues related to stigma that really prevent people from getting help and prevent people like us from delivering that help to people.


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