The Covid-19 pandemic has caused more than half a million deaths in the United States. Sadly, those direct results of the virus may not tell the whole story.
Across the United States, drug overdose deaths increased nearly 20 percent in the 12-month period ending last June, with a noticeable spike occurring during the early months of the Covid-19 shutdown.
These figures, provided by the Centers for Disease Control, represented the highest number of fatal overdoses ever recorded in the U.S. in a single year.
Throughout New England, the rates of death have seen an increase in the past year in every state except for one. New Hampshire, once labeled “a drug-infested den” by a U.S. president, saw its rate of death dip from 2019 by just over one percent.
At its worst, the state did have far higher death rates than others in New England. In Massachusetts, deaths peaked in 2016 at 30.6 per 100,000.
In Connecticut, that number was 27.4. The other rates are as follows: Vermont – 22.2; Rhode island – 30.8; and Maine – 28.7.
At 39 deaths per 100,00, New Hampshire in 2016 had the second highest rate of deaths in the entire country (behind West Virginia).
To explain why substance abuse deaths have increased in most areas this past year, experts have pointed to the enforced isolation that may allow addiction to flourish along with on-going stress, financial and housing difficulties, and difficulty in accessing services.
“I think the pandemic has created stress on the entire community whether they have mental health or isolation issues or not,” said Roger W. Osmun, Ph.D. president and CEO of West Central Behavioral Health, a non-profit community mental health care provider in Lebanon, New Hampshire.
“The isolation that has resulted from the pandemic shutdowns can be more difficult particularly with those with substance abuse disorders. Among other things, they may not feel as connected to treatment or to self-help programs.”
How has New Hampshire managed to continue its much-needed downward trajectory of the rates of death?
Jonathan Ballard, MD, chief medical officer, Department of Health and Human Services, pointed to a state-wide Doorways program started at the beginning of 2019 as a key factor in its moderate success rate even during the stressors of the pandemic.
“Death data doesn’t show you how many addictions or substance abuse disorders there are,” said Ballard. “It only shows you how many succumb to the disorder. The more people are having their needs assessed and attempted to be met, the more it shows that treatment does work and can help the person survive the illness.”
Doorways connects mental health services with every client no matter where they enter the system. A steady increase in clients after an initial drop off during the early part of the shutdown is a testament to its success, said Ballard.
“It shows how tremendous the need is and it is showing services being delivered,” he said. “During times of social isolation, we have to be mindful that these diseases of despair can worsen and what we can do as a state. The goal of Doorways is to do as much outreach and let them know they are not alone.”
While it may not be completely fair to compare the rate between states when the starting points were so different, it still is fair to applaud a better direction for New Hampshire.
“With New Hampshire so elevated, I suspect that there is greater potential you will experience a regression towards the mean,” said Osmun. “It can trend down because it is such an outlier; it almost has to. But, I think how we look at it is that, regardless of what is contributing towards a slight decline, we will take it. It is now about how do we implement interventions so it is a mindful decline and we continue to control the direction of the curve.”