The title of this post is a quote from "Marvin K. Money will you Please go Now," by Theodor Geisel (also known as Dr. Seuss).
The protagonist in Groundhog Day (1993), Phil Connors (Bill Murray), noted that "When Chekhov saw the long winter, he saw a winter bleak and dark and bereft of hope." That quote returned to me as I read the sobering news recently of addiction and worse in the time of COVID-19. It has been a long winter indeed. Certainly, there is much for us to celebrate in the spring of 2021, see The Future's so Bright (February 2021) and A Great Hamburger with a Smile (April 2021).
For much of the last year, there have been prognostications that COVID-19 could result in personal and societal issues beyond the immediate scope of infection and treatment. ABC News reminded last year of concerns regarding "suicides, drug overdoses, and domestic violence." There were those who raised concerns about mental health repeatedly throughout our recent isolation and constraint secondary to COVID-19. I say "our" but some of us were fortunate to weather the year in a relatively open and free Florida. I cannot imagine the stress of living in those more constricted states, territories, or countries often featured in the news.
I heard from people in response to the Great Hamburger. They assure me that the lockdowns, isolation, masks, and other challenges are not over everywhere. Some expressed envy that Florida's economy is running wide open and lamented their own local inability elsewhere to enjoy dining out, retail shopping, and other social interactions. But, in short, we will all eventually put COVID-19 behind us. It is not yet, by any means, over everywhere. I feel for you if you remain masked, locked down, and unvaccinated. Hopefully, however, we can each see signs of hope and improvement.
I have focused on overdose death before. In January 2017 I posted Like a Broken Record regarding overdose deaths. I lamented that the American death rate was an excruciating 55,403 in 2015. I recounted the history of increasing deaths (2012 = 33,775; 2013 = 37,542; 2014 = 42,225). The Center for Disease Control reports that "Nearly 841,000 people have died since 1999 from a drug overdose." In 2019, the rate of overdose death was 70,630, double the number in 2012. The situation, it seems, has not been improving.
Statnews reported in February 2021 that in the "12-month period ending" June 2020, there were 81,003 deaths from overdose. It says that reflects "a 20% increase and the highest number of fatal overdoses ever recorded in the U.S. in a single year." The Commonwealth Fund report is more dire still. It says that "September 2019 through August 2020" recorded 88,295 predicted deaths." It notes this is "a record high," perhaps when the final figures confirm this prediction it will be about "27% (higher) than the prior 12-month period."
The drug overdose situation, it seems, is getting worse. As a nation, we near one million overdose deaths since 1999. It is entirely likely that we will reach one million by the time we are 25 years into this still new century, 2024. At our current pace, with it nearing 100,000 annually, it is almost a certainty. And, if that rate continues, the path to the second million deaths of this millennium will be shorter still.
In February 2021, we collectively lamented that the SARS-CoV-2 coronavirus, COVID-19, had killed over 500,000 Americans. Flags were ordered to half-mast. We were encouraged to remember the suffering and death wrought upon us by this virus. I do not suggest in any way that we should not acknowledge and mourn those losses. However, it seems that we remain inclined, societally and individually, to ignore or overlook that we lose so many Americans to overdose.
Will recognition and flag lowering occur when we hit 100,000 per year? 150,000? At what point will we decide that society cannot endure the loss of these people, these thousands of people, each year? Why is there not a similar focus on this killer? Why is there no massive education and research focused on stopping it? Why do we not collectively focus on somehow saving these people? After flooding our conscious and communities with Narcan to treat overdoses, the deaths continue and are accelerating. Perhaps more attention and imagination are needed?
But, the worst news is that overdose has been exacerbated in the last year. One of the more dire consequences of our governments' COVID reactions appears to be the impact on our mental health and stability. StatNews reports that "drug deaths started spiking last spring." Some are attributing the increase to the pandemic. They note that it "has ushered in stress, isolation, and economic upheaval — all known triggers for addiction and relapse." There are, more simply stated, stressors that result from a pandemic.
And, perhaps more so, there are stressors that are created in response to a pandemic? The pandemic did not shut down a single economy in 2020. The shutdown was a government response to illness and the threat of infection. What if the scientists had not advised us against wearing masks last spring? See Anger and Acting Out. Might our outcome have been different without the massive work stoppage, economic impact, and sequela?
Lamentably, we will now study the impacts and results of those government efforts. Academics and researchers will spend coming years pouring over data and writing to describe the impacts that this virus has had on mental health, addiction, and some say violence, suicide, and more. Last spring, I read a piece that predicted there would be mental health impacts of this pandemic. Last spring, when many of us predicted a return to normal within months. Last spring, when our history and experience with the pandemic in America was very limited. Last spring some predicted a coming storm.
Last Spring, I authored Stress in the Time of COVID (March 2020). I suggested that we remain vigilant, and offered some unscientific and untrained advice on dealing with stress. I suggested that there was a need for us to remain cognizant of the needs, emotions, and challenges of those around us. I have spent much of the last year striving to remind people that we have all faced challenges and have struggled.
I was encouraged to that view, in part, by articles written by others. One, by Pew (no, not the RxProfessor, the other Pew) was an early predictor of potential challenges. On May 12, 2020, Christine Vestal wrote "Fear, Isolation, Depression: The Mental Health Fallout of a Worldwide Pandemic," and America had only entered what Chekhov might foretell as a coming long winter. She warned that there would be "emotional trauma." She warned it would be "long lasting." She noted that in May 2020 "more than 4 in 10 Americans say that stress related to the pandemic has had a negative impact on their mental health." That is 40% to you and me. That is like 131 million of us. That was a year ago, light years ago.
There has been a somewhat related discussion also of suicide. There were predictions during 2020 that the pandemic, stress, and challenges could lead to increased suicide rates. There were some reports of "spikes" in rates, and prognostication of pandemic implications. The Washington Post recently noted conclusions of increased suicide rates expressed by national leaders but says the current data does not necessarily support that American suicide increased last year.
The outcome of that discussion seems to be uncertain for now. The author suggests that after further study, with the passage of time and investment in research, some might eventually conclude that suicide attempts in 2020 were influenced by COVID-19 implications. It also notes overdose in a broader context than the deaths noted above. It reports an "almost doubling" of calls for help regarding overdose in 2020. It suggests that some of those, or some of the currently categorized "unintentional injuries" may end up categorized instead as suicide.
Note that. Hidden in that discussion of suicide, is an overdose fact worthy of reiteration and our careful attention: calls for help regarding overdose almost doubled in 2020. Drugs are a problem. As regards the surfing fad of the 1960s, the Beach Boys noted in "Surfin' Safari" (1962) "I tell you surfin's mighty wild, It's getting bigger every day." I would suggest that opioids, drug overdose and related societal challenges are likewise "getting bigger every day."
It is lamentable that so many faced overdose challenges last year, and that so many died. It is more lamentable that we now approach a million dead since the turn of the century and the trend shows no sign of relenting. Not to be a broken record, but I ask yet again, how many will be enough? I suggest, again, that the time has come for action and progress in our fight against drugs, overdose, and avoidable deaths.
