The toll taken by COVID-19 extends into fatal and near-fatal drug overdoses in the community.

Drug overdoses in Greene County and across the state continue to surge during the pandemic, as does the need for addiction and mental health treatment.

Nolachuckey Mental Health professionals told the Greene County Anti-Drug Coalition last week that solutions are needed to keep individuals, especially younger people, from becoming a statistic.

Amy Mullins, program manager of Children and Youth Services at Nolachuckey Mental Health, told anti-drug coalition members that despite a decline of nearly 2 million opioid prescriptions filled between 2017 and 2020, from 6.97 million to 5 million, reported opioid-related overdose deaths in the state were up by over 1,000 over the same time frame, from 1,268 in 2017 to 2,388 in 2020.

Law enforcement, court officials and mental health experts all agree that as prescription opioids become harder to obtain due to more restrictive laws, methamphetamine is now the illicit drug of choice in Greene County and the region. Meth-related overdose deaths statewide spiked from 319 in 2017 to 961 in 2020.

Overdose deaths from “benzos,” psychoactive drugs such as Xanax, Valium and Klonopin, rose from 504 in 2017 to 571 in 2020.

Those trends continue into 2021, Mullins said. During 2020 and into this year, many people are self-isolated during the COVID-19 pandemic.

“There was a big increase in overdoses in 2020 at the state level. I can promise you it was pandemic-related,” Mullins said. “We still are having a lot of folks struggling with addiction.”

Fentanyl, a powerful synthetic narcotic 50 times more potent than morphine, is also finding its way into street drugs turning up in Greene County.

Reported fentanyl-related overdoses statewide stood at 501 in 2017, compared to 2,014 in 2020, Mullins said. Heroin-related overdose deaths remained fairly constant, from 311 in 2017 to 331 in 2020.

Greene County statistics illustrate the impact fentanyl is having locally. Nine of the 12 overdose victims in Greene County in 2020 had fentanyl in their system. Some people mix drugs in deadly cocktails that include fentanyl.

“We’re starting to se more fentanyl coming into the city with the (international) borders open and other drugs, too,” Sheriff Wesley Holt told anti-drug coalition members.

Mullins said that actual drug overdose death counts are significantly under-reported, offering an estimate of more than 3,000 statewide in 2020.

While 12 fatal drug overdoses were reported in Greene County in 2020, the number is well below the 21 reported in 2017, 23 in 2018 and 15 in 2019.

The drop in overdose deaths is likely due to the increased availability of naloxone, an effective overdose treatment drug also known by the brand name Narcan.

Police and other first responders now carry naloxone, which is also made available to the public.

“Narcan is making a huge difference,” Mullins said.

Sherry Barnett, a regional overdose prevention specialist for the Sullivan County Anti-Drug Coalition, told the group she is attempting to make naloxone available in area schools. Holt said he will assist promoting the effort in Greene County Schools.

Mental health treatment programs like Nolachuckey Mental Health, part of the Frontier Health system, are seeing an increase in clients for all issues. Between July 1, 2020, and June 30 of this year, there were 110,000 individual and family therapy interactions serving over 28,000 people.

There were more than 140,000 case management and “wrap-around” services involving referrals to other providers. Twenty-one percent of cases involved clients ages 17 and younger, Mullins said.

Cindy Tvarde, clinical site director of Nolachuckey Mental Health, said mental health professionals were told to expect more business when the pandemic began.

“We were warned we would have an influx, and it was more than we could have imagined,” Tvardy said. “We knew the need would be there, and it certainly was.”

Grants to provide therapy and other aspects of case management for individuals without insurance have helped, as has funding related to the COVID-19 pandemic, she said.

While meth and opioids remain a destructive force in the community, nearly half of those with substance abuse issues reported that they also turned to alcohol.

“Meth is certainly the drug of choice in our area, but the use of alcohol has really increased,” Tvardy said.

In some instances, those who consider themselves social drinkers “got to the point where they were using it for stress relief.”

“There have been issues for people abusing alcohol” during the pandemic, Tvardy said.

Use of more than one drug is also common. All but one person in a recent client survey of men and women reported “polysubstance” use of drugs, Tvardy said.

Some adults with small children became “super isolated” during the pandemic and turned to alcohol or drugs.

Many of Nolachuckey Mental Health clients are young.

“Almost a quarter of those folks we are serving are less than 18 years old,” Mullins said.

COVID-19 and isolation factor into the total.

“The number of kids we are seeing with depression and anxiety have skyrocketed,” Mullins said. “There are increases in intake not just for at-risk kids from underprivileged homes.

“We are seeing more day-to-day referrals. (Children) are getting in trouble. They are isolated. Their parents are working a lot more,” Mullins said. “They keep getting quarantined for two weeks and they get behind in their schoolwork and get depressed.”

Frontier Health is seeing more young adults “who have never had depression or anxiety issues before the pandemic. It is triggering them,” Tvardy said. “The 18-to-25 population is really suffering.”

Kenneth Bailey Jr., Greene County General Sessions and Juvenile courts judge and a member of the anti-drug coalition, said that more young adults are appearing in his courtroom.

“We’re seeing 18- to 25-year-olds by the boatload in court,” Bailey said.

Bailey said about 20 juveniles appearing in court have tested positive for meth over the last two years.

“It terrifies me when you get a 15-year-old using meth several times a week,” he said.

Tvardy said a licensed therapist spends several hours per week at the Greene County Detention center to provide assessment services for inmates.

Other volunteers work with defendants in court to act as liaisons with the justice system.

“A lot of the folks they are dealing with don’t understand the system,” Bailey said.

Mental health issues directly related to the virus are also common. Those who had COVID-19, or relatives of those who were ill or died due from the virus, are affected, Mullins said.

“We are seeing so many bereavement issues,“ she said. “A lot of the problem is they have not been able to grieve (because) they were not allowed to have services.”

Some who have had the virus have vague memories of being on a ventilator. “They think they are going to die,” Mullins said.

The pandemic is also stressful for caregivers and mental health specialists who have spent countless hours helping others.

“Through the pandemic, most of you have lived through your own personal lives,” Tvardy said. “As a caregiver, your tank is not as full as it normally would be. It is emotionally draining for everybody. When your cup is running over, realize it’s time to step back and help yourself and be mindful of that.”

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