Last year was a deadly one for overdoses in the Chattanooga area, as a pandemic worked to overshadow the ongoing — and still growing — opioid epidemic in the region.
Unlike in the early days of the opioid epidemic, during which prescription drugs were front and center, the highly potent synthetic opioid fentanyl is now the driving force behind the crisis.
While 270 Hamilton County residents died due to COVID-19 in 2020, 160 are reported to have died from overdoses and drug-related deaths, according to the Hamilton County Medical Examiner's office.
The numbers of overdoses and drug-related deaths have trended upward year over year, said Vanessa Spotts, regional overdose prevention specialist for the Hamilton County Coalition, a nonprofit group that fights drug abuse.
But 2020 was different as the pandemic brought economic strain, isolation and delayed access or hesitancy of care, as people avoided seeking treatment for fear of contracting the novel coronavirus.
While most agencies calculate overdose data differently and numbers for 2020 are still preliminary, according to a new report released by the state, the information coming in paints a grim picture of overdose deaths across the region.
"Though 2020 data are still preliminary, the trend of increasing overdoses through 2019 combined with the exacerbating effects of the COVID-19 pandemic have created what current data suggest will be the state's deadliest year for overdose," says the 2021 annual overdose report from the Tennessee Department of Health.
- Hamilton County Coalition
- Overdose recovery, alcohol awareness training
- Nu-Start treatment and recovery services
- Drug Disposal
- Council for Alcohol & Drug Abuse Services
- Adult and adolescent treatment programs
- Residential and outpatient programs
- Drug Screenings
In 2019, there were approximately 106 recorded overdose and drug-related deaths in Hamilton County, according to the medical examiner. And in 2020, that number jumped about 50% to 160.
According to the Chattanooga Police Department, officers responded to 575 overdose reports, 107 of which resulted in deaths. The Hamilton County Sheriff's Office also reported an additional 13 overdose-related calls in unincorporated areas of the county in the same time frame. Other cities in the county also have their own figures.
Overall, according to data from the Tennessee Bureau of Investigation provided by the Hamilton County Coalition, law enforcement across the county responded to approximately 741 overdose incidents, and 90 to 95% of those calls resulted in the use of Narcan, suggesting the involvement of opioids.
Narcan is a medication used to reverse the symptoms of an opioid-induced overdose.
The medical examiner's office records show that at least 59 of the 160 drug-related deaths in the county included fentanyl, which, according to the United States Drug Enforcement Administration, can be 80 to 100 times stronger than morphine.
"It is such a deadly synthetic drug," said Knox Farmer, marketing director for the Chattanooga-based Council for Alcohol and Drug Abuse Services. "And while we have seen prescription overdoses go down slightly, what we are seeing is the fentanyl overdoses going in the wrong trend, and that is scary in and of itself."
Terry Topping, a narcotics investigator for the Chattanooga Police Department, said that fentanyl helps dealers' bottom lines as it is more potent in lower doses than other substances, so more can be sold from a single batch or added to other drugs. And many times some users may not know what is in the substance they are taking.
Most drug-related deaths in the county involved either a single opioid or a combined drug toxicity, mainly affecting white and male demographics, ages 26 to 55.
Methamphetamine accounted for about 14% of the deaths, while methadone, alcohol, and cocaine each made up 2.5%.
More people seem to be turning to substances of many varieties in the pandemic, even if they don't have a history of substance abuse.
"One of the things that we did see was that, you know, people dealing with increased depression, at home, they're dealing with boredom, anxiety, stress, financial stress, hopelessness, and all of those together are triggers for a lot of people that are in recovery," Farmer said.
Many times, those same factors can be triggers regardless of drug history.
"I think the pandemic just brought about a lot of other risk factors," Farmer said. "We're seeing some folks that maybe were depressed and scared and anxious, and they started taking outside medications to feel better about themselves, and now they themselves have developed a problem and they were unable to function like they were before the pandemic."
Treatment and prevention organizations like the Council for Alcohol and Drug Abuse Services and the Hamilton County Coalition recommend that people seek help as soon as possible.
"Probably the worst thing that anybody can do is to wait," Farmer said. "If you or a loved one has a problem, and you know that you need help or that a loved one is asking for help, definitely don't let the pandemic and what is going on deter them from seeking help."
Investigator Topping said that especially during the early months of the pandemic, it was harder to find beds and open slots in treatment centers as intake protocols were adapted to COVID-19.
Many centers required negative COVID-19 tests and quarantine periods, sometimes delaying care in an effort to mitigate the effects of the virus.
"Prior to COVID-19, the Nu-Start staff was able to place most participants in in-patient or out-patient treatment within two to five days or less," said a statment by Camilla Bibbs, executive director of Hamilton County Coalition. "After COVID-19, mandatory testing delayed admissions to a treatment facility for up to two weeks. In other cases, patients were released early from treatment due to a COVID-19 exposure in the treatment facility."
The programs began to include virtual meetings and assessments as individualized solutions were sought, in addition to continuing to admit new patients throughout the year.
In 2020, the Hamilton County Coalition was able to secure more than $64,600 in funding from the Tennessee Community CARES program for things such as personal protective equipment, while the Council for Alcohol and Drug Abuse Services added a new 24-bed detox center to accommodate more people affected by addiction.
- Properly dispose of any narcotics in home that are no longer needed
- If you know that you or someone around you faces addiction, keep Narcan on hand which can be bought at local pharmacies or obtained through programs like one offered by the Hamilton County Coalition
- In case of medical emergency, call 911
As the pandemic continues into 2021, there seems to be no conclusive answer on how many overdoses there could be by the end of the year. But there is hope.
When it comes to law enforcement, in recent years Topping said that trends have turned to helping place individuals in treatment centers, rather than seeking harsh charges for those with addiction, while increasing the severity of cases for dealers whose sales lead to fatal overdoses.
"The whole plan that we are working now is reducing addiction, increasing sentencing for dealers, lower the demand for the drugs, lower the profitability of drug dealers selling drugs in Chattanooga [all so] that they'll find that Chattanooga is not a good place to be selling drugs," Topping said.
While he said he has personally seen a significant number of overdose calls already in 2021, he believes that more people are willing to call during an overdose situation now that they know treatment center referrals are more prevalent. Also, the department has arrested and has pending cases for multiple dealers already in the new year, lowering their projected number of overdose deaths in Chattanooga from 130 to 104.
Spotts said that her records also show promising trends compared to last year as people seek out help.
"Since things have started to open up, people are not at the point where they feel like this is Armageddon," she said. "And we see a decrease in the number of overdoses."
To provide support to those facing addiction and their families, Farmer and Spotts work to educate community members to help fight the stigma of addiction by seeing it as a disease, not a moral failing.
"This is a disease just like heart disease, diabetes," Farmer said. "You'll hear people say sometimes 'Oh it's just willpower. They'll get off of it if they want to.' That is the farthest thing from the truth."
Spotts echoed those sentiments.
"They need to have a better understanding of what addiction is. And the reason I say that is because there is such a stigma associated with chronic dependency and addiction," Spotts said. "They're shamed for the addiction, whereas, if they were supported and provided the necessary resources to be able to get into treatment, then that stigma would go away."
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