Understanding the Opioid Overdose Crisis

% of Methamphetamine and Cocaine Overdose Deaths without Opioid Involvement

Count and percent of overdose deaths with opioids involved: 2018: 83% 2019: 87% 2020: 84% 2021: 79% 9%

5% 6% 6% 6%

3% 3%

1%

by David Kostival

2018 2019 2020 2021

Cocaine, no opioid Methamphetamine, no opioid

Source: Berks County Coroner's Office

When tracking national overdose deaths involving opioids, there has been a steady and sometimes rapid increase over the past 20 years. The National Institute on Drug Abuse reports that overdose deaths from any opioid overdoses were well under 10,000 in 2000. But by 2010, the number had risen to 21,088 and continued to rise to around 47,000 deaths in both 2018 and 2019. In 2017, The New York Times called the opioid crisis the deadliest drug crisis in American history, with it taking the lives of 90 Americans every day during that year. And then a significant rise occurred in 2020 when the number of deaths rose to 68,630 overdose deaths.

The Pennsylvania Department of Health has released information that there were 5,162 fatal overdoses in Pennsylvania in 2020, with 128 of those occurring in Berks County.

That statistic isn’t really all that surprising since the COVID-19 pandemic has been attributed to the highest annual number of fatal drug overdoses on record in the United States. The COVID-19 pandemic did not help matters any because emergency rooms at hospitals were not as accessible for those who overdosed. And the numbers did not fall when many restrictions associated with COVID-19 began to ease. Preliminary data shows there were 5,224 lives lost to overdoses in the state in 2021. When speaking in the broadest terms, the opioid crisis includes prescription opioids; natural and semi-synthetic opioids and methadone; heroin and synthetic opioids (mostly fentanyl). The National Institute of Health explains the problem with prescription opioids is that they are powerful drugs which are often over-prescribed for the reduction of pain from a surgery or injury. The opioids can produce harmful side effects, including drowsiness, mental fog, nausea, constipation and respiratory depression (slowed breathing) that can lead to an overdose death. Continued use will lead to addiction, when average citizens – who never intended to use illegal drugs – are forced to turn to street drugs,

But the problem with street drugs is that there is no quality control, and they are often laced with additional substances such as Fentanyl. The Centers for Disease Control states Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine and is a major contributor to both fatal and nonfatal overdoses in the United States. The danger is that people are not usually aware that their drugs are laced with fentanyl.

The drug crisis in Berks County received considerable attention last September when there was an extreme surge of 101 overdoses and three deaths from a bad batch of street drugs. At the time, Berks County District Attorney John Adams said the incident

did shine a light on the topic of drug abuse. “It hits home that we need to make the efforts from a global perspective, not only from law enforcement, but also treatment facilities and resources to attack this problem,” Adams said a few weeks after the incident occurred. Another incident occurred this spring on April 9 when four people died and seven were hospitalized because of fentanyl-tainted opioids.

In early May, the Pennsylvania Department of Drug and Alcohol Programs Secretary Jennifer Smith came together with State Senator Judy Schwank and local substance abuse treatment providers in a roundtable discussion to discuss the continuing crisis.

Smith said there must be a continued urgency in addressing the crisis at the community level. “That is where change begins, and we must do all that we can to support substance abuse disorder treatment providers because treatment is such a crucial step on the road to recovery,” Smith explained. Schwank agreed, saying that Berks County should be an example for others to follow in terms of addressing the opioid crisis. She also said she wanted to continue working through the state to make sure local recovery teams have everything they need to help as many people as they can. Berks County Commissioner Kevin Barnhardt has addressed the crisis many times in his official capacity as commissioner. Barnhardt is the co-chair of the SOS Berks Opioid Coalition, which was formed in 2018, branding itself as SOS Berks. The coalition consists of community members who are committed to reducing the number of opioid-related deaths in the county by fighting the stigma attached to addiction.

Dr. William Santoro, chief of the division of addiction medicine at Tower Health and a member of the coalition, has said that because of the stigma attached to addiction, those suffering from addition often do not get treatment. He stresses that people should not be defined as addicts, but rather as having a medical condition.

Santoro also says that the public needs to be educated in understanding addiction. Often, he said, people view addiction – especially the opioid crisis – as someone else’s problem until it affects them first-hand. Help with the education process could be on the way, as Berks County officials recently learned the county will receive more than $16.3 million over the next 20 years as the result of a settlement of a national lawsuit against four of the country’s largest pharmaceutical providers.

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