This story was produced by the Kentucky Center for Investigative Reporting, a nonprofit newsroom by Louisville Public Media. For more, visit KyCIR.org.
Isabell Slusher knows how close she came to becoming a statistic in the opioid epidemic.
She started using heroin when she was 18. And last year, the now 24-year-old was forced into isolation during the global COVID-19 pandemic, a dangerous place to be for someone with a substance use disorder.
“As addicts, you already isolate yourself. And then when the pandemic hit, you’re then being forced to not be around your loved ones,” Slusher said. “You do start to get lonely. What better thing to do than just lay around and get as high as you can get?”
She got so depressed that she felt her life had no purpose, and her thoughts turned hopeless.
“Who would even know I was gone? Who would miss me?”
Slusher entered treatment last November, and hasn’t used drugs since. But many young people never made it to recovery in 2020.
Young Kentuckians experienced the highest increase in drug overdose deaths last year, according to the state’s overdose fatality report released this month. The report showed increases in mortality across all age groups, and overdose deaths grew overall by 49%. But the jump for young people was much higher: 127 people aged 15-24, 90% more overdose deaths than the previous year.
Total overdose rates had been climbing steadily over the last decade, increasing by 95% since 2010. But by 2018, those numbers were starting to trend down — at least until 2020 hit.
The exact cause of the increase is unclear, but it’s possible that young people may be dealing with unique challenges during the pandemic.
“They’re already dealing with a lot of uncertainty and just figuring out life,” said Julie Duvall, CEO of Adult and Teen Challenge of Kentucky. “Their peer groups are so important to them and all of that has kind of been disrupted.”
Duvall also said drug use among young people can be misinterpreted as rebellion or behavioral issues instead of a deeper problem.
“We always ask when people come in as part of our intake what drove them to begin experimenting and almost always it’s coping with life,” she said. “These are people that need compassion and healing, not people that need judgment and are just acting out.”
‘Suffering in isolation’
State records show that over the last five years, increases or decreases in overdose deaths have correlated with the number of people reaching out for help and seeking emergency care. But in 2020, emergency admissions didn’t keep pace.
In 2020, emergency department visits for nonfatal drug overdoses increased statewide by just 13%, compared to the 49% increase in total overdose deaths, according to the Kentucky Injury Prevention and Research Center. For young people, the discrepancy is even wider — emergency room visits increased by 10.5% while overdose deaths jumped by 90%.
And Duvall says her treatment program hasn’t seen an increase in admissions.
“I see the statistics and hear that overdoses are increasing and drug use is increasing, but they’re not calling us,” Duvall said. “So, what that tells me is they’re suffering in isolation at home or wherever they are and not reaching out for help.”
Duvall said the restrictions and closures during the pandemic made the process of finding an open bed at a recovery facility even more daunting.
Slusher came into treatment through a court order. She was arrested for violating her federal probation and a judge sent her to Adult and Teen Challenge of Kentucky.
“I think maybe if I didn’t get locked up that day, I know that I probably wouldn’t be here,” she said.”
Slusher started using drugs after her 21-year-old sister died from an overdose six years ago. From that point on, she said she was in and out of jail and began selling drugs — all while experiencing an array of sexual, physical and emotional abuse.
Her addiction caused her to push her family away and the pandemic made that even easier, Slusher said.
“I didn’t want any relationship with my family,” she said. “They were a nuisance to my life because they wanted better for me.”
Slusher said she still has a lot of work to do to earn back her family’s trust, including her 6-year-old son, but she’s dedicated to rebuilding those relationships.
Courtney Duerksen also felt the impact of that isolation. Duerksen, 24, is in treatment with Slusher.
“There have definitely been times where I would take a lot of pills and just not really care. I didn’t care if I woke up or not,” she said.
Now five months into recovery, Duerksen has one piece of advice for anyone struggling with substance use:
“Make sure that you’re reaching out if you need help. Make sure you’re talking to someone,” she said. “Because that’s one thing that I didn’t do. I isolated to the fullest. And if I needed help, I didn’t call anyone.”
While the pandemic likely had an impact on the number of people who sought emergency care or other recovery resources, the lethality of the drug supply also plays a part.
Dana Quesinberry, public health policy and program evaluator for the Kentucky Injury Prevention Research Center, said the opioid epidemic started in the 1990s with primarily prescription opioids. Then heroin was the dominant drug. Since even before the pandemic began, it switched to fentanyl, a much more fatal substance.
“We do know that mortality was increasing in the fourth quarter of 2019, prior to the impact of the pandemic,” she said. “In some ways that makes a tremendous amount of sense, because of the lethality of fentanyl in comparison to heroin and prescription opioids.”
Fentanyl was detected in approximately 71% of all overdose deaths in Kentucky last year.
“It is disheartening. I won’t tell you that it’s not,” Quesinberry said. “Substance use in general has always been something of a whack-a-mole problem. You think you have a particular substance knocked out, either through prevention or law enforcement interventions. And then something else pops up.”
Upward trend continues in 2021
In total, 1,964 people died of a drug overdose in Kentucky last year, about 29% of whom were 35 to 44 years old. Kentucky had the third-highest increase of overdose deaths in the nation in 2020, according to the Centers for Disease Control.
In the United States, more than 94,000 people died from drug overdose last year— the highest number of overdose deaths ever recorded in a 12-month period.
And it seems to be getting even worse this year, according to Quesinberry.
“There had been a hope … that once vaccines became available and we’re reintegrating our society that we would see a decline in overdose deaths, and we are not seeing that.”
Quesinberry said the goal for experts and advocates is to turn the data into actionable steps for prevention and harm reduction strategies. If experts and advocates know they’re seeing larger increases in younger people, they can figure out how to approach the problem differently for those age groups and be hopefully more effective in their prevention efforts.
And while the data is important, Quesinberry said it’s about more than just numbers.
“Every person who has died, every person who has had a non-fatal overdose, every person who has suffered with substance use disorder is somebody’s parent, somebody’s child, somebody’s brother, sister, coworker, neighbor,” she said. “That’s why prevention and harm reduction services and support for them are very important.”
Jasmine Demers is a Report for America corps member. Contact Jasmine at 502.814.6547 or [email protected]
Resources: Kentuckians can call 1-833-8KY-HELP (1-833-859-4357) to speak with a specialist about substance use treatment options and available resources. To find openings at addiction treatment facilities, you can also visit www.FindHelpNowKY.org.