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General News    H3'ed 9/15/20

Tomgram: Mattea Kramer, Isolation and Opioids During the Pandemic

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It's hardly news that we're heading for 200,000 American Covid-19 deaths within the next week, at least 300,000 by December or even, as the Institute for Health Metrics and Evaluation at the University of Washington recently predicted, possibly 410,000 (or, worst case scenario, 620,000) by year's end. That, of course, would only be if the pandemic gets a second wind in the fall and winter when so many more Americans will be jammed inside homes, schools, workplaces, wherever. And those figures don't even include things like excess deaths from despair (via drug overdoses and suicides), which are likely to be on the rise in our pandemic world.

In fact, though not all the figures are in, we already know that, in a society gripped by unemployment, disease, and Donald Trump, drug overdoses are on the rise. According to a recent Washington Post report, they "jumped 18% in March compared with last year, 29% in April and 42% in May, according to the Overdose Detection Mapping Application Program... In some jurisdictions, such as Milwaukee County, dispatch calls for overdoses have increased more than 50%." With people more isolated, opioid deaths in particular are on the rise because no one is around to administer the highly effective and available antidote, naloxone, also known as Narcan, while various treatment and recovery centers have either had to scale back or close (as financial support for them plunges).

Meanwhile, a study by the Centers for Disease Control and Prevention found anxiety and depression on the rise nationally in this seemingly never-ending pandemic moment, "disproportionately" among "young adults, Black and Hispanic adults, and essential workers." And it's likely that, though they won't be included in those pandemic death totals, suicides, too, will be on the rise. Researchers asking the young whether, in this period, they had seriously considered such an act found that a shocking one in four claimed to have done so. In a moment when isolation, even quarantine, is often the order of the day and in a polarized America of increasingly sharp divides, a country in which, under the ministrations of one Donald Trump, even democracy looks in danger, mental health is not exactly America's strong suit.

With that in mind, TomDispatch regular Mattea Kramer considers what kindness, supportiveness, and "technologies of solidarity," whether naloxone or face masks, if taken seriously (or maybe I just mean humanly and humanely), might mean in what otherwise looks increasingly like a world from hell. Tom

Medicating Isolation
Drug Use in the Covid-19 Moment
By Mattea Kramer

In our new era of nearly unparalleled upheaval, as a pandemic ravages the bodies of some and the minds of nearly everyone, as the associated economic damage disposes of the livelihoods of many, and as even the promise of democracy fades, the people whose lives were already on a razor's edge -- who were vulnerable and isolated before the advent of Covid-19 -- are in far greater danger than ever before.

Against this backdrop, many of us are scanning the news for any sign of hope, any small flicker of light whose gleam could indicate that everything, somehow, is going to be okay. In fact, there is just such a flicker coming from those who have been through the worst of it and have made it out the other side.

I spoke with Rafael Rodriguez of Holyoke, Massachusetts, on a sweltering Thursday afternoon in late July. He had already spent hours that day on Zoom and, though I could feel his exhaustion through our pixilated connection, he was gracious. His salt-and-pepper beard neatly trimmed, he nodded gently in answer to my questions. "Covid-19 has made it more and more apparent how stigmatizing it is to be less fortunate," he said. As we spoke, the number of Americans collecting unemployment benefits had just ticked up to around 30 million, or about one in every five workers, with nearly 15 million behind on their rent, and 29 million reporting that their households hadn't had enough to eat over the preceding week. Rodriguez is an expert in what happens after eviction or when emergency aid dries up (or there's none to be had in the first place) --- what becomes, that is, of those in protracted isolation and despair.

Drug-overdose deaths were up 13% in the first seven months of this year compared to 2019, according to research conducted by the New York Times covering 40% of the U.S. population. More than 60% of participating counties nationwide that report to the Overdose Detection Mapping Application Program at the University of Baltimore saw a sustained spike in overdoses following March 19th, when many states began issuing social-distancing and stay-at-home orders. This uptick arrived atop a decades-long climb in drug-related fatalities. Last year, before the pandemic even hit, an estimated 72,000 people in the United States died of an overdose, the equivalent of sustaining a tragedy of 9/11 proportions every two weeks, or about equal to the American Covid-19 death toll during its deadliest stretch so far, from mid-April to mid-May.

What people do in the face of protracted isolation and despair is turn to whatever coping strategy they've got -- including substances so strong they can be deadly.

"I think of opioids as technologies that are perfectly suited for making you okay with social isolation," said Nancy Campbell, head of the Department of Science and Technology Studies at Rensselaer Polytechnic Institute and author of OD: Naloxone and the Politics of Overdose. Miraculously, an opioid overdose can be reversed with the medicine naloxone, commonly known by the brand name Narcan. But you can't use naloxone on yourself; you need someone else to administer it to you. That's why Campbell calls it a "technology of solidarity." The solidarity of people looking out for one another is a necessary ingredient when it comes to preserving the lives of those in the deepest desolation.

Yet not everyone sees why we should save people who knowingly ingest dangerous substances. "I come from a small town in northeastern Pennsylvania and I have a large extended family there," Campbell told me. She remembers a family member asking her, "Why don't we just let them die?"

Any of us can answer that question by imagining that the person who just overdosed was the one you love most in the world -- your daughter, your son, your dearest friend, your lover. Of course you won't let them die; of course it's imperative that they have another chance at life. There are people like Rafael Rodriguez who have dedicated themselves to ensuring that their neighbors have access to naloxone and other resources for surviving the absolute worst. One day, naloxone may indeed save someone you love. Perhaps it already has.

Another technology of solidarity has recently become commonplace in our lives: the face mask. Wearing such a mask tells others that you care about their well-being -- you care enough to prevent the germs you exhale from becoming the germs they inhale, and then from becoming the germs they exhale in the company of still others. Face masks save lives. The face mask is a technology of solidarity. So is naloxone. And so is empathy.

"The Sheer Power of Being With Someone in the Moment"

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Tom Engelhardt, who runs the Nation Institute's ("a regular antidote to the mainstream media"), is the co-founder of the American Empire Project and, most recently, the author of Mission Unaccomplished: Tomdispatch (more...)

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