United States, Double Drug Deaths in 2020

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The alarm was raised in the United States : according to data collected by the Washington Post newspaper from outpatient clinics and districts in 35 US states out of 52 in the Union, drug overdose deaths, which had steadily decreased over the past 18 months, they presented a sharp turnaround and equaled deaths by one year in less than six months: a doubling of mortality.

In Italy the epidemiological situation will be known in its entirety only at the end of the year but the available data, which concern some regional observers, go in the same direction. However 2020 develops as a whole, the months coinciding with the pandemic and the lockdown have a precise connotation: the crisis caused by the COVID-19 has led to a serious crisis also as regards the processes of treatment and prevention of addictions .The causes identified by the specialists are numerous. As reported by the American newspaper, statistics prior to the pandemic show that every 1% increase in unemployment causes 3% more deaths due to opioid overdoses. There is a tendency to think of drugs as a personal problem, but if deaths from overdose increase during situations of employment crisis, some researchers see this as a system problem. The rapidity, the totality, the unpredictability of the crisis, the upheaval of life habits, the surprise, disorientation, uncertainty and confusion of the institutions accentuate the sense of loneliness of the citizens, the anguish of having to get by on their own, the despair that nobody will intervene to bring help.

Furthermore, prolonged social isolation and greater vulnerability to stress, in people who are fragile on a relational and existential level, may have amplified both elements of malaise, favoring self-destructive thoughts, and on the contrary the euphoric feeling of no longer having controls. In this situation, the search for containment or treatment solutions for COVID-19 has led to drastic choices. Like other services open to the public, health services have also reduced their accessibility: patients treated for addiction have seen visits, checks and interventions in general slow.

«The dramatic American experience», explains Emanuele Bignamini, member of the Scientific Committee of the European Institute for the treatment of addictions , «must teach us to reflect with the right concern on the possible consequences also in Italy of the COVID-19 epidemic on overdoses from drug. The recent case of the two 15 and 16 year old boys from Terni, who died from a probable methadone overdose, indicates the importance of investing in health policies, also taking the opportunity of the availability of innovative solutions related to digital health control ».

The greater difficulties in accessing services have necessarily led to fewer controls on adherence to therapy. In the case of replacement therapy with methadone or buprenorphine, it has led to an increase in the practice of entrusting the drug to patients, even for long periods (the law allows it for up to 30 days), reducing in-person administrations and health checks. Inevitably, the delivery of significant quantities of product to patients being treated for drug addiction creates “opportunities” for improper use or even worse of transferring their doses for money to others, obviously illegal.

In the meantime, drug trafficking and retail sales have shown inventiveness, flexibility, ability to penetrate information, attachment to the customer. In addition: expansion and differentiation of the offer of products, not known to most. With all the dramatic risks that this entails.

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