Addiction Epidemic Inside the Pandemic: The story from Malden

By Will Sullivan

Paul Hammersley, an Addiction Recovery Resource Specialist in Malden’s Health Department, says he sometimes feels as if he’s “working a pandemic during a pandemic.”

As a result of economic and emotional stressors exacerbated by the COVID-19 pandemic, more people are dying from drug overdoses nationwide. The Centers for Disease Control estimates that the country was on pace for more than 80,000 drug-overdose deaths in 2020, more than any other year [NYT requires free login]. The majority of these deaths will have been caused by opioids, a class of drugs that includes prescription medications like oxycodone (Oxycontin) and hydrocodone (Vicodin), as well as fentanyl and heroin. 

According to Hammersley, after only three people died from an overdose in Malden in 2019, that number jumped to 13 in 2020, with five of those deaths occurring in the second half of December. Nearly all overdoses in Malden are caused by opioids. Hammersley said the extended quarantine required to halt the spread of COVID-19 is the primary reason why there’s been an increase in substance use, relapses, and overdoses during the pandemic. “It’s a huge issue. It’s the issue,” he said. “The worst thing for a person struggling with a substance use disorder is to be alone.”

It may not be as apparent as other issues, but addiction is one of devastating side-effects of the COVID-19 pandemic, which has killed more than 384,000 [NYT requires free login] Americans. In Malden, like many cities and towns across the country, people are struggling with addiction and can’t access the resources they need to recover, Hammersley said.

First Church of the Nazarene Pastor Gerald Whetstone, who runs the Malden Warming Center, knows at least one, possibly two, of the Warming Center’s guests have fatally overdosed since the pandemic began, which he says is “an indicator of just how intense it’s getting.” Hammersley placed six people in detox facilities the week before he and this reporter spoke in late November. “It’s been a struggle,” he said. “Our numbers are not where we want them to be.”

The opioid epidemic began in the 1990s, when doctors started to prescribe more opioid medications. A rise in heroin overdoses followed in 2010, and a third spike in deaths was triggered a few years later by the increased prevalence of fentanyl, a synthetic opioid 50 to 100 times more powerful than morphine that is frequently found mixed in other drugs, such as heroin. As a result, the rate of opioid deaths nearly tripled across the country and more than quadrupled in Massachusetts between 2000 and 2015. In 2017 alone, 47,000 Americans died from an opioid overdose and 1.7 million people had a prescription opioid-related substance use disorder.  

When Massachusetts began shutting down in March, it wasn’t just the schools and movie theaters that closed. Churches stopped holding services and hosting in-person meetings for those struggling with substance use. Malden Overcoming Addiction (MOA), an addiction-support non-profit co-founded by Hammersley, cancelled all in-person events through the rest of the year.

As a certified Addiction Recovery Coach, Hammersley guides people through the recovery process. Over the summer, he sometimes met with people socially distanced in a park, but that became harder once the weather grew colder. He said it’s hard “to not see facial expressions with people, to not be able to feel the feelings.” He said this isolation is a big challenge for those in the recovery community. “Not many people were hanging in there on Zoom,” he said. “I’ve lost contact with hundreds of people that I still haven’t talked to.”

After over 2,100 people died of an opioid-related overdose in Massachusetts in 2016, the numbers slowly started to drop, to an estimated 2,020 deaths in 2019 (which still remains well above the 375 deaths in 2000). But initial reports from 2020 suggest the decline has halted, with an estimated 33 more deaths across the state in the first nine months of 2020 compared to 2019. Malden has followed a similar trend. After 16 people died of an overdose in Malden each year from 2016-2018, that number dropped to three in 2019, before rebounding to 13 in 2020. And according the Middlesex County District Attorney’s Office’s Opioid Task Force, there has been a “sharp” increase in opioid-related fatalities in Black and Brown communities, which have also been among the communities hit hardest by the pandemic.   

In March 2020, the Malden Warming Center at 529 Eastern Ave. closed two weeks ahead of schedule, as did some other shelters. This left the Warming Center’s guests, of whom Whetstone estimated 50% to 60% have substance use disorders, with fewer resources and increased stress levels. According to Whetstone, one guest died of a drug overdose within a month of the Warming Center closing. And he worries that homelessness will rise after the state’s moratorium on evictions ended in October, after which a federal moratorium, which expires at the end of the January, took effect.

Both Whetstone and Hammersley point to financial struggles brought on by the pandemic as an additional source of stress, on top of the emotional toll of quarantine. “People are turning to substances to change the way they feel,” said Hammersley. He foresees a long rest of the winter. “It’s going to get worse before it gets better,” he said.

The good news is that the Warming Center, featured in this Neighborhood View article, re-opened on Jan. 1. It is open Monday through Sunday, 7 p.m. to 6:30 a.m. Volunteers are needed to cover shifts. (See link below.) And in 2020, 18 Malden residents successfully completed a sober living program, which funds sober housing for thirty days for those with substance use disorders. Malden residents can apply for a sober living scholarship through either the Health Department or MOA’s website.

Between 2001 and 2005, 34 people died in Malden due to an opioid-related overdose. That number grew to 64 people between 2011 and 2015. But overdose deaths only account for a tiny percentage of the opioid-related incidents reported by emergency medical services, which also include non-fatal overdoses and cases of withdrawal. EMS reported nearly 10,000 incidents across the state in the first half of 2020, 56 of which took place in Malden.

Beyond increasing amounts of substance use, Hammersley said the pandemic has also made the entire process of helping a person who has relapsed more challenging. Getting someone into detox takes longer when they need to get tested for COVID-19 first, and some people are afraid of going to a hospital or facility where they might have a greater risk of catching the virus. Hammersley also said he sees more people with issues with their health insurance. “Everything is harder to do during COVID,” he said. 

While the rest of the winter will be difficult, the first COVID-19 vaccines were administered outside of trials in the United States on Dec. 14, and experts predict that we could begin to reach herd immunity as early as the late spring. Hammersley said that as things open back up, the most important thing will be “getting the meetings back up and running,” and that there will be more in-person counseling.

Hammersley has two other certified recovery coaches working for MOA, as well as two additional coaches who are contracted workers for the Health Department. Despite the pandemic, 30 Malden residents are currently receiving coaching. You can be connected with a recovery coach through MOA by filling out this form.

The Bridge Recovery Center, a peer-to-peer resource center for those in recovery, opened in Malden in late November for online meetings and pre-scheduled in-person appointments. In the future, the center will offer exercise classes and courses in subjects including resume building and computer skills. 

Hammersley said the Mayor’s office is committed to fighting the opioid epidemic, and that Malden is serving as an exemplar for other cities and towns across the state. “My position doesn’t exist everywhere,” he said. He also worked with the Mayor’s office to launch an opioid task force this month. The group will be a collaboration between Hammersley, the Mayor’s office, the police and fire departments, the school department, and other community members. Among other things, the task force will work on providing sober housing and will study overdose hot spots in the area. The Mayor’s office “has been over-the-top supportive,” said Hammersley. “Everyone is on board.”

While Hammersley projects cautious optimism about the future of the crisis, he warns that there’s still a long way to go. “It’s going to be a slow process, but the numbers are going to come back down,” he said. “But we’ll still be in the [opioid epidemic]. That’s going to be alive and well. But at least, maybe we can get back to where we were in March.”

If you or a loved one is struggling with addiction in Malden, please visit this page for information on how to get help. If you would like to assist the Malden Warming Center, you can sign up to volunteer here or make a donation here.

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