We are having a record-breaking year for deaths from drug overdoses. There are many factors playing into it–synthetic fentanyl and its rapid spread from East to West coast; the silent pandemic of loneliness and despair that underlies covid and brings with it more drug use and abuse; a financial crisis leading to more homelessness which sort of closes the circle on the previous two factors. It’s hard to separate one thing from another as the bad news this year just kept piling on, and ultimately everything seems related in some way to the worldwide pandemic and the fallout from it.
So here we are. A record year for drug overdoses. An article from New York Magazine points out not just how we’re going to break records for drug ODs but that here in San Francisco, overdose deaths actually outnumber covid deaths. Maybe we should just add OD deaths on to the covid death totals… But then again, that is a slippery slope. We could say the same for heart attacks and strokes, and diabetes and decreased exercise tolerance. Maybe “pandemic syndrome” should be a new diagnosis. Let’s spitball a formal diagnosis criteria–it would probably involve 1) financial, housing, food, and/or racial insecurity AND 2) a concurrent development of a chronic illness, plus one of the following two categories 1) depression and/or anxiety; 2) alcohol and/or drug use disorder. I’m sure we don’t need this diagnosis–what we have covers it since this probably falls into the territory of a psychological diagnosis.
My fictitious diagnosis would be covered easily by “adjustment disorder” from the DSM V, but we’d all run into trouble when our adjustment problems go beyond 6 months. But you know what? Perhaps we’ll see a lot of PTSD or cPTSD coming out of this pandemic. I can only speak from what I see or read, and I know that many healthcare providers are being severely traumatized over and over by this pandemic.
They are taking care of patients who are isolated and lonely and sometimes, dying alone. There are times when the only visitors are Zoom calls with family, and the nurse usually is the one holding the iPad, absorbing day after day of each family’s sadness and overwhelm.
There are the days when even though they are sick, the patients still lash out at the nurses and other medical staff violently, sometimes causing permanent disability. Even though my hospital has done all of the things discussed in this article, we still have violence from patients and visitors: Cash-rich hospitals have done little to prevent violence against nurses and other medical staff — from The Milwaukee Journal Sentinel (the last of a five-part series called “In the Shadows” about violence against healthcare workers)
And none of this takes into account the high risk healthcare workers are at to actually get covid. This story of an ICU nurse in her 60’s who gets covid and ends up in the hospital for 8 months fighting for her life and then relearning how to walk is inspiring. But not many souls would fare so well with such a challange.
Could you imagine going to work, thinking that could be you? That was my previous 9 months. I did get my first vaccination, but I won’t consider myself safe until about two weeks after my second dose. Then–approximately February 1–I will consider my fully vaccinated, which wiull give me about 90% protection from covid.
But until then, everyday I go to work, I am still at risk. There is more covid than ever. And at my hospital, I personally see the high number of drug overdoses. Its like they come in waves… when the fentanyl hits the street, we get between 3-8 cardiac arrests “found down.” A complex cycle of homelessness, mental illness, drug abuse, and trauma all coming to an end in the ICU.
