The Other Epidemic Killing Americans

When North Carolina was besieged by Covid-19, Louise Vincent almost died – but it wasn’t the virus that almost caught her. She shuffled in and out of clinics for months, seeking appropriate medical treatment. Eventually she was poisoned while desperately trying to get herself some medicine. The drug she needed was methadone, which is used to help people treat opioid use disorders. She could have easily accessed it; Vincent helps lead the North Carolina Urban Survivors Union, a drug user advocacy group and harm reduction group.

But Vincent got into trouble with her usual methadone clinic, also because she had missed appointments because she had traveled to work.

“They didn’t let me come back saying I failed their program,” she told me.

She tried switching to another local methadone supplier, but said that doing so limited her to insufficient doses due to other medications she was taking. During her months of struggling to find the drug she needed to function, she eventually returned to street heroin.

“I tried to use as little as possible to get through the day,” she recalled. But even their limited exposure to street food resulted in frightening side effects. “[The drug] caused skin lesions, all sorts of things … It was horrible. I didn’t know what was wrong with me. And the end result was I was almost dead with 2.9 inches of hemoglobin – a dangerously low reading caused by the substance she later discovered had been mixed in: a horse sedative called xylazine.

The avoidable crisis that befell Vincent, which ended in what she described as traumatic hospitalization, reflects a public health crisis that has tacitly metastasized. While health officials focused much of the attention last year on rising infection rates and death tolls from Covid-19, another worrying trend – an increase in deaths from overdose in the first few months of the pandemic – showed a health crisis emerging shadow played out during the pandemic: people are dying at record rates from an epidemic that killed around 450,000 people over the past two decades.

As the pandemic paralyzed parts of the economy and left millions of people unemployed, people with opioid use disorder – including both prescription pain medication users and people who inject street heroin – were bombarded with social stressors, from social isolation to barriers to treatment since vendors have closed their doors. Harm reduction advocates are now calling on the Biden government to revise the government’s handling of the opioid overdose crisis.

According to the Centers for Disease Control and Prevention, overdose deaths across the country died from October 2019 to September 2020 rose 29 percent in the past year the vast majority of opioids who killed an estimated 66,813 people. During the first few months of the lockdown according to the Commonwealth FundMonthly deaths from opioid overdose rose to more than 7,200 last May, compared to just over 4,000 deaths the previous year. Racial differences have continued through the pandemic, with overdose deaths from 2018 to 2020 rose many times faster for black and Latin American people than for white users.


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