MILWAUKEE (SPECTRUM NEWS) — Even as COVID-19 has caused nearly 200,000 deaths in the U.S., it’s also exacerbated other dangerous and potentially deadly issues for some Americans — like those struggling with addiction and mental health.

According to the Milwaukee County Medical Examiner’s Office, overdose deaths in the county this year are projected to surpass 500, on pace to set another annual record and outnumber coronavirus deaths. 

The office shared on Twitter that if current trends continue, the death tolls would amount to 514 overdoses, 455 COVID-19 deaths, 193 homicides, and 120 suicides. Wisconsin as a whole has seen a significant rise in overdose emergencies and deaths in the first half of 2020, compared to the same time period last year.

Over the Labor Day weekend alone, the medical examiner reported 11 probable overdoses, three homicides, three suicides, and two COVID-19 deaths. 

With pandemic-related shutdowns putting people out of work and limiting access to in-person treatment, it’s not surprising that these numbers are high, says David Gustafson, director of the UW-Madison Center for Health Enhancement Systems Studies.

“I don’t know if they are what I expected, but they certainly are what I had feared,” Gustafson says.

Overdoses had already been increasing in Milwaukee County in recent years. Last year, the medical examiner reported 418 deaths from drug overdoses, a record at the time. 

Gustafson attributes some of that overall trend to an “unconscionable” push by drug companies to use more opioids. The medical examiner’s office reported that deaths tied to fentanyl, a powerful synthetic opioid, rose by 29% between 2017 and 2019.

And as the pandemic has left many people unemployed, it’s created a tough situation for people who struggle with addiction, Gustafson says. Without work to keep them occupied, they may be more inclined to turn back to substance use — which can also make them “much more of a danger” for others in their household.

“When you have people who are locked up at home, you're going to find them to become more frustrated, more challenged to maintain control in their lives,” Gustafson says.

The overdose numbers may not even capture the full toll of substance abuse, says Ginny Stoffel, an associate professor at UW-Milwaukee whose research includes recovery for people with mental illness and substance use disorders.

Substance abuse can affect many aspects of a person’s health and decision-making, Stoffel points out. It can make them more likely to drive under the influence and therefore be involved with a fatal accident, or to make riskier decisions about protecting themselves from COVID-19.

“It’s also the picture that’s not there,” Stoffel says. “In fact, their substance use disorder sets them up for all the other things.”

Across the country, people have reported increased struggles with mental health issues, including substance abuse, during the COVID-19 crisis. A CDC report from this summer found that 13% of respondents said they’d started or increased substance use to cope with the pandemic, while almost 11% said they’d seriously considered suicide in the past month.

In Milwaukee County, suicides increased more than 300% in the month of August, according to the medical examiner’s office. 

Adding to the other stresses of the pandemic has been the difficulty of getting treatment in the midst of social distancing measures. In-person counseling sessions and group meetings have been mostly shut down, which can be a problem for those in the midst of their recovery, Gustafson says. 

“You find that the people who were sort of hanging by a thread in terms of their addiction, that the thread is lost,” he says.

Some sessions have moved online, with Alcoholics Anonymous and Narcotics Anonymous groups offering virtual gatherings and counselors turning to telehealth platforms. Gustafson had already been part of a research project developing an online platform called A-CHESS, which offers different services for patients to manage their addictions, like options to follow relaxation exercises or chat virtually with others on the platform.

The virtual format can actually make treatment more accessible in some cases, Stoffel says. A Zoom meeting may be able to accommodate a greater number of attendees, who won’t have to physically travel anywhere or face the stigma of showing up in person.

“Some of the aspects that in the past have been barriers — about, ‘Gee, if I walk into that library room, everybody knows that's an AA meeting’ — instead, nobody has a clue if you’re there,” she says. “But you get the benefit of hearing and interacting.”

However, Gustafson points out, an important barrier for online support systems is that those who lack internet access might get shut out. 

As cases continue to pile up in Wisconsin and beyond, restrictions on many in-person meetings look like they will stay put for the time being. 

Even after that, though, Gustafson thinks shifts in treatment will stick around once the COVID-19 crisis wanes — and once more businesses open up, they’ll also have to consider ways to support their employees who may have been struggling with addiction or other mental health challenges over the course of the pandemic.

“We're entering a new world of addiction prevention and treatment,” Gustafson says. “It’s never going to return to the way it was before.”

Stoffel says she’s worried that “things are going to get worse” in the next few months as people continue to deal with the isolation of the pandemic in combination with economic challenges and other stressors. 

She encourages people to find ways to support others and find support themselves, even through simple check-ins and acts of kindness, instead of trying to go through this time alone. The term “social distancing” isn’t quite right, she says — rather, we should be physically distancing while socially connecting.

“This is the time for all of us to learn about ourselves, and what we do, and how that impacts our state of health,” Stoffel says. “We don't know what's down the road, and we want to be at our healthiest and our most supportive to be able to manage that together.”

To find more information on substance use treatment and recovery services, contact the Wisconsin Addiction Recovery Helpline online or by calling 211. Call 800-273-8255 to contact the National Suicide Prevention Hotline.