PORTLAND, Maine — The spring-like setting was sublime, Casco Bay shimmering below a large hillside park where hundreds of people, memorial balloons in hand, had gathered in sorrow.
They came to remember 502 Mainers who died of drug overdoses last year, a staggering toll in a state that thought it had endured the worst of the opioid crisis. But then the pandemic came, bringing isolation and depression, and cutting many people off from counseling and group meetings when they needed them most.
Their struggles at once obscured and deepened by the virus, many fell into despair, recovery specialists said. Last month, public health officials delivered the grim news: Fatal drug overdoses had climbed nearly one-third in 2020 to set a record. January was worse still, a single-month high of 58 deaths.
Maine, like most states, is beginning to reopen as COVID-19 cases decline. But the collateral damage already done to people struggling with drugs and alcohol — through anxiety, relapse, and death — has been a heavy blow for the state and its recovery community.
“You feel alone already, and then you throw in the fact that you’re stuck at home, and you can’t do anything, and you can’t see anybody,” said Ashley Reny, executive director of Journey House Recovery, which operates five group residences in Maine.
“So, you go find an alternative. And when you’re in that state of mind, you’ll do whatever you have to do to get what you want,” she added in a phone interview.
The trend also is reflected in national statistics. In December, the US Centers for Disease Control and Prevention reported 81,000 drug fatalities from June 2019 through May 2020, the largest number ever recorded for a 12-month period. In Massachusetts, the mortality increase was more modest, a 2.2 percent rise over the first nine months of 2020.
When the arrival of COVID shut down the country last March, it also shut down many of the tools for recovery. In Maine, group meetings were canceled, and counseling was curtailed. And Zoom sessions, some based in faraway states, could not match the in-person support provided by a sponsor and other familiar faces.
“Imagine you’re in recovery and you want to engage. Imagine the challenge of doing that virtually,” said Dr. Ron Springel, program manager for the Maine Association of Recovery Residences. “How do you pick a sponsor you’ve never met?”
Eric Skillings, a Sanford man who relapsed in 2019, said the virus has added a frightening degree of difficulty to the fight against addiction.
“You get into a depression, and you can’t socialize with certain people,” said Skillings, 37. “You just dig yourself into a hole, and you can’t climb out of it.”
Skillings, who helped found Journey House, knows too well how recovery can collapse — even for people who have worked for years to help themselves and others become sober.
His fiancee, Crystal Waugh, overdosed with him Jan. 30 in Sanford on a combination of fentanyl and Xanax, an anti-anxiety medication. Skillings survived; Waugh, 39, did not.
“I was lucky that God spared me,” Skillings said. “When I woke up, Crystal had passed away. I jumped off the couch and wiped the foam from her mouth.”
The pandemic, Skillings said, compounded the dangers facing his fiancee, who once managed the Sanford women’s residence for Journey House.
“She was scared to go out. She got very depressed from de-socializing, and then the drug use just got worse and worse,” he recalled.
“My bottom is usually jail or prison. Her bottom was ultimately death, because she wasn’t able to get the help she needed,” Skillings said.
Waugh’s death was the latest tragedy for the Journey House community. Jesse Harvey, a founder, died of an overdose Sept. 7 at the age of 28.
“It didn’t seem real when that happened,” said River Joshua-David Banks, who runs the Journey House men’s program in Lewiston. “Here you have a person who put his neck out there for so many people. He gave so much of himself.”
Such stories, many of them overwhelmed by the focus on COVID-19, were told over and over at last weekend’s memorial event in Portland. There, Courtney Allen held a black balloon for Tim Bellavance, a 53-year-old Augusta man who died of an overdose Aug. 8.
Bellavance had recently completed a drug court program and was digging bloodworms for a living. But the pandemic upended everything, said Allen, policy director for the Maine Recovery Advocacy Project.
Bellevance could not read or write and wasn’t familiar with computers, Allen said. As a result, her friend lost access to Suboxone, a drug that helps prevent cravings for other opioids, because he could not join the provider’s mandatory video sessions.
Bellevance relapsed and died, Allen said.
Gordon Smith, the state’s director of opioid response, said last year’s record deaths were the result of a “perfect storm” that combined increasingly powerful drugs, predominantly fentanyl, and a pandemic that severed many support lines for recovery. Through Thursday, COVID had killed 723 people in Maine.
“It’s certainly been disheartening,” Smith said. “We’re doing everything by the book ... evidence-based, data-driven, and then we’re losing 10 people a week in Maine. It’s unacceptable.”
Smith said the spike began at the end of 2019, before the pandemic. But the isolation that followed has exacerbated “an epidemic within a pandemic.”
Under Governor Janet Mills, the state has launched a wide-ranging campaign to reach people struggling with substance abuse, by expanding recovery services, for example, and working to reduce the stigma associated with the disease.
The initiatives are a major shift from previous governor Paul LePage’s approach to opioid abuse. Unlike Mills, who assumed office in 2019, LePage opposed broadening access to naloxone, a drug marketed as Narcan that reverses opioid overdoses.
When Maine’s drug fatalities dropped to 354 in 2018 from 417 the previous year, some health officials believed that the state had turned a corner. But then the numbers began climbing again, to 380 in 2019 and the record high of last year.
The state now is publishing data every month on fatal overdoses, and its new campaign to save lives is focusing on high-risk groups such as the homeless, those who have left treatment, and the recently incarcerated.
“So many people have lost someone they know,” Smith said. “When the imagery changes from somebody away in a big city who’s a heroin addict to someone who could be your friend’s 17-year-old son who died in his bedroom, it dramatically changes the compassion and the stigma.”
As COVID cases fall, group meetings and in-person counseling are reappearing.
Kari Morissette, who is in recovery, leads group sessions in Portland and is executive director of the Church of Safe Injection, an organization that Harvey, her friend who died, founded to distribute sterile needles and naloxone to drug users.
“I’ve been shot, I’ve been stabbed, I’m a human-trafficking survivor and a 28-time convicted felon,” Morissette said. “But I struggled with the shutdown. You’re alone with your head.”
Now, she is back with others, encouraging them toward a better way. Morissette wears a sweat shirt that says “Hope Leader” on its front. And as the virus begins to wane, the state’s opioid-response director said he is hopeful that overdose deaths will drop, too.
“It should get better as we come out the other side of the pandemic,” Smith said. “But I almost feel that a year has been taken from me.”
Brian MacQuarrie can be reached at firstname.lastname@example.org.