How climate change affects addiction

Wildfires, extreme heat events and other environmental disasters can have a significant impact on those who are already living close to the edge. For people in addiction or recovery, these kinds of events can disrupt whatever stability they may have found. We talk to Robin Buller, who wrote about the connection between climate change and addiction for High Country News.

Note: This transcript was computer generated and edited by a volunteer.

Dave Miller: From the Gert Boyle Studio at OPB, this is Think Out Loud. I’m Dave Miller. Across the Western US, climate disasters compound the devastation already caused by the deepening addiction crisis. That’s the big takeaway from a new article in High Country News. It explores the twin crises of climate change and substance use disorder. Robin Buller is a freelance journalist based in Oakland, California. She joins us now. Welcome to the show.

Robin Buller: Thanks so much for having me.

Miller: Thanks for joining us. What made you want to look into this issue?

Buller: I was actually writing a related but different story for our local paper here in Oakland about meth. And I was speaking with one source who works in emergency departments and she told me about this connection. She told me a story from back in September 2020, Oregonians may not be as familiar with this event but here in the San Francisco Bay area we had one day in September when the sky just completely turned orange. And she told me that on that day and in the days and weeks following, she saw a huge increase in overdoses and in complications from substance use. And that sort of got me thinking about this connection between climate disasters, which we’re seeing more and more frequently and with greater intensity, and the addiction crisis which is also playing out especially in these states that are impacted by climate change.

Miller: Could you tell us the story of one person you profiled, Marin? I hope I’m pronouncing their name correctly. Marin Hambley and 2018′s Camp Fire.

Buller: Yeah, correct. Marin is a harm reduction worker based in Chico, which is sort of in the Sacramento Valley in Central California. They actually weren’t working in harm reduction at the time that the fire broke out. It was November 2018 and they were working as a landscaper actually and saw over the horizon this big plume of smoke coming up, and it turned out to be the beginning of the Camp Fire, which is most infamous for what happened in Paradise where at least 85 people died.

Marin had experience working in harm reduction in the past and they kind of were aware that there were certain groups of people who were likely going to be impacted more than others by this event. And sure enough, they quickly saw people coming out from the Valley towards Chico looking for places of refuge. There was a sort of a pop- up shelter that emerged on an empty lot near a local Walmart. And so they went there trying to sort of see how they could help, especially with regards to how they could help people who use drugs and who might need help accessing safe use supplies.

Sure enough, as with all groups of people and in all sorts of locations, there were people who regularly used drugs and who needed assistance. And Marin started working with local activists to try and get supplies into that site, and it was more difficult than they anticipated. There were rules against using drugs in these sort of refugee camps. There were rules, even against having safe use supplies as a result so they had to sneak supplies into these sites. And that struck me because they also told me that wealthier people, people with means, weren’t really staying at this pop-up location. They were more likely to have rented Airbnbs or to be staying at hotels. And so they probably were more likely or more able to get their own safe use supplies or their own supplies of substances. And people with lower incomes, people who may already be on the margins, were more likely to be in this camp. And it was that group who sort of struggled to get these safer supplies.

And sure enough, overdose rates did go up in the county, in Chico in particular, and in the zip code surrounding Paradise in those days and weeks following the fire. So, people really did need these supplies in order to stay alive.

Miller: Has that been borne out, after other fires or climate induced disasters, an increase in, say, overdose rates or overdose deaths?

Buller: Yeah, absolutely. I heard this story from Marin, I wasn’t sure how universal this would be and it really was something that I found sort of across the board, across California. I’ll sort of pepper you with a few statistics here. Over the past five years, emergency department visits for opioid overdoses have peaked during wildfire season. So during the third quarter of the year - August, September, October - that’s when opioid overdose rates have reached their peak. And across the past eight years, California’s counties with the highest opioid overdose rates are primarily those that are really in fire prone or fire affected areas, which are typically more rural parts of the state. And this isn’t only something that we see in California. In Oregon, I checked out the CDC statistics for Jackson County, which is where the Alameda Fire was in 2020. There, too, overdose rates sort of go up every year in August, September, October.

Miller: It seems like there are two big pieces of this. One of them is the huge increase in chaos and uncertainty that climate-fueled disasters can introduce into people’s lives. What can that mean for people who are already dealing with substance use disorder?

Buller: There are a couple of different aspects of that. The first is just the psychological aspect. I’m sure that any listeners who have lived through a climate sort of disaster, an acute climate disaster, or even listeners who have experienced residual smoke from a wildfire, can relate to that feeling of gloom, of dread that comes with it. People who have substance use disorder, when they experience psychological trauma or upset, that makes them more likely to use.

And then there’s also, as you mentioned, sort of the chaos, the disorder. Substance use professionals and harm reduction workers that I spoke with told me that that chaos really leads to more chaotic use, less managed use, and that type of use is really more dangerous, especially for people who may not be able to access their regular supply of substances, they may resort to alternate suppliers. That might mean that it’s more potent. It might mean that it’s laced with fentanyl. That, of course, then increases someone’s likelihood of overdosing.

And I should also mention that this isn’t something that only affects people who illegally use drugs or opioids. It also very much impacts people who might legally use an opioid through a prescription or something like that. If they can’t access their prescription, they might look elsewhere for a supply and that could be dangerous. Also, if someone can’t access treatment that they’re undergoing, medication assisted treatment for drug use, that can then lead to chaotic and dangerous use. One person I spoke with told me that if MAT - medication assisted treatment - is halted, if there’s a lapse, someone is three times more likely to die of an overdose.

Miller: We just have about a minute left. What does this all suggest to you in terms of what officials should be thinking about or planning ahead for as climate-fueled disasters become more common?

Buller: Yeah, that’s such a good question. I heard a few things from the people that I spoke with. The first and perhaps most important is for people to be thinking about this population, for people to get rid of their stigmas about people who use drugs and to think about them like they would the rest of the population in an area that might be impacted by an acute climate disaster, and think about helping them and making sure that they stay safe.

The second thing, and really the only thing that people can do sort of on a tangible practical level, is to be prepared, and to be prepared with supplies. So pharmacies should have backup supplies of prescription opioids, of Narcan - that’s the opioid overdose reversing nasal spray. Harm reduction groups need to be able to have backup supplies also of Narcan, but also of clean needles and syringes, cotton swabs, other supplies that enable safe drug use. Also maintaining communication between groups - between harm reduction groups, between medical authorities and local government agencies, making sure that these groups are all connected.

Miller: Robin Buller, thanks very much.

Buller: Thanks, Dave.

Miller: Robin Buller is a contributing writer for High Country News.

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