Fighting the Opioid Crisis in the Era of COVID-19: What One Grantmaker is Doing

The U.S. opioid crisis was already dire at the start of this year, but early statistics indicate the pandemic is making the problem even worse. Forty-plus states have reported increases in opioid-related mortality in recent months, according to the American Medical Association.

“Evidence shows that drug overdoses, which reached a record high of more than 70,000 cases last year, continue to surge this year due to disruptions in face-to-face interventions and treatments, job losses, anxiety and social isolation magnified by COVID-19,” said Andrea Barthwell, M.D, who chairs the Foundation for Opioid Response Efforts (FORE) board of directors. Barthwell announced that FORE will provide $634,869 to 10 organizations working on solutions to the twin crises. This is the foundation’s second wave of funding since the onset of the pandemic, bringing the total to almost $1 million.

A disease of isolation

The 10 recipients of the FORE grants serve a diverse range of populations around the country. One grantee, the Hispanic Urban Minority Alcoholism and Drug Abuse Outreach Program, for example, works with Latino communities in Cleveland and Northeast Ohio. Renewal House in Nashville provides support for parents, including pregnant and postpartum women with opioid use disorder, a group that is at a particularly high overdose risk.

The FORE grants will help the organizations adapt to new pandemic restrictions. The Denver-based group, Young People in Recovery, for example, which has 50 chapters around the country, is pivoting to provide more digital recovery meetings and life-skills training, for example.

A key goal all the organizations share, according to FORE President Karen Scott, M.D., is to reduce isolation for those with opioid use disorder. “Opioid addiction is a disease of isolation, and the pandemic has increased isolation for everyone,” she says, ticking off other factors that experts believe are contributing to the rise in overdoses, including financial stress from job losses and disruption in access to medical and other types of care.

Street medicine

Psychologist Edward Suarez, the behavioral health director at the University of Miami’s IDEA Syringe Services Program, says the FORE grant will allow the program to expand outreach services to low-income Black communities in Miami-Dade County. The program does needle exchanges, helps clients get tested (and treated) for HIV/AIDS and hepatitis C (and now COVID-19), and steers them toward drug treatment. Says Suarez, “Our program is like an iceberg. We’re a needle exchange program on the surface, and below the surface, we are doing so much more.”

Suarez and his colleagues practice what he calls “street medicine”: The program has a telemedicine-equipped van and outreach workers go out and find patients where they live—which, for many of the people they see, means in a tent on the street or under a bridge.

The FORE funding will help Suarez hire two peer recovery specialists, former addicts now in recovery, to assist their outreach efforts. Research has shown the effectiveness of peer mentors in the treatment of opioid use disorder, and it’s an approach that FORE supports. “We’ve been struck by how effective peer mentors are in working with those struggling with addiction,” says Karen Scott. “This approach is beginning to look pivotal in most of the projects we are supporting.” As Suarez puts it, “Who better to meet you there than someone who’s been there?”

Payback time

It might surprise many of those with opioid use disorder to find out that some of the companies that reaped mega-profits from their addiction are now funding treatment and recovery programs. FORE, for example, was founded by McKesson, among the largest companies in the U.S. and one of the leading drug and medical supply distributors in the country. As IP has previously reported, McKesson was hit with over 200 lawsuits for its role in filling a staggering number of opioid prescriptions during the peak of the crisis—ignoring risks while raking in billions. (To learn more about McKesson’s role, see this 2017 episode of “60 Minutes.”)

McKesson launched FORE in 2018 to combat opioid abuse, pledging $100 million to the effort. FORE president Karen Scott says that McKesson has allowed her and board chair Andrea Barthwell, an expert in addiction medicine, to lead the foundation’s programmatic work. “FORE was founded with a simple charter: to address solutions to the opioid crisis,” she says. “That has given us leeway to focus on evidence-based, patient-centered projects where we can leverage and expand efforts to drive solutions.”

Two other major players in the opioid distribution business are also now working to prevent prescription drug abuse through their charitable foundations: Cardinal Health and AmerisourceBergen. As IP has pointed out, the opioid crisis is an area that has, to date, been largely overlooked by philanthropists. Small regional organizations around the country provide some support, and a few big donors have also stepped in, among them Bloomberg, Arnold Ventures and GE (the Robert Wood Johnson and Conrad N. Hilton Foundations both provided funding for substance abuse prevention in the past, but phased out their programs).

The contributions of McKesson, Cardinal Health and AmerisourceBergen, then, are helping to address a yawning gap, but, as we’ve argued before, they could be doing more: Their charitable giving amounts to a small fraction of their tremendous profits from fueling a public health crisis that’s claimed hundreds of thousands of lives.

It seems fitting—and it’s certainly much needed—for the corporations that benefited so extravagantly from the opioid crisis to support efforts to solve it—work that to Edward Suarez seems, on many days, Sisyphean. “The need is so great and our patient population is so damn vulnerable,” he says.