Data from the Georgia Department of Public Health (DPH) indicates just how prevalent overdose-related emergency room visits are in Bartow County. Every single month in 2020, Bartow has ranked in the top five in the DPH’s syndromic surveillance of all 159 counties in the state. With 36.4 overdose-related emergency department visits per 100,000 residents, Bartow had Georgia’s absolute highest rate in the month of April.
There’s no denying the role COVID-19 — directly and indirectly — has played in those somber numbers, said Candace Wilkerson.
“A lot of people are by themselves,” the 36-year-old Cartersville resident said. “This past year has been rough on everybody, and they turn to drugs.”
Another Cartersville resident — 38-year-old Jessica Gordon — noted that quarantine protocols and procedures have also served as barriers to those with substance use disorders from actually receiving the treatments and supports they require to maintain sobriety.
“Not being able to go to meetings on a regular basis, it’s nothing but virtual meetings on Zoom,” she said. “There’s a lot of people that like the unity and the fellowship in the rooms versus the video.”
The two recognize just how important such social connectivity is in the battle against substance dependence. Gordon has been in recovery for almost three years while Wilkerson has been in recovery for 13 months.
“My addiction was killing me,” Wilkerson said. “My brain just went kaput — the last thing I remember is having a seizure and winding up in a ditch and being in an ICU.”
She recounted the fragmented details of that severe methamphetamine overdose. Photographs taken from a subsequent hospitalization depict her in a nearly skeletal state, weighing less than 100 pounds.
“I remember the police being there and I remember the ambulance and I remember this woman trying to talk to me,” she said. “It’s all foggy, but I remember waking up and everybody just looking at me like I was just the craziest person in the world … I just wanted my mama to hug me.”
Although she was an intravenous heroin user for years, Gordon considers herself lucky to never have experienced an overdose — or, at least, one that required hospitalization.
“I did a shot that was way, way too much,” she recalled. “It was like I just went out for six hours and I stumbled to the bathroom and I just sat — it had to be dark, I didn’t want to see any light.”
It was an experience, Gordon said, that she never wanted to feel again.
“My heart was just pounding and I just thought it was going to come out of my chest,” she said.
The disheartening DPH numbers indicate that other Bartow County residents aren’t so fortunate. Figures from the department’s online analytical statistical information system quantify 21 total drug overdose deaths in the local community last year, 15 of which involved opioids.
While the DPH has no official data on Bartow County drug overdose deaths for 2020 publicly available, preliminary statewide data from the first three months of the year list 219 total opioid-related overdose deaths. The same data set suggests at least 537 hospitalizations stemmed from opioid-involved overdoses from January to March. From October to December of 2019, the DPH only tabulated 485 such hospitalizations.
Over that same timeframe, opioid-related emergency department visits also increased in Georgia, from 1,231 to 1,274.
“Instead of you hearing of one or two overdoses a week, at one point there was six or seven overdoses in one week just here in Bartow County,” Gordon said.
Both she and Wilkerson attributed such increases to drugs being laced with extremely potent synthetic opioids, such as fentanyl and carfentanil.
“They’re putting fentanyl in everything,” Wilkerson said. “They’re overdosing left and right because they’re doing drugs … what they’re getting is not what they thought they were getting.”
It’s not just heroin being cut with the high-powered analgesics — the local supply of cocaine, meth and MDMA is also being laced.
“The drug dealers don’t care,” Gordon said. “It may not be fatal, but the overdoses are a lot closer together now.”
For Barbara Hoffman, executive director of the nonprofit Recovery Bartow, that makes getting Narcan more widely available in the community an imperative.
Also known as naloxone — and under other trade names such as Evzio and Nyxoid — the opioid antagonist works by attaching to the same dopamine receptors as the opioid substances themselves.
“It’ll actually kick them off the receptor, and that’ll last for maybe 30-90 minutes,” Hoffman said. “And it may take more than one dose, depending on how strong the opioid is that they’ve taken.”
While Narcan is an over-the-counter drug that does not require a prescription, Hoffman noted that the price point — at some pharmacies, easily eclipsing $100 — could keep it out of the hands of individuals who need it the most.
That’s one of the reasons why Hoffman’s organization recently partnered with Atlanta-based nonprofit Georgia Overdose Prevention to distribute the life-saving drug throughout the community — for free.
“It’s about building relationships with these people letting them know that recovery’s real,” she said. “You can recover, and we’re here if you ever need us.”
At the front lines of that distribution model are Wilkerson and Gordon, whose business cards describe themselves as Bartow County’s “hope dealers.”
“I know the areas that need it the most,” Gordon said. “These types of people, they’re not going to go into a CVS or a Walgreens or call overdose prevention … obviously, if they’re doing heroin or whatever, they’re just worried about getting high.”
Wilkerson said plans are already underway to conduct free Narcan training sessions at several spots throughout the community.
“We may not save everybody, but it helps save lives,” Gordon said.
MetroAtlanta Ambulance data demonstrates the need for such services. Just halfway through the year, at least 120 total Narcan doses were administered by EMS personnel throughout Bartow County.
The year prior, MetroAtlanta logged 441 drug-related calls in Bartow. Of those, 396 involved the administering of at least one shot of Narcan.
“We gave the Bartow-Cartersville Drug Task Force Narcan, that was several months ago,” Hoffman said. “The local fire and EMS, they already carry Narcan … but most of our police departments, unfortunately, don’t, although U.S.-wide, there are many police departments that carry Narcan.”
The more the community is aware of and understands how Narcan works, Wilkerson said, the easier it is to make sure such resources are readily available throughout Bartow.
“I feel personally responsible that we need to get out and just go everywhere, because it’s so important,” she said. “It’s about establishing trust, where they will call us when they’re having a problem.”
August 31 marks the 20th anniversary of International Overdose Awareness Day. Initiated in Australia, the observance has since grown to encompass events in over 40 countries.
“The purpose is to recognize and bring awareness to overdoses, as well as remembering those who died of an overdose,” Hoffman said. “We’ve had more than our share in Bartow County, so we decided to hop onboard this year.”
While some may be quick to stereotype those with substance dependence issues as “junkie-looking people,” Wilkerson said Bartow’s drug problem has certainly enmeshed itself in the lives of suburban, well-to-do families.
“It’s all the time that this is going on,” she said. “People get hooked on something, you don’t even know that they’re using. But there’s such a stigma on it that if they decided to get help, people will look at them bad — so they’re scared to even receive the help that they want.”
The community’s substance dependence problem, Gordon said, impacts the blue collar and the white collar alike. She also believes that the stigma around acknowledging overdoses and other substance abuse issues is making the local problem even worse.
“If we feel any guilt, shame or remorse in other people finding out what we’ve done, it’s kind of hard to be open with anybody,” she said. “It don’t matter what you’ve done, what you’re doing, you’re always welcome in my arms, because I’ve been there, I know what it feels like to be lost … if your family member comes to you about a drug problem, just be there for them. That’s all you can do.”
Wilkerson pointed to her heart.
“When they’re using, it’s usually because of something in here, something you’re battling,” she said. “But you’re also battling 'what does she think about me, what does he think about me,' and you’re just really stuck.”
As have many individuals with substance use disorders, she said she experienced intense trauma as a child. At the age of 16 she was diagnosed with bipolar disorder.
“I was afraid if I stopped using I’m going to kill myself, because I could not deal with what I’ve done,” she said. “I wanted to reach out, but it took me 11 years to get here.”
So many times, Hoffman said individuals turn to drugs not to cope with physical pain, but emotional pain — to numb some form of guilt, or shame or unworthiness.
“There comes a point in your addiction where it's not about just getting high, it’s about not getting dope sick, it’s about being able to just get through the day, to feel normal,” she said. “Substance use disorders and mental health disorders — whether it’s anxiety or depression or bipolar or suicide ideation — they go hand in hand. If you don’t have one when you start using, you’ll get one, you’ll get a mental health condition.”
Amidst the COVID-19 outbreak and its fallout, Wilkerson said maintaining peer support services are especially important.
“We’re the ones who are giving other people hope and actually wanting to get help,” Gordon said. “I couldn’t tell you how many times a day my phone blows up with phone calls, just somebody wanting to talk, needing advice on where to go or what they can do about their mental health.”
To truly address a social problem so deep-seated, however, Hoffman said community members must look past the numbers and “humanize” the overdose statistics.
“There are people in your church that have an opioid problem,” she said. “Every opioid overdose death, that is somebody’s son or daughter.”
For Wilkerson, breaking that vicious cycle means addressing the social stigma surrounding overdoses — and refraining from passing judgment on those with substance use disorders as a whole.
“I just feel like the whole community should be involved and be knowledgeable,” she said. “They’re worth saving — we’re worth saving.”