With drug deaths at record levels, Iowa lays out plan to combat substance abuse

DES MOINES — The leader of the Governor’s Office of Drug Control Policy has issued a 2022 strategy that hopes to build on Iowa’s positive trends while addressing challenges tied to the COVID-19 pandemic and the availability of more potent and addictive substances.

On the upside, Iowa drug czar Dale Woolery points to recent federal studies that rank Iowa sixth lowest in the nation in the rate of total illicit drug use and fifth lowest in the rate of drug overdose deaths. But the bad news is that alcohol- and drug-related deaths have risen to record levels.

“Iowans face a growing threat from psychoactive substances that are increasing in variety and strength, and doing so with quickening speed,” Woolery noted. “The types of substances available to Iowans is expanding, poly-substance use involving mixtures of lethal drugs is becoming more common, potency is rising in many products, and for many these risks are being exacerbated by pandemic stressors.”

Among some key findings noted in the 2022 strategy report:

• Sales of alcoholic beverages remained strong in 2020, as alcohol-related deaths rose 26 percent to a record 836.

• Teen vaping of nicotine declined sharply over the last two years nationally although Iowa-specific data has been delayed due to the pandemic after Iowa raised the legal age for smoking/vaping to 21 in 2020.

• Marijuana/THC use among Iowans ages 12 or older ranked third lowest nationally and ninth lowest among youths ages 12 to 17.

• Clandestine methamphetamine labs numbered eight in 2020 — the lowest level in over 20 years — but the volume and purity of meth smuggled from Mexico into Iowa remains at or near all-time highs with amounts seized by law enforcement likely to exceed 513 pounds in 2021.

• Stimulant-related overdose deaths (159 in 2020) and the proportion of Iowans entering substance use disorder treatment primarily due to meth (23.7 percent in 2021) remain at or near record levels.

• Treatment for cocaine use remained low at 1.2 percent in the past year, but law enforcement cocaine seizures are on track to reach their highest level in six years with more than 14,000 grams projected for 2021.

• Prescription opioids dispensed to Iowans decreased for the fourth straight year, but opioid-related overdose deaths increased 35 percent to 210 in 2020 and fentanyl was implicated in 87 percent of Iowa’s opioid overdose deaths in the first half of 2021.

In an interview, Woolery said the pandemic has “hidden from view” some of the problems associated with alcohol or substance abuse and has made providing and receiving services more challenging. Though he did credit new telehealth options with mitigating some of those concerns.

Q: What’s your takeaway from the latest survey data cited in the 2022 strategy?

A: “It’s got a mix of positives and negatives as far as areas where we need to recognize progress and achievement and then also those areas where we have challenges. There is always room for improvement on all of the fronts, but overall we continue to have very low rates of usage of illicit drugs.

“But we have a relatively high rate of meth use as one of those illicit substances and higher-than-average use of tobacco or nicotine products and in binge drinking/alcohol consumption. Behind all of that, the things that stand out to me are the potencies of those substances that are psychoactive or addictive.”

Q: How has the pandemic factored into Iowa’s trends?

A: “I’ve compared it to an accelerant. When you think of what gasoline is to a fire, I think the pandemic is having that same type of effect on behavioral health issues where it’s given new fuel or more fuel to some of these risky behaviors. As a consequence, we are at all-time highs, it appears, in terms of alcohol-related deaths and drug overdose deaths in particular as they relate to opioids and stimulants in the state of Iowa for the year 2020.”

Q: You indicated more Iowans are using multiple substances, such as fentanyl, heroin, meth or alcohol together or in succession. What is the biggest concern there?

A: “The changes in the substances, the combinations, the potencies, the pandemic — which has altered either temporarily or perhaps long-term drug supplies, substance choices or options and I think behavior to include risky substance use alone, and using other substances and not necessarily always knowing the contents. I think that’s been a recipe for what we’re seeing.”

Q: Alcohol sales are up, but with bars closed during the pandemic, how did that impact consumption and abusive behavior?

A: “I think the isolation has been bred by the pandemic. It’s been necessary in many cases to social distance, so what has been recommended in some cases because of the pandemic has created unfortunately an isolation for individuals, and I think where that presents a risk for anyone who is either an alcoholic or has a substance abuse disorder of any kind – it not only changes the atmosphere in which the products are consumed but you have less opportunity for an individual to intervene and say ‘I think you’ve had enough.’ Whether it’s alcohol or heroin or something else, those intervention opportunities have been fewer, and getting services has been more difficult due to pandemic responses. All of that makes for challenges.”

Q: Iowa’s low rankings nationally appear to be good news, or does it just mean there are bigger problems elsewhere?

A: “We are at a lower starting point and have a more manageable type of situation than a lot of other places, but we have our own challenges. It’s not all roses. We have some thorns. You don’t want to see trends going the wrong direction and increasing. We need to keep at it.

“I’m encouraged by some of our relative low rates, but I’m concerned we’re seeing increases in some of those areas (like overdose deaths). Some of that might be that we are getting better at reporting. But we also have to concede that some of that is true increase. Many substances are new and we don’t even know their names — there are new things coming on the market and we don’t appreciate their strength.”

For the most part, Woolery said Iowans have been responsible in their health choices and behaviors. He advised that for anyone facing problems for themselves, their friends or family members, the Iowa Department of Public Health offers 24/7 assistance at the YourLifeIowa.org help center or 1-(855) 581-8111.

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