Early reports show San Francisco is headed for its deadliest year yet from opioid overdoses. While the Coastside isn’t seeing the same sky-high numbers, a year of isolation has only made addiction problems worse, experts say.

“It feels like everybody is in crisis,” said Mary Fullerton, supervisor of the San Mateo County’s Integrated Medication Assisted Treatment team, which helps people addicted to opioids. “There is more at stake. There is a sense of desperation, loneliness and not as many ways to get help.”

According to data from the county coroner’s office, four people in Pacifica and two further down on the Coastside died from accidental opioid deaths in 2020, making up just 7 percent of the county total. The city with the most opioid deaths last year was Daly City at 12, and an additional 12 sheltered or unsheltered people without a listed city of residence died from opioids last year. Overall, the county saw 81 accidental opioid deaths in 2020, up from 65 in 2019. To Pacifica Police Capt. Bill

Glasgo, Pacifica’s numbers are nothing out of the ordinary for the area.

Fullerton said, on the countywide level, she suspects the numbers are even higher.

“What we report and what we see is often the tip of the iceberg,” Fullerton said.

Fullerton said administration of two or more doses of Narcan, a drug used to treat people in an altered state, doubled from 2019 to 2020 across the county. It’s not a perfect measure of local opioid use — it may actually indicate that access to treatment is increasing — but anecdotally, Fullerton has seen the effect the pandemic has had on people struggling with addiction.

She said isolation from the pandemic has shattered support systems like group meetings or friends and family connections and created lonely conditions that can trigger drug relapses. She explained that the treatment for addiction is not sobriety, but creating and maintaining social connection. Plus, the pandemic has killed loved ones, cost people their jobs and created personal and financial distress, driving many people toward anxiety and depression and starting the cycle back toward relapse.

“People are using substances more and they are struggling more,” Fullerton said. “… Substances are a way that people cope.”

The way her team responds has to look different, too. Working out of San Mateo Medical Center’s emergency room, they’re wearing masks and protective equipment and staying socially distanced. She said it makes connecting on a personal level and providing that critical social support much harder.

Still, numbers in San Mateo County aren’t as high as in San Francisco or elsewhere in the nation. Fullerton said it may be because the county’s ability to trace and track substances like fentanyl, which requires a more specialized lab test to detect, is less sophisticated than in San Francisco. Glasgo said many of the people Pacifica police encounter are repeat users.

One thing that’s constant across the entire county, however, is that opioid use and addiction affects all demographics. Fullerton said after an unusually high number of people came into the emergency room one weekend this year, she sat down with county epidemiologists to comb through the data, but nothing — not age, nor race or income — stood out.

“There was no trend,” Fullerton said. “Addiction is not a disease that discriminates. We’re a long ways from being out of this pandemic, and we’re a long way from healing,” Fullerton said.

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