By NUNYO DEMASIO

Well before Americans started hoarding toilet paper upon learning the word “coronavirus,” the nation faced another health emergency: Drug overdoses — mostly opioids — had killed about a half-million people over the previous decade. But the pandemic that halted the world’s activities couldn’t pause America’s insatiable appetite for drugs — and likely exacerbated the country’s other health crisis.

As coronavirus dominates the nation’s conscience, the opioid crisis lurks amid a dangerous trend involving methamphetamines. Overdose fatalities spiked throughout communities in several states that include Florida, New York, Ohio, Pennsylvania, South Carolina and Texas. The Center for Disease Control (CDC) hasn’t provided precise data on overdoses during the pandemic. But studies indicate that in the aftermath of a national calamity, recovering addicts are more likely to relapse because of anxiety and fear. Catastrophes generally trigger an increase in substance abuse— one way that folks cope with uncertainty. So with a pandemic that’s upended the economy, any surge isn’t surprising even as drug traffickers have struggled to produce their usual supply.

In a normal year, Americans spend an estimated $110 billion on illegal drugs — by far more than any other nation. More than three million Americans are addicted to opioids, which include heroin, pain medication and synthetics like fentanyl. During the pandemic, recreational users may have prioritized expenses such as rent and food. Naturally, though, addicts seek their fix above all else. Some drug abusers panic bought their favorite narcotics as much as they did items such as hand sanitizers.

The global lockdown, which closed borders and restricted air travel, decimated both legal and criminal enterprises. Most illegal drugs enter the U.S. in vehicles through ports of entry and border patrol checkpoints. (The overwhelming major  of hard drugs come from Mexico through ports of entry.) Typically, more than one million people pass through the nation's borders daily. But reduced traffic substantially diminished the needle-in-a-haystack cover for vehicles smuggling drugs. (In March, Arizona border officers seized 690 pounds of methamphetamine hidden within the floor of a tractor trailer carrying tomatoes and bell peppers. The largest meth seizure in Arizona’s ports history, it was valued at close to $700,000.)

Since 2000, opioids have killed more than 300,000 Americans, including a record 47,600 in 2017. Most of those fatalities stem from fentanyl, the synthetic exponentially more potent than heroin. The deadliest opioid, it’s regularly mixed in a host of recreational drugs. Precursor chemicals are required to create fentanyl and methamphetamine. The essential ingredients largely come from underground factories in China, particularly Hubei, a landlocked province. Before the outbreak, Hubei’s capital, Wuhan — where the virus originated in late 2019— was a major source of precursors. But quarantines disrupted the supply chain that traffickers relied on before selling their wares in the U.S. Despite China ending Wuhan’s lockdown in early April, its factories aren’t quite back to normal.

B.P. (before the pandemic), precursors for fentanyl were both cheap and easily available. About $3,000 invested in fentanyl potentially reaped six figures in profits. Mexico’s two biggest cartels, the Sinaloa and Jalisco New Generation dominate the illegal drug trade in America. But hard-pressed to acquire precursors after COVID-19, the cartels have suffered substantial revenue losses. The new virus even created difficulties in importing cocaine — which has roared back in recent years — from South America. Narco-traffickers responded by jacking up prices on popular drugs. Compounded by stockpiling, illegal drugs have been selling at all-time highs, similar to virus-related items such as disinfectants.

The dark web — which facilitates anonymous drugs sales through the mail — remains open. And now its products include purported cures for COVID-19, including the blood of ostensibly recovered patients. But the Drug Enforcement Agency (DEAhas observed a sizable drop in money laundering, which frequently occurs on the dark web. Regardless, the pandemic could benefit Mexican cartels in the long run: They’ve accelerated steps to recruit homegrown scientists to make their own precursors.

To the chagrin of Mexico’s president Andres Manuel Lopez Obrador, cartels have distributed aid packages throughout Mexico, often overshadowing its government. And El Chapo’s eldest daughter, Alejandrina Guzman Salazar, made news after a video surfaced showing her fashion company, El Chapo 701, providing boxed aid to the elderly and impoverished in Guadalajara — Mexico’s second-largest city. The packages included rice, sugar, toilet paper, disinfectants and face masks emblazoned with El Chapo’s likeness. (Btw: Kudos to Twitter’s chief, Jack Dorsey, who outshined his fellow billionaires by donating $1 billion largely toward coronavirus relief. The amount is nearly one third of Dorsey’s net worth!)

COVID-19 — the respiratory disease caused by the new virus — tends to victimize the elderly and immunocompromised: Drug addicts have higher rates of medical conditions, such as HIV and Hepatitis C; and they suffer more from chronic lung diseases. The new virus attacks the lungs, making drug abusers and smokers more vulnerable. Opioids slows breathing, decreasing lung capacity while increasing the risk of overdoses. Methamphetamine constricts blood vessels, contributing to pulmonary damage. Furthermore, drug addicts tend to live in congested settings; and scores of them are homeless or incarcerated.

Face-to-face meetings, highlighted by support groups, are considered key in combating addiction: And clinics play a pivotal role by providing prescriptions that help reduce cravings while preventing relapses. More than 1,700 clinics are certified to give medication such as methadone and buprenorphine. In normal circumstances, about 350,000 Americans who visit methadone clinics take their daily medication under strict supervision. However, social distancing guidelines have caused those highly-regulated facilities to either shut down, limit access or revamp operation by moving on line.

On March 16, the government issued emergency guidelines, relaxing rules for medication-assisted treatment: Instead of requiring inpatient visits, prescriptions can be approved after telemedical appointments. The government also authorized clinics to give stable patients take-home doses lasting as much as 28 days. Virtual counseling sessions have replaced inpatient visits. Prescription deliveries are being shipped to quarantined patients. And to try limiting opioid overdoses during the pandemic, officials have tried to distribute Naloxone (or Narcan), the lifesaving tool. Still, medical experts consider isolation as being antithetical to treatment. Loneliness increases the risk of depression — and an overdose with no one around.

While COVID-19 targets the infirm, drug addiction pervades all segments of America’s population. Last year, overdoses killed roughly 69,000. And it remains the leading cause of death for Americans under 50. The NUNYO & COMPANY podcast, featuring the real Ray Donovan, examined  the worst overdose crisis in U.S. history. Donovan, the DEA honcho who oversaw the historic operation to recapture El Chapo, offered a master class while revealing the biggest trends in drug trafficking: methamphetamine and cocaine. Donovan also declared that despite marijuana’s legalization in much of America, demand for Mexico’s supply remains high.

As the Sinaloa cartel’s leader, El Chapo received tons of blame for the opioid epidemic after popularizing fentanyl-laced heroin to increase potency. Nonetheless, the crisis began during the 1990s after pharmaceutical companies downplayed addiction risks while pushing painkillers, especially Oxycontin by the Sackler family. From 2006 to 2012, America’s largest drug companies unleashed 76 billion pain pills throughout the nation. That’s 230 pills for each American!

The crisis drew renewed attention — and compassion — in 2017 as it devastated rural communities and working-class families: More than 70,200 Americans died from overdoses — a record number with seemingly no end in sight. Thus, the federal government declared the problem a “public health emergency.”

Attention from the government, media and public health officials seemed to make a difference. The pandemic struck after a glimmer of hope: Entering 2019, overdose deaths had dropped for the first time in almost three decades. (And America’s life expectancy rose for the first time in four years.) But even with a 4 percent dip in overdose deaths, the figure remained high at 67,367, especially as it related to opioids.

The U.S. failed to maintain the downtick last year, with fatalities increasing slightly. Unfortunately, Americans will face their other health emergency long after COVID-19 subsides — with Mexican cartels more self-reliant than ever in feeding this nation’s voracious demand for drugs.

nunyodemasio.com/podcast