In April, Rob Camidge was released from a short stint in jail and right into a pandemic. Recovering from a heroin addiction with long stints of sobriety, Camidge knew the routine that helped to keep him clean: Working. Going to the gym. And three times a week, visiting an outpatient program where his urine was tested.

Now, due to COVID-19, there was no work. The gym was closed. And his recovery program moved online, sans drug tests. Narcotics Anonymous meetings via Zoom “don’t feel real,” he said. “There’s nothing like talking to someone across from you, looking from eye to eye.”

Besides, he was isolated from his friends and family on the Jersey Shore—and idle. “I can’t do what I normally do,” he said. “So what I know best is getting high.” And without in-person drug screenings, he figured “no one knows, the only person who knows is me...It’s only going to be this one time.”

Camidge got what he calls “the stinkin’ thinkin’” and began using heroin again in June before finally getting into a rehabilitation program. He’s now clean, living at a halfway house in Newark. And he’s finding a semblance of stability at a nonprofit for the formerly incarcerated called the New Jersey Reentry Corporation, where those who have dealt with incarceration and addiction are pouring into their offices, telling stories about how the recent pandemic worsened the health emergency that was already here: opioid addiction.

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Early government data from throughout the region show a spike in suspected drug overdose deaths since the lockdown began in March. Deaths in New Jersey were up 15 percent from March to June, compared to the same period last year. In 2019 overdose deaths in New Jersey totaled 3,021—a slight decrease from the year before. But any progress appears to be wiped away in 2020. There were 309 deaths in May alone, compared to 248 in May 2019.

Queens saw a 56 percent spike in overdose deaths during the first five months of the year. In Staten Island, the 58 overdose fatalities so far this year represent an increase from 49 at this time last year (though a spokesperson from the district attorney’s office said the numbers are preliminary and could change).

Another indicator: Emergency Medical Technicians in New York City administered naloxone, the drug used to revive those who overdose on heroin, 23 percent more often than last year, according to NY1. Unlike in New Jersey, which maintains an online overdose tracker, neither the state or city health departments in New York said it had public data about overdose deaths in 2020.

Nationally, a White House drug policy office analysis showed an 11.4 percent increase in fatalities during the first four months of the year, while a New York Times analysis estimated the increase to be 13 percent.

When the coronavirus epidemic first began to take hold in March, President Trump presaged the problem. “You will see drugs being used like nobody has ever used them before,” he said. “And people are going to be dying all over the place from drug addiction, because you would have people that had a wonderful job at a restaurant, or even owned a restaurant.”

Those struggling in recovery and the network of people who work with them describe myriad reasons for the spike in overdose deaths during COVID:

  • A pause in drug screenings at outpatient facilities meant that those in recovery weren’t being held as accountable for staying off drugs.
  • In-patient drug treatment facilities halted or limited in-take to preserve social distance. The New York State Office of Addiction Services and Support even advised that admissions be reduced.
  • Group therapy sessions could no longer be held, leading to therapy via Zoom—which requires that patients have a video-enabled device. Such sessions also lack the human interaction many struggling with addiction require.
  • Quarantine-imposed social isolation and separation from friends and family not only exacerbated some of the mental health challenges associated with addiction, but it led some people addicted to heroin to use alone, with no one there to revive them with naloxone or call 9-1-1 if they overdosed.
  • Government offices were closed, so those leaving prison on drug charges had a harder time accessing housing, food and other public benefits, leading to a sense of desperation that can trigger relapses.
  • Many doctors’ offices, where suboxone is prescribed to help people get off heroin, closed.
  • The economic crisis has made jobs and affordable housing scarcer, especially for those re-entering the community.
  • Fentanyl, an opioid far deadlier than heroin, is becoming increasingly common on the streets.

Jim McGreevey, former governor of New Jersey and now the chairman of the New Jersey Reentry Corporation, has spent much of the last 16 years since he left office ministering to prisoners and running nonprofits that assist those leaving incarceration.

“Some people suffer COVID watching Netflix; other people suffer COVID being out in the street worrying about how they’re going to eat, where they’re going to sleep,” McGreevey said to a group gathered at the nonprofit’s facility in Paterson on a recent Monday morning. “The stack is already against [those struggling with addiction] on so many levels, but COVID just made it worse, COVID made it almost insufferable.”

And yet, as the need increases to help the formerly incarcerated with addiction recovery, government support is in peril. McGreevey laid off 10 percent of his staff due to state budget cuts, and without more funds, he said his Paterson office could close this fall.

“We’ll spend a fortune to keep people locked up in prison, but we don’t do much to help people when they come out of prison in terms of addiction treatment, in terms of employment,” he said.

Budget cuts are playing out similarly in New York, where lawmakers are alarmed by a possible 31 percent reduction in drug treatment funding. Advocates for drug treatment say the federal government needs to provide emergency relief to mental health and addiction services, but little has been appropriated.

The irony of COVID is it prompted officials to release scores of incarcerated people—like those held on drug crimes—in order to prevent the spread of the virus behind bars. But without jobs or treatment programs waiting for them, they weren’t necessarily better off on the outside.

Rev. Wilfredo Toro, chaplain at the Hudson County jail in New Jersey, prayed with an inmate, Carlos Rivera, who died of an overdose while sheltering at a church.

Rev. Wilfredo Toro, head chaplain at the Hudson County Corrections and Rehabilitation Center, saw this first hand. For years Toro counseled his step-daughter’s brother, Carlos Rivera, as he struggled with heroin addiction. Rivera had found his brother dead from an overdose five years earlier, and he used heroin to deal with the pain, Toro said. And so when Rivera was at the Hudson County jail earlier this year on a robbery charge (he needed money for heroin, Toro said), Toro visited him in his unit, gave him books and crossword puzzles, and prayed with him.

“He would ask God to help him,” Toro said. “He would look for God.”

Then Rivera was released early as part of an effort in New Jersey to get hundreds out of jails to keep them safe from COVID. There was no advance warning before Rivera was released, and so Toro couldn’t arrange to send him to a treatment center in Puerto Rico, where most of Rivera’s family lives. Instead, Rivera found temporary shelter in the basement of a church in Elizabeth, where men released early from jail stayed on cots.

Soon enough, Rivera overdosed—twice. He was twice revived by another man living at the church.

One night in the spring Rivera was seen kneeling in prayer near his bed for an extended period of time. “So when they touched him: ‘Hey Carlos, how long are you going to be praying? He then just fell back. He was already gone,” Toro said. Rivera had overdosed a third time, and died.

After his death, the church closed its temporary shelter. So the men inside were left again to figure out how to face both their addictions, and the pandemic.

The federal government’s 24-hour hotline for those facing mental and/or substance use disorders in need of local treatment is 1-800-662-HELP (4357). Or, go to findtreatment.samhsa.gov.

Correction: The use of the term "addict" in the headline and body of this story has been revised to avoid stigmatizing people with substance use disorders.

Matt Katz reports on air at WNYC about immigration, refugees, hate, and national security. You can follow him on Twitter at @mattkatz00.