Community efforts seek to stop the rise in musician ODs during the COVID-19 pandemic

Peter Elwell kicked off 2020 in promising fashion. The frontman for Asheville-based rockers Bad Molly began the year at the Sundance Film Festival premiere of Bloody Nose, Empty Pockets, in which he plays a supporting role, and returned home with a renewed commitment to recording his band’s music.

“He’s just beaming in the Sundance press photos,” says bandmate Lynn Fister. “He really felt positive about the way his life was going, and he was extremely excited by the prospect of us putting an album down more professionally and mastering it more properly.”

On Sept. 20, while out working on shrimping vessels in Florida, Elwell died of a drug overdose, confirms Fister. In subsequent months, fellow local bands Shaken Nature and Thee Sidewalk Surfers also lost integral members, part of an overall increase in area overdoses brought on by the COVID-19 pandemic. The Buncombe County emergency department reported 54 visits for opioid overdoses in January-February 2021, up 26% from those same months in 2020. And Amy Upham, who spearheaded the county’s Post Overdose Response Team, sent out a spike alert in late February that sustained through early March after EMS saw an average of four or more overdoses per day — up from two-three — for several consecutive days.

Risk factors

Jimi Hendrix, Janis Joplin, Jim Morrison and other famous musicians died via overdose, and reports of area artists’ deaths by such means occasionally make their way through social media. But Elwell’s friend and fellow musician John Kennedy says 2020 was the first year that he lost people he personally knew to drugs. Though all local residents have been affected by the pandemic, he feels that the music community has been disproportionately hit and is struggling in distinct ways.

Numerous artists support themselves through service industry jobs, Kennedy notes, and are dealing with the economic stress brought on by restaurants and bars closed or operating at reduced capacity due to state-mandated restrictions. These same individuals were also used to the rush of instant audience feedback at the heart of performing live, which likewise vanished when venues temporarily shuttered.

Many of these artists, he adds, especially those in the underground scene, are empaths who feel compelled to express themselves through song, a process that leaves them emotionally vulnerable. To cope with the feelings that can arise with such raw, honest sharing, many use drugs to self-medicate and to sustain the electricity derived from being onstage.

“For some people, either alcohol or substances help you get into a space where you can be that vulnerable,” says Bayla Ostrach, Kennedy’s bandmate in Bad Banker and Dark City Kings. “But then also, there’s something about that vulnerability that it can be hard, once you’ve been in that space, to come down from that.”

The fentanyl factor

Kennedy refers to 2000-15 as a time when “pharmaceutical grade opioids were just being pumped out everywhere in the country” and falsely marketed as having extremely low addiction rates. While such efforts as the Centers for Disease Control and Prevention’s Guideline for Prescribing Opioids for Chronic Pain in 2016 led to changes that were implemented by health plans and clinic systems, he says demand for opioids remains high. Compounding matters is the rise in synthetic fentanyl-based opioids — estimated to be 25-50 times stronger than heroin and 50-100 times stronger than morphine — at prices similar to marijuana. According to Kennedy, one pill can go for $10-$20.

Additional pandemic-related issues have resulted in “a perfect storm” of risk factors, says Ostrach, who works as an applied medical anthropologist and community research liaison with local syringe access and overdose prevention program the Steady Collective, Holler Harm Reduction and N.C. Harm Reduction Coalition. Over the past year, many people who use drugs (aka PWUD) have experienced supply-chain disruptions, leading them to obtain substances they are less familiar with (e.g., a heroin user turning to meth), further increasing the chance of an overdose.

And if a PWUD’s regular drug dealer is quarantining or arrested and sent to jail — which could happen at any time without warning — the user often gets desperate and buys drugs from unfamiliar sources. Ostrach says these trusted drug providers often test the supply for contaminants and even provide the overdose prevention medication naloxone to loyal customers so that the dealer can encourage continued sales.

Self-isolation additionally means PWUD may be more likely to use alone, which Ostrach says is another risk factor for overdose. But it’s the increased presence of fentanyl — 2 milligrams of which can be lethal — in everything from pressed, seemingly prescription pills to cocaine and ketamine that’s especially troubling. To better understand this trend, the Steady Collective is distributing fentanyl test strips and encouraging people to use them on any drug they plan to take and report back positive results.

“A lot of the conversations that harm reductionists are having at certain service programs or when they’re distributing safe drug consumption supplies is saying, ‘Fentanyl is not just a concern for people who think of themselves as opioid users. So if you think of yourself as someone who primarily uses other drugs, you’re also at risk for overdose,’” Ostrach says.

Musicians united

Kennedy has family members dealing with addiction, and his work outside of music has included projects on leaving the prison system — where addiction and mental health issues play major roles — as well as drug use and recovery in the Southern Appalachians.

“I was in that space, and I was in the music space,” he says. “And then me and my wife [Cinnamon Kennedy] were like, ‘There’s such a big overlap, and it’s so obvious that someone needs to just step in and make sure every music venue in Asheville has naloxone on hand.’”

The Kennedys launched Musicians for Overdose Prevention in January 2020 and partnered with Buncombe County Health and Human Services to get around 50 naloxone kits, which MOP distributed until the pandemic started. Efforts then shifted online in the form of livestreams and compilation records, and all participating bands were sent MOP goodie bags with T-shirts and naloxone to encourage them to carry the medicine. As pandemic restrictions are lifted and venues reopen, additional efforts will be made to have naloxone available in these spaces, and a national campaign is also in the works to get kits in music clubs, tour buses and at festivals.

In his capacity as board member and co-founder of Asheville Music Professionals, Josh Blake helped connect MOP with area venue owners. He and his fellow board members also made it a priority early in the pandemic to provide mental and physical health resources to local musicians. The AMP website includes links to local therapists and health care providers who either accept all insurance plans or have sliding payment scales, and the organization has hosted a pair of mental health workshops, facilitated by grief counselors and other professionals.

“I think one of the biggest challenges for anybody who’s dealing with addiction is reaching out — finding a place to reach out and feeling like they’re at a place where they want to reach out,” Blake says. “It’s the person who needs to want to change and take the first step. So, I think AMP is just providing a few safety net resources for people who are willing to do that.”

Legal ramifications

As a MOP board member, Ostrach serves as a conduit between musicians and harm reductionists, and dispels myths about naloxone, which they point out is available over the counter to anyone at most pharmacies and billable through insurance.

“If you’re a musician, you’re going to be somewhere where somebody is using drugs, so go ahead and take responsibility for this,” Ostrach says. “Cinnamon often talks about it as ‘deputizing’ musicians to be the ones to take care of other musicians, and I really like that framing of it.”

But in order to confidently provide that care, Ostrach says musicians must know their rights. North Carolina’s 911 Good Samaritan law, passed in 2013, protects individuals who call for emergency help — as well as the person overdosing — from being arrested. And the state’s syringe exchange law, passed in 2016, allows syringe exchange programs to operate legally, though in the event of an arrest, program employees, volunteers and participants must provide written verification to law enforcement officers to be granted limited immunity.

Despite these laws, Ostrach says community members continue to be arrested, discouraging individuals from seeking potentially lifesaving help. “Participants routinely report that in such situations, local law enforcement — who accompany or precede EMS — ignore or tear up their syringe service program participant cards,” they say.

Local law enforcement representatives, however, dispute these claims.

“The Asheville Police Department does not, and cannot, charge an individual who calls for assistance to an overdose with the possession of drugs in an amount that would constitute a misdemeanor charge in another context; possession of drug paraphernalia; and possession of less than 1 gram of cocaine or heroin,” says Christina Hallingse, APD public information officer.

Aaron Sarver, Hallingse’s counterpart in the Buncombe County Sheriff’s Office, likewise says he’s not aware of officers violating the Good Samaritan law. But Ostrach says that in the experience of local substance abuse professionals they do research with, “law enforcement leadership are often unaware of what their patrol officers and deputies are actually doing on the streets” and “will officially state that laws and policies are being complied with when direct observation, research and even review and comparison of paraphernalia arrests, dropped charges and overlapping overdose incident reports would show otherwise.”

The county’s Community Paramedic and Post Overdose Response Team deploys a community paramedic and a peer support person to the scene of an overdose instead of law enforcement, according to Community Paramedic program manager and PORT co-lead Claire Hubbard. Though that represents a positive development, Ostrach nevertheless recommends carrying and being trained in administering naloxone to save lives without risking arrest.

Gone but not forgotten

As allies work to better understand the complexities of the opioid impact and provide support from different angles, the goal of preventing the loss of more local musicians to drug overdoses remains the primary directive. In the meantime, they’re also honoring the recently departed with various projects. Bad Molly’s debut LP is nearly ready for release, and a split 7 inch with Ouroboros Boys — two of whose members are in both bands — arrived in February and has already cleared overhead costs, paving the way for all future proceeds to be donated to MOP. Kennedy says that Tristen Colby of Hush Records is also creating a compilation of songs by Thee Sidewalk Surfers frontman Jimmy McGuirl, another immensely talented artist who died in January from an overdose.

“The music scene — the Fleetwood’s, Odditorium, Sly Grog, Mothlight, when it was around, music scene — of these bands, their music is un-f***ing-believable,” Kennedy says. “Shaken Nature and Jimmy and Peter are just incredible musicians. And right now, within the music industry, there’s not a lot of infrastructure or labels running around looking for people, especially not from small music scenes. But these people are real artists, 100% of the way, and they produced incredibly beautiful pieces of music.” musiciansforoverdoseprevention.org