Jeana O’Malley picked up her daughter Jordan on April 7 from the residential treatment facility in Dartmouth, Massachusetts.

Jordan O’Malley had been there 30 days, during which the coronavirus pandemic had transformed the world outside. She could have stayed in rehab longer, 90 days or even 180, but was anxious to leave, her mother said, and clinicians agreed she was doing well.

The day after she left, Jordan died from a drug overdose in a motel room less than five miles from the treatment center. She was 29.

Her mother wonders if staying in rehab would have saved Jordan’s life.

“I know she felt so isolated from everything. No one could visit her there,” her mother said, recalling how Jordan, who was always at her best around family, was handling the uncertainty brought on by the coronavirus outbreak.

O’Malley, a 2008 Deering High School graduate who lived most of her life in Portland, struggled with substance use disorder for years and could have succumbed to an overdose long before now, her mother said. But her death in this unprecedented time underscores what addiction and mental health professionals have been warning about – that the current societal conditions are perilous for people who are struggling.

“Obviously, we’re very alarmed by the risk. I don’t think in our strategic plan we ever planned for this,” said Gordon Smith, Maine’s director of opioid response.

The state doesn’t have comprehensive data about overdose deaths yet for this year, but Smith said he can access real-time mapping used by some police departments and additional data from emergency medical professionals.

“So far, we’ve not seen increases out of line from what we’d expect,” he said. “Unfortunately, we’ve been averaging one a day, or more than one a day, for some time and that’s far too many.”

Malory Shaughnessy, executive director of the Alliance for Addiction and Mental Health Services, which represents providers, said she’s heard anecdotally from members about a rise in overdoses. She said the risk for people coming out of treatment or incarceration is especially high.

“I think providers want to stress that there are still services out there for people and that’s hard to communicate during a time of isolation,” she said.

Zoe Brokos, program coordinator of substance use prevention and harm reduction service for the city of Portland, said she and her colleagues are still doing a lot of outreach.

“What we’re hearing is a lot of fear and a lot of sadness,” Brokos said. “People are really scared and not knowing what to do with those feelings. They’re not feeling safe to go to pharmacies to get medication, and people in active use, their substances are becoming harder to find.”

Smith agreed that the shutdown has disrupted access to some drugs.

“That can send people in one of two directions,” he said. “Some come into treatment, and we have seen in some parts of the state a small uptick in the number of referrals. Unfortunately, not everyone goes in that direction.”

A 21-year-old Southern Maine Community College student from Connecticut, Samuel Brackett, died from an accidental overdose on March 22, according to an obituary published in the Press Herald.

Shon Myers, a commercial fisherman from Cape Elizabeth, had been sober for almost a year and was active in Portland’s recovery community. His mother, Gayle, said he attended 12-step meetings every day until the pandemic forced meetings to go online. Myers died on April 13 of an apparent drug overdose at age 43.

Another obituary revealed that Christopher Williams died from a drug overdose April 11 in his Sanford home.

“Chris struggled with addiction from an early age in spite of numerous treatments spanning the decades,” the obituary read. “Addiction is a terrible disease that Chris fought valiantly against but it won the battle, leaving a very heartbroken and devastated mother and family.”

Even before the coronavirus hit, Maine was stuck in a prolonged opioid epidemic that has killed about 1,800 people over the last five years.

Although the number of deaths came down in 2018 after a high of 417 the year before, projections for 2019 suggest that overdoses went back up slightly. The state Attorney General’s Office has not yet released the full report for 2019.

Many other states have seen dramatic increases in overdose deaths as well and have emphasized treatment, but the coronavirus outbreak has forced a shift in the way services are delivered.

In Maine, crisis beds and residential treatment centers have largely remained open, but most counseling and group therapy sessions have moved to online platforms, which are a lifeline for many but inadequate for others. For patients who take either Suboxone or methadone to treat opioid use disorder, providers have allowed bigger supplies of take-home doses but haven’t been able to do regular in-person visits or the urine tests that often go with them.

This month, the Mills administration eased restrictions on needle exchange programs. Normally, clients can exchange used needles for clean ones on a one-to-one basis. Now they can get clean needles as needed.

That shift acknowledges that some drug users might not be ready to quit using, but they can be provided supplies that keep them safe from infections or diseases like HIV or hepatitis C. Needle exchange programs are also an effective way to steer people toward treatment.

Smith said the state has distributed thousands of kits of the overdose reversing drug naloxone, or Narcan, and is purchasing 10,000 more.

“We are looking at it every day,” he said. “If we do see a spike, we need to talk about what we’re we going to do because I think we’re doing what we can.”

During her outreach with clients through the needle exchange, Brokos said, “people don’t linger and chat with us like before.” But she said local agencies are working hard to stay connected to vulnerable groups.

“I think that everyone is doing a really good job with what they have,” said Brokos, Portland’s prevention and harm reduction coordinator. “I think we need to keep making sure everyone knows what’s available and what’s accessible.”

Shaughnessy agreed that treatment providers are adapting, but it’s been stressful.

“Reimbursement rates for most services are still stagnant and providers are having to spend a lot to shift how they do their work,” she said. “This is hitting providers pretty hard. Most that were hanging on by the skin of their teeth are now having a real struggle. They are going to need to be around, not just now but six months from now when the need could be even greater.”

Jeana O’Malley is still waiting for a final report from the state Medical Examiner’s Office, but she said her daughter used cocaine mixed with the powerful opioid fentanyl before her death.

“I believe it was accidental but it’s so easy for this to happen,” she said.

Jordan’s cousin, Brittany Ames, said the family was always able to “somehow bring her back to her true, silly, loving, happy self,” and to help quiet her demons, temporarily. But they couldn’t this time. They can’t even get together properly to mourn her loss because of coronavirus restrictions on gatherings.

When police told her what had happened to her daughter, Jeana said, it felt like her torso had filled with cement. She couldn’t breathe. Now, Jeana said, her daughter’s death gives her a small sense of relief. Jordan lived a tough life. She lost her father at age 13 and battled depression. Drugs were how she escaped, her mother said.

“She was a tortured person,” she said. “She’s not going to be in agony anymore.”

Still, Jeana would have gladly taken more time with her daughter. On her cellphone, she has saved several old messages Jordan left. She hasn’t been able to listen to them yet.

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