Kristina Brant, the study’s lead author, began the research after watching healthcare providers struggle to maintain addiction treatment and harm reduction services during catastrophic floods in eastern Kentucky in 2021 and 2022. Here's HowThe researchers found that overdose deaths began rising in the years after an inundation and remained elevated for at least a decade. Over that period, annual overdose deaths in flooded counties increased by about 28 percent, while overdose mortality rates rose by 26 percent compared with the year before the flood. Addressing the instability that so many people are still dealing with two years after Helene is what harm reduction is all about, Sinn said. “When it comes to things like flood preparedness conversations or flood recovery conversations, it’s not the case that often a substance use service provider might have a seat at that table,” she said.