The COVID-19 pandemic has presented unprecedented challenges for people with substance use disorders (SUD)—both in active addiction and in recovery. Dr. Nora Volkow, the director of the National Institute on Drug Abuse (NIDA) recently described the dilemma in a video conference: “We immediately can recognize the unique challenges of COVID-19 for people having an addiction. Some of these are structural; the healthcare system is not prepared to take care of them. They relate also to stigma and social issues. The concept of social distancing makes such people even more vulnerable because it interferes with many of the support systems that can help them to reach recovery. And, on top of that, drugs themselves negatively influence human physiology, making one more vulnerable to getting infected and more vulnerable to worse outcomes. So that’s why there is tremendous concern about these two epidemics colliding with one another.”
The collision of the American addiction epidemic with a global viral illness has also been a major challenge for addiction professionals trying to help patients with SUD. The recovery community is doing its best to continue helping people with addiction but it has been a steep learning curve under very difficult circumstances. Addiction professionals have tried hard to keep the recovery support system going while abiding by social-distancing requirements.
One important strategy is sharing the experience with colleagues, so people can learn from each other. In April, the Virginia Center for Addiction Medicine (VCAM) invited 12 accomplished addiction professionals for a webinar panel discussion entitled “Recovery in the Era of Coronavirus.”
Several panelist remarked how the pandemic has presented a breakthrough for telehealth. Previously primarily utilized with rural patients unable to go to a clinic in person, communicating with clients via online tools such as Zoom has suddenly taken on a central and widespread role in therapy.
The forced switch to virtual treatment has yielded some interesting side effects. Several panelists confirmed that participation in meetings and therapy groups has seen a significant uptick possibly because people in recovery are more anxious at the moment but also because there isn’t much else to do. But the lack of face-to-face interaction cannot easily be rectified with a video conference. As VCAM’s clinical program director Andreas Bienert pointed out, it’s much harder to read the body language of a client which may reveal otherwise hidden problems to the therapist. And not all clients are comfortable talking into a computer screen instead of chatting with a counselor.
Crucial modalities of primary addiction treatment, including detox and much of residential treatment, cannot be moved online at all, of course. In order to comply with the declared state of emergency in Virginia and CDC recommendations, The Farley Center—an inpatient addiction treatment program—had to make significant adjustments to keep patients safe at all times. New admissions are now carefully screened for COVID-19 symptoms. “We’re keeping therapy groups as small as possible and have implemented the use of cloth masks,” Farley’s medical director Jonathan C. Lee, M.D, told the webinar audience.
Lee, who is also the President of the Virginia Society of Addiction Medicine, said the Farley team has to deal with “more stressors, more anxiety, and exacerbated drug and alcohol addictions” because of the pandemic. The Farley Center had to suspend visitors from coming to the campus for the time being. In addition to family members, this visitor modification includes all community programs, such as AA, that regularly meet on campus. Because of these restrictions, some patients actually feel safer in residential treatment because they remain in a contained environment under medical supervision.
While the treatment task has become more complicated for addiction programs, the need for treatment is increasing. After serving for decades as a Richmond police officer, Michael Zohab founded the Virginia Recovery Foundation in 2016. He told the panel that the trend into stimulants in the country is continuing and that treatment progams should prepare for more patients addicted to stimulants such as methamphetamines. Also, “alcohol sales and prices for illicit drugs are way up,” likely driven by increased demand and reduced supply during the pandemic.
Support groups, treatment centers and recovery organizations across the US are making great efforts to offer services and community from a distance. But vulnerable people all over the country are seriously stressed by an invisible illness, lack of income and health insurance, and much reduced human interaction.
The Farley team continues to help people with substance use disorder under these unprecedented circumstances. People in active addiction ready to go into recovery should not delay seeking treatment for their disease.
If you or someone you know is struggling with substance misuse but you are unsure what addiction treatment services are available during the COVID-19 pandemic, please contact The Farley Center at 800.582.6066 to find out about your options.
NIDA COVID-19 resources https://www.drugabuse.gov/related-topics/covid-19-resources
ASAM COVID-19 resources https://www.asam.org/Quality-Science/covid-19-coronavirus