The isolation required as part of the state’s efforts to slow the spread of the new coronavirus is a challenge for many of us, but particularly difficult for people dealing with addiction, those in recovery, and for the providers who are treating these populations.
One of the established principles of getting people with substance use disorder into treatment - and keeping them healthy - is founded on connection and communication.
“Call, use the phone, ask for help. Say ‘I don’t know, can you help me?'” says Katherine, who asked that her last name not be used. Katherine is herself in recovery, and works as a peer-to-peer counselor at the Portland Recovery Community Center.
She says the center and treatment providers have become concerned about isolation among their client communities. They’ve turned to tech tools such as digital conference calls and shared video chats to bridge the gap between clients and their support systems.
Katherine says participants clearly appreciate the space - even online - to share their feelings of fear in the face of a growing pandemic. "The share comes to a point where they have this thankfulness, gratefulness that there is a meeting.”
Addiction treatment specialist Mark Publicker applauds the recovery community’s quick pivot to digital modes of communication. He’s one of a number of medical experts who say that isolation and loneliness, on top of the general stress of dealing with a pandemic, are triggers that can increase the risk of relapse or drug use.
"So it's not simply a matter of are having less access to treatment," Publicker says, "but at least for us to be aware that the challenges of addiction recovery in a crisis such as this is likely to endanger many lives.”
And Publicker says a marked increase in cases of relapse could potentially be felt well beyond the recovery community. “Untreated, without access, we can only imagine that the consequences of untreated progressive illnesses will only serve to overwhelm our current overburdened medical system.”
Some on the treatment side of recovery say they are already feeling the pinch when it comes to medical supplies. Bob Fowler, director of Milestone Recovery, says he recently drove from Portland to deliver thermometer probes to a Milestone site in Old Ochard Beach to test clients for symptoms of illness.
Speaking by hands-free phone from his car, Fowler says the lack of basic equipment has posed problems.
“The inability to be able to get things like thermometers and masks, and all the really just basic personal protective gear has really just hampered a lot of our efforts.”
Milestone also recently closed the only detox center in Portland in order to provide more space for people at its homeless shelter who developed signs of illness.
Publicker says unsupervised detox from some substances can cause seizures, hypertension, delusion, and even death. For now there’s no alternative detox center available, other than through hospital emergency rooms.
Some healthcare providers have also expressed concerns about the possibility of additional clinic closures and the limits of telemedicine. Portland Recovery Community Center’s Executive Director Leslie Clark says they’ve had to close their offices and move to digital meetings as well. And she’s worried about how the center can begin to serve people who may be trying to stop using, but can’t reach out for help.
“There’s a concern that people who are at home, who are isolated, who don’t already have this connection, how do we reach them?” Clark says.
Medical professionals say they have not seen indications that people who are now in medically assisted opioid treatment programs will be unable to access suboxone proscriptions. And some pharmacies say they are discussing increasing their inventories of Narcan, the opioid overdose antidote, should the pandemic contribute to an increase in drug use.
On the support side, Clark says, people in recovery are used to reaching out to each other, and working together to get through tough times.