by Theresa Collins
on April 22, 2020
There is a group of people that are accustomed to getting very little attention and the coronavirus epidemic has been no different. People suffering with opioid use disorder or any substance use disorder have been left one of the most vulnerable populations during the COVID-19 epidemic. People struggling with opioid use disorder have recently been highlighted amongst people who struggle with substances because of the continued rise of overdose deaths. Although we are in quarantine and much of the nation remains on lock down, does not mean this seemingly sneaky and deadly disease has just disappeared. In fact, quarantine and social distancing have the potential for the highest deadly results for those with opioid use disorders.
One of the biggest obstacles we have faced as an industry is the lack of face-to-face counseling and in person support. We have been fortunate enough in Philadelphia that the traditional restrictions on telehealth have been lifted and we have been able to continue to treat patients on a virtual platform. Pennsylvania takes a very “old school” and conservative approach to treating substance use disorder, so for DDAP to lift these restrictions it has made all the difference in being able to continue to treat and support patients at this extremely difficult time. In addition to therapy being mostly telemedicine, especially in our hardest hit areas, almost all 12-step meetings around the country have switched to a virtual platform. Again, while we are grateful that there is continued support virtually, one of the biggest parts of the recovery process is human connection in any form. That human connection can come in the form of 12-step work, church, therapy, culturally specific support groups, gender specific support groups, etc. Whatever group you connect with, that weekly and sometimes daily connection is imperative to the recovery process.
Some people struggling with opioid use disorder are reporting struggling to get harm reduction services and medication-assisted services. Many methadone clinics are closed at this time. This leaves people with opioid use disorder to figure out take home doses or risk going to the few clinics still open which are struggling to comply with social distancing guidelines because they are overwhelmed. Harm reduction activists are still in the thick of the epidemic, handing out narcan and other supplies to addicts but continue to struggle to get funding and support. Other doctors are limiting visits and patients leaving many of those seeking recovery and in early recovery in a holding pattern that they don’t know when they will get out of.
With an increase of unemployment and an inevitable increase in poverty we will continue to see an increase in opioid use disorder. Poverty and unemployment are both correlated with substance use disorder. In private treatment, which typically treats a very specific demographic, the “world is ending overall doom” that our patients are experiencing is what worries me the most. Although the demographic that we typically serve is least likely to have severe complications from COVID-19, they are the most likely to have complications related to opioid use. We need to give this population some hope that there will be an end in sight soon. We need to get creative in content and keeping the attention of those who need us the most right now. We need to continue to do our part to flatten the health care curve, but by doing that and staying home we need to make sure we are not sky rocketing our own overdose curve.
Check on your friends and family who struggle with mental health or substance use disorder. Quarantine can be detrimental to them. We need to make sure in a world and time of social distancing we aren’t lacking human connection. COVID-19 can’t take away love, patience, empathy, service, and selflessness from us. Thank you to all of our healthcare workers but specifically those in the field of substance use disorders and mental health. You will get very little accolades during this time but we see you. We have a lot of staff on the front line right now, from techs to case managers to therapists to medical staff. We have staff behind the scenes switching fully virtually in a career that thrives on human interaction. We see you and we appreciate you.
From our Directions family, stay safe, wash your hands and don’t give up hope-our patients need us. Thank you for being essential workers.