STAY-AT-HOME ORDERS TAX ADDICTS’ RESILIENCE
Fear of COVID-19 is keeping many from seeking help
While stay-at-home orders keep us from getting haircuts, seeing friends and family, or heading back to the office, this inconvenience pales to the challenges it presents for those fighting addiction.
Particularly those living alone.
“One of the biggest things substance abuse is triggered by is isolation,” says Kirsten Freitag Murray.
“Isolation was already a problem before COVID-19 and now that its mandated, isolation can be a trigger for cravings or relapse,” said Freitag Murray, a former counselor and now director of development and public relations for Creative Health Services in Pottstown.
“It’s already a very significant factor in usual times,” she said.
And these are anything but usual times.
Testing Inner Strength
In usual times, Creative Health would be providing recovery services through a combination of therapy and medication for those fighting opioid addiction, as well as services for those addicted to other substances.
“It reduces cravings but does not give you a high and will make you violently ill if you do re-use,” Freitag Murray said of the agency’s method.
But with the pandemicimposed isolation, “Creative Health has seen an increase in self-reporting, which is how we measure it. People are having cravings and an increase in actual substance use,” she said.
“It’s harder when you’re feeling isolated when you can’t go to a group, it’s very difficult. It adds to the stress and it’s not something the ERs can handle right now,” said Louis Tovar.
Tovar is president of the Kennett Square-based Kacie’s Cause, a non-profit organization with 11 chapters in Southeast Pennsylvania dedicated to helping victims of the opioid crisis and their families.
And as the world’s attention focuses on the pandemic health crisis, the health crisis on which it was previously focused hasn’t gone away. It’s just taken a back seat.
“The opioid crisis is still front and center. There are people dying every day,” said Tovar.
“If you can’t go to the doctor, can’t get methadone, which is like a diabetic who can’t get insulin, your inner strength will break down and you go find the nearest dealer,” he said.
“Everyone else is closed, but the dope dealer isn’t,” said Brian Corson, founder and director of MVP Recovery, in Media.
“Friday, my wife was in Kensington trying to get a lady into treatment and there was drug use going on all over the place. Treatment and recovery may be on hold, but addiction and drug use is not,” Corson said. “People are running to Kensington with their stimulus checks to buy drugs.”
Going to Meetings Online
Addiction, like treatments, comes in many forms, with many substances and the treatments are almost as varied as the people and their addictions — some work better than others for different people.
Some struggling with addiction find help through the 12-step process introduced by Alcoholics Anonymous.
And for a recovering alcoholic like Greg, there’s nothing quite like being in an Alcoholics Anonymous meeting.
“There’s a power there,” said Greg, whose last name is being withheld because of the anonymous nature of AA. “It’s very palpable,” he told reporter David Mekeel for an article in the April 12 edition of the Reading Eagle.
But the current social distancing protocols now in place make traditional AA meetings impossible.
That means they’ve moved online.
The Reading Berks Intergroup website — readingberksintergroup.org — has 28 pages filled with meetings being held online across the country with the video conferencing program Zoom.
In Delaware County, a partnership of WEconnect and Unity Recovery to provides four daily recovery meetings every day at 9 a.m., noon, 3 p.m. and 9 p.m. at unityrecovery.zoom. us/my/allrecovery
But on-line group meetings can be problematic.
The Online Disconnect
Firstly, not all addicts have technological resources — computer, smartphone, internet access — to participate.
Second, as Freitag Murray noted, there is a privacy issue. To participate in a Zoom meeting, or even a one-on-one session with a counselor, you need a place away from others, where you can’t be overheard.
If you’re stuck at home with your family, and the issues you want to discuss in therapy involve those self-same family members, it can be difficult to be open about the problems you’re facing during a session.
“Even if you could go to the library to use the computer, you can’t participate in a meeting there either,” she Freitag Murray.
Further, it’s important to remember, that the therapists conducting these online sessions, or using telehealth, are themselves at home with their families and may have issues with privacy and confidentiality on their end, said Amber Eisler, Creative Health’s Director of Drug and Alcohol Services.
Privacy and confidentiality can also be threatened by technology.
As shown by the hacking of an April 21 Norristown Council meeting, at which pornography was suddenly visible, online meetings are not always secure, a big issue for health care providers who must comply with privacy laws.
And participating in online therapy “can be intimidating if you’ve never done that before,” said Corson.
MVP Recovery runs Silver Lining Recovery Homes, 20 single-family sober living homes in Delaware County with about six residents per house. It is a place for those nine to 12 months beyond initial treatment.
“Recovery is a connection. At MVP, we have a community, it’s about connecting with a person who can offer sober support. This isolation mandate is the exact opposite,” said Corson.
For those living together in his homes, Corson says “they can still do in-house 12-step and sober support.”
Others are not so lucky, both because of reduced services and fear of COVID-19.
“Many of the treatment centers, which had waiting lists, are now at 40 or 50 percent capacity because people have a fear of COVID,” said Corson. “Two months ago, those centers were full.”
But those in need of treatment, particularly young people, should push through their fear and weigh the risks, said Corson.
“Yes, the death rate from COVID is up, but last year thousands of people died from opioid overdoses. If you are 18 to 20 years old, you have a better chance of recovering from COVID than you do from addiction,” said Corson. “But there is intense fear out there.”
Fewer Seeking Treatment
And that can keep people from seeking treatment, especially if it’s in a hospital.
“We’re working with (Delaware) County on peer support and to try to get people straight into treatment without having to go to the hospital,” Corson said.
“Right now, if you have private insurance, you can just call up and go to a treatment center. But if you have state-funded insurance, you need to be assessed at a county assessment center and here in Delco, in the southern part of the county, one of those centers is in a hospital,” he said.
“After-case treatment is the baseline for recovery, those outpatient centers, 12step programs, sober homes for when you walk out of treatment. Those things are non-existent right now,” Corson said.
Others, said FreitagMurray, who may be in treatment as part of parole agreement, may be using the pandemic as a reason not to participate in treatment, knowing supervision by their parole officer is likely to be less stringent during the pandemic.
“Some people really want to go to therapy, they need this. Some are mandated to go, but all these obstacles, can provide an off-ramp, a reason not to go and it’s understandable. This is not easy. This is work,” she said.
Getting Naloxone
To make things worse for opioid users, the pandemic has reduced access to naloxone, also known as Narcan, the emergency treatment for overdoses.
Kacie’s Cause provides the antidote, and training in how to use it, but did much of its outreach through meetings and events, said Tovar.
With such gatherings off the table, there are fewer opportunities to get the Narcan where it’s needed, he said.
That’s why Montgomery County has partnered with the Pennsylvania Harm Reduction Coalition to provide its residents access to naloxone during the Pennsylvania COVID-19 stay-at-home order.
Due to the COVID-19 emergency, Montgomery County health clinics shut down on March 16, leaving a gap for county residents to access naloxone.
According to an announcement made Thursday, residents without insurance or unable to afford the copay at a pharmacy can obtain naloxone by submitting a request to the Pennsylvania Harm Reduction Coalition by visiting https://www.paharmreduction.org/naloxone.
Individuals requesting naloxone online will receive in the mail a kit with two doses, written instructions on how to administer the medication, resources for accessing treatment and supports, and instructions on how to request another kit if the first one has been used, according to the announcement.
The Pennsylvania Harm Reduction Coalition will also provide a training video with instructions on how to administer the drug.
You Can Suffer From Both
It’s also important to remember that COVID-19 and addiction are not mutually exclusive.
In fact, those abusing substances are far more likely to undertake risky behaviors that can increase their chances of contracting the virus.
“When my wife in Kensington the other night, the streets were packed with people. They aren’t wearing masks, they are not practicing social distancing,” said Corson.
“There are two groups among this population when it comes to COVID-19 beliefs. Some believe the virus is a scary thing, and the fear of contracting the virus is keeping them even more isolated at home, including preventing them from even getting to the office for face-to-face psychiatric and medical appointments requested of them,” according to an analysis provided by Creative Health.
“Others believe it is a scam, that the government is trying to scare people and that the pandemic is not really a thing. This group has continued to have close social gatherings, and typically with others who engage in unhealthy behavior, putting themselves and others at higher risk,” the Creative Health information concluded.
The Ripple Effects
Additionally, those with a substance use disorder are more likely to experience homelessness or incarceration than those in the general population, and these circumstances can increase the possibility of COVID-19 infection and transmission.
There are also the secondary considerations of regular life that COVID-19 can make even more challenging — things like lack of housing, food insecurity, job loss.
All those challenges have been exacerbated by the pandemic and the government response to contain it; and all of which can tax the resilience of those living on the edge, both of recovery and economically.
Those in recovery who lose their jobs due to a business shut down, and who may have been living paycheck to paycheck, can find themselves unable to pay rent, or buy food. It’s hard to follow a stay-at-home order when you lose your home.
These circumstances can have the double impact of putting someone at greater risk of contracting the virus, as well as relapsing due to the stress and anxiety.
“There are going to be so many ripple effects from this,” said Corson. “We are going to be dealing with this for years to come.”
MediaNews Group staff writer David Mekeel contributed to this article.