One perspective on How COVID-19 Is Impacting People in Recovery from Mental and Substance Use Disorders
The clever animation above illustrates how social distancing can reduce the spread of infectious diseases such as COVID-19, Novel Coronavirus (The Spinoff, retrieved March 24, 2020). The animation shows that our actions (or lack thereof) impact hundreds or thousands of people. Most people are willing to cooperate as a community to help defeat COVID-19. Even though the impact of social distancing is uncomfortable and inconvenient for everyone, it seems logical that those with mental and substance use disorders may be more severely affected by social distancing. But is that really the case and does being unable to meet face to face with care providers, peers, and particularly in groups necessarily have a negative impact on those in recovery?
The very nature of treatment and recovery seems to support the potential for problems. Writes one author, “Given the high degree of socially driven support and reliance on recovery affirmative connection, one may wonder the impact of the COVID-19 virus and social distancing practices on such a community” (Brown, 2020). For those concerned about how people in recovery are doing, you may be surprised by his answer. Citing William L. White’s book Recovery Rising: A Retrospective of Addiction Treatment and Recovery Advocacy, Austin McNeill Brown writes about several characteristics of the recovery community that may have set them up for success during the COVID-10 crisis because they have come to rely on one another in ways people who are not in recovery would have trouble understanding. These beneficial characteristics of the recovery community are:
- a philosophy of “one alcoholic/addict helping another,” that has existed since at least the 1930s,
- the “grassroots nature” of recovery organizations,
- a fundamental spirit of altruism,
- the “decentralized and self-supporting nature of the community, create a well-suited model for response and adaptation to a crisis,”
- the ability to mobilize in response to crises,
- a fundamental distrust of policymakers and officials cue to their ongoing marginalized and stigmatized status (and resulting low priority for most governmental systems) that has led to a highly networked and self-reliant community that is poised to respond.
As a result, the response of the recovery community to the COVID-19 outbreak has been to mobilize. Brown goes on to describe excellent examples of how quickly recovery organizations have responded or mobilized, calling upon “the goodwill, knowledge, expertise, and networks that they have built up over decades of marginalization (Brown, 2020). He adds that at this point we don’t know if it is enough but that it is important to also note that the support and services provided are mostly free and available to anyone, adding to their value.
A different perspective is offered in a 3-Minute Listen on Morning Edition (transcript available) COVID-19 Outbreak Impacts People In Addiction Recovery posted this morning on NPR (Bebinger, 2020). In an interview with Dr. Marvin Seppala, chief medical officer at the Hazelden Betty Ford Foundation and a client in methadone treatment for heroin, a different viewpoint is revealed. “Emma” is waiting in line for her daily treatment medication. She still uses, but not as much and for her the main change is that the weekly groups she used to attend are no longer being held. While she does miss the support group, she attends AA meetings, mostly online now. She would like to be given “take-homes,” doses of methadone that patients can take at home. Although federal agencies have eased up on restrictions to accommodate the realities of COVID-19 and the Opioid crisis, clinics are just starting to implement the new rules. According to Seppala, who considers addiction a “disease of isolation,” people in recovery are now being told to stay home and use the telephone and internet. Some additional concerns expressed by Seppala were:
- The amount of work needed to help people in recovery adapt to telehealth counseling, online meetings, social networking and computer or telephone applications,
- The fear of coronavirus that drives anxiety that can result in relapse,
- The compromised immune systems and health conditions that co-occur or result from some substance use disorders, such as chronic lung disease,
- And the potential difficulty for providers in trying to differentiate between COVID-19 and similar symptoms associated with withdrawal, particularly without freely available tests for the virus.
These two differing points of view underscore the complexity of the potential for negative impact on those in recovery. This also highlights the importance of “recovery capital” and the often disparate resources of people in recovery that determine whether they are able to maintain recovery or relapse. The topic of recovery capital is addressed in more detail in the following previously published CASAT OnDemand blog posts:
What Can People Do to Support Recovery During the COVID-19 Outbreak?
For policymakers it is imperative that existing barriers to treatment and recovery services be reduced or eliminated to provide continuous service to those in recovery. Behavioral health providers might consider offering free online therapy if they or their organizations do not do so currently. Those in recovery need to continue in existing networks, using alternative methods if necessary, and seek out alternatives, and they should consider finding ways to serve others in this trying time (Brown, 2020). A wealth of resources to assist providers have been developed. Some resources and links have been available since before this pandemic and many others have been developed in response. For Opioid treatment providers (OTPs) the AATOD has issued a Guidance in Response to the Coronavirus (COVID-19). New resources appear almost daily. Some of the most helpful are listed below. Additional resources and links will be made available in the CASAT OnDemand Resources & Downloads section of the website as they appear. If you do not find a resource you need let us know in the comments.
What resources have worked for you as a provider? As a person in Recovery? Share in the comments below!
Resources and Links
Federal and National Resources
- Centers for Disease Control and Prevention (CDC) Mental Health Tools and Resources
- Substance Abuse and Mental Health Services Administration (SAMHSA) – The purpose of the Technology Transfer Centers (TTC) is to develop and strengthen the specialized behavioral healthcare and primary healthcare workforce that provides prevention, treatment and recovery support services for substance use disorder (SUD) and mental illness.
- National Consortium of Telehealth Resource Centers – COVID-19 Telehealth Toolkit and more…
- American Association for the Treatment of Opioid Dependence, Inc. (AATOD) – Guidance to OTPs in Response to the Coronavirus (COVID-19)
- Bureau of Justice Assistance (BJA)-supported Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP – formerly COAP) COCVID-19 Resources and Materials Supporting Substance Abuse Programs and Recovery Efforts in the COVID-19 Environment:
- U.S. Department of Justice (DOJ)
- U.S. Department of Health and Human Services (HHS)
- Partners and Stakeholders
Collegiate Recovery Resources
Bebinger, M. (2020, March 24). COVID-19 Outbreak Impacts People in Addiction Recovery. Retrieved March 25, 2020, from https://www.npr.org/2020/03/24/820543018/covid-19-outbreak-impacts-people-in-addiction-recovery
Brown, A. M. (2020, March 20). Syracuse University. Retrieved March 24, 2020, from https://lernercenter.syr.edu/2020/03/20/mobilization-of-the-substance-use-disorder-recovery-community-in-the-time-of-coronavirus/
Morris, T., Easby A., Wilson, N., Wiles, S., and Wallace, R., The Spinoff. The side eye: viruses vs everyone, retrieved March 24, 2020.
White, W. L. (2017). Recovery rising: a retrospective of addiction treatment and recovery advocacy. North Charleston, SC: Rita Chaney.