Recovery support services in a time of social isolation
BRATTLEBORO - On Wednesday morning, Suzie Walker, executive director of Turning Point of Windham County, is trying to figure out whether the work she does at Turning Point would be considered “essential” under Gov. Phil Scott’s new “stay at home” order, which ordered the closure of all in-person businesses. The governor’s list of those deemed essential and therefore exempted from the order had included health care workers but hadn’t explicitly outlined recovery services.
“We want to see if recovery support and peer recovery workers can be added to that list,” says Walker. “We want an explicit statement from somebody so that we can go to the recovery center. Coaching in particular has become a very essential service in a lot of areas.”
She says that one-on-one meetings with people in recovery would still not be possible but that some of the center’s recovery coaches, who are now engaging in support services through phone and video chat, don’t have adequate phone or internet access at home.
“It would allow us to be able to go to the center to have access to the infrastructure our people need,” says Walker. “We still couldn’t meet one-on-one. But our trained staff are already so limited in how we can help right now. It would allow us to be able to have some of our very skilled people on the front lines offering that support.”
The mission of Turning Point is to “provide a safe, supportive gathering place for all whose lives have been affected by addictions and are seeking to begin or strengthen their individual path in recovery.” Their focus is to support people who are in recovery or are seeking recovery from a range of substance use disorders, including alcoholism and opioid use disorder.
For now, the gathering place outlined in that mission is closed, due to COVID-19 (coronavirus) concerns and in accordance with a growing list of orders from Gov. Scott aimed at slowing its spread. Walker and her staff are doing all they can to provide support services through video chat and daily phone calls to check on people who are in recovery. She also hopes to have someone available to answer incoming calls daily during set hours, which are still being worked out.
Walker notes that people who are in recovery or are using may be at increased risk during periods of social isolation.
“We’re just trying to do everything we can to consider the impact that isolation will have on people,” she says. “Even people who have been in recovery for a while, that can be a very risky place.”
She says that people who are using opioids alone risk overdosing, and with a relative shutdown of the state, it may be hard to make sure people have adequate Narcan on hand. She also is concerned that people may run out of sterile needles and turn to dealers they’re unfamiliar with and will get drugs they aren’t sure of the contents of. Meanwhile, she says, those who drink risk withdrawal should alcohol not be available.
“We’re going to be seeing an uptick, we think, in alcohol withdrawal and dependencies, and people may run out of sterile supplies and things like that.”
Though the isolation may create new risk factors, people with opioid use disorder are also at a heightened risk for complications from COVID-19. A paper published this week by the National Institute on Drug Abuse outlined enhanced risks.
“People who use opioids at high doses medically or who have opioid use disorder face separate challenges to their respiratory health,” said the paper, explaining that opioids slow breathing and can cause a harmful decrease of oxygen in the bloodstream. “While brain cells can withstand short periods of low oxygen, they can suffer damage when this state persists. Chronic respiratory disease is already known to increase overdose mortality risk among people taking opioids, and thus diminished lung capacity from COVID-19 could similarly endanger this population.”
Walker says she has concerns about how the specific needs of those with substance use disorder will be met during the pandemic. For example, should the disease become widespread enough that field hospitals with congregate isolation are created, she wonders how people with substance use disorder will be treated as a subset of patients within the greater population of patients. She is engaging in multiple emergency preparedness calls per week to advocate for the needs of those with substance use disorder in those scenarios.
For those who are in recovery for opioid use disorder and are receiving medically assisted treatment, Dr. Peter Park, of Southwestern Vermont Medical Center’s Deerfield Valley campus, who administers MAT locally, says treatment is ongoing, despite some changes.
“At this time we are conducting their follow-up visits remotely, either via telephone or telemedicine with video. The interval is determined by their stability,” says Park. “If they need support during this trying time we are ‘seeing’ them more frequently.”
Park says it is also still possible to enter into medically assisted treatment, noting that if someone is at a point where they are ready to enter into treatment, they should call the office.
“We would advise the best course to establish care,” he says. “If not in distress, we will have them speak to our MAT nurse to get their history and have them complete our intake process.” If they are in “dire straits,” he says, he may recommend the emergency room, where emergency MAT could be administered. However, he says, he is trying not to encourage visits to the emergency room in an effort to preserve resources.
Park says he encourages his patients and anyone in recovery to contact Turning Point for support services, and to embrace the support systems they have in their lives. “We strongly advise them to lean on their support networks, family, friends, peer supports, 12-step groups, individual counselors, sponsors, and anyone else in their lives who support them and to ‘double down’ on these supports,” he says.
Walker says that however connection can occur, whether by phone or video chat, it is integral in providing support.
“This is a population of people who does tend to fall through the cracks for a lot of reasons, and we’re trying to be sure that even in this extraordinarily unusual circumstance, we can be sure we’re connecting with them,” says Walker. “First and foremost, to have that main connection and to help keep them alive. We don’t want anybody lost through any of this.”
Walker notes that if anyone, whether currently working with Turning Point or not, in recovery or approaching it, needs support, they should call Turning Point of Windham County and leave a message if no one answers. The number to call is (802) 257-5600.