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OP-ED: Responding to an epidemic in a pandemic

Pam Gay, Brittany Shutz, Dave Sunday, Dr. Matt Howie and Kyle G. King
York Opioid Collaborative
Not One More York Chapter Bob Glatfelter Memorial Walk and Overdose Awareness Vigil York College campus in York, Saturday, Oct. 15, 2016. Dawn J. Sagert photo

While our community has been doing everything it can to maintain social distancing and decrease the risk of viral spread during the COVID-19 pandemic, there has been a lot of attention paid to the overall effects of the pandemic (and rightly so). But there’s also been some speculation over what is now a growing concern — that the social isolation needed to slow the spread of the virus is impacting those with past or present substance use disorders in a markedly negative way.

EMS, fire departments and law enforcement are reporting increased numbers of overdoses here in York County, and the York County Coroner’s Office reported recently that the deaths suspected or confirmed to be due to opioid overdoses tripled from the eight that occurred in January to 24 by the end of March 2020. The coroner’s office has also seen some alcohol-related and prescription drug-related deaths intermingled with the opioid deaths.

And in the first half of April 2020, we have already seen 14 suspected substance use disorder-related deaths. Accompanying these grim statistics, the naloxone administrations are up overall from the 2019 administrations — already about 140 more naloxone administrations in 2020 than the entire year of 2019. And we’re only in April and not even three weeks into Gov. Tom Wolf’s “stay-at-home” order for York County. 

More:COVID-19 adds extra hurdles for those being treated for addiction

The overpowering theme that seems to be prevailing right now is that social isolation is not a good thing in the life of those in recovery.

While we understand and generally support the measures implemented to stop the spread of this potentially deadly virus, we must not forget that prior to COVID-19, we were already experiencing an opioid epidemic. Now it is imperative that we continue to come up with solutions for how to combat the opioid epidemic — and how to continue to treat the mental health disorders often accompanying the substance use disorders — in the midst of the COVID-19 pandemic.

Substance use disorders and mental health disorders do not cease to exist amidst a pandemic, but are often exacerbated due to isolation, uncertainty and fear. The COVID-19 pandemic has real or potential challenges for individuals with substance use disorders and their families. Individuals with substance use disorder are also at increased risk to develop complications of COVID-19, due to effects of substance use on respiratory health. 

It is important that family members and those struggling with substance use disorder know that inpatient facilities have precautions in place to reduce the possible spread of COVID-19. The recommendations being put forth by the Centers for Disease Control, the Pennsylvania Department of Health and other state organizations can increase the steps necessary for the delivery of services, but services will remain to assist those in need of critical behavioral health services. 

With the loss of jobs or inability to get a job, those with a substance use disorder not only experience lost income, but they also lose the sense of purpose or fulfillment that gainful employment brings.

While many qualify for unemployment or federal assistance due to the COVID-19 pandemic, some might fall behind on rent at one recovery house, then move on to another recovery house, and the owner they owe money to often has little to no recourse. Or they might stay at a house they should have been evicted from because they cannot be evicted due to the stay-at-home order and other safeguards, meaning they are living rent-free and their utilities cannot be shut off.

While the temporary measures put in place to ease financial burdens may seem necessary and kind during such difficult financial times, for those with substance use disorder, and the landlords they rent from, it becomes a “vicious cycle” as those seeking to recover from their substance use disorder might be more enabled to stay in their current situation. In pre-COVID-19 days, the landlord or homeowner evicted them if they did not pay rent, and sometimes this was the incentive that forced them to go get help as they had nowhere else to turn. Now, those evictions are not happening.

Because this incentive and others are temporarily non-existent, the substance user may not get to their “rock bottom.” As a result, we have learned that treatment beds are not being utilized to the capacity they were prior to COVID-19. And the effect is that recovery houses are experiencing severe financial constraints as a result of the issues cited above, and there is real concern that some may have to close. With an increase in overdoses, most would agree that a decrease in recovery house beds is a dangerous state of affairs for our community.

There are ways the public, church groups and other organizations can help show their support of the recovery houses — such as by providing groceries and toiletries and other items for the residents. Contact Not One More in York at 717-424-8890 if you or your group are interested in helping the recovery houses in some way.

If you are a family member/loved one of someone who may be struggling with a substance use disorder, stay connected to them as much as you can during this time — via phone, text, Facetime, Skype — whatever it takes. Check in on them as often as you can, even more than you usually do. Remember: These daily and frequent contacts can make all the difference in the life of someone struggling with substance use disorder and mental health issues.

As we navigate through these difficult waters in the remaining weeks or months of this pandemic response, treatment providers want those who struggle with substance use disorders and their families to know that there is still help — both inpatient and outpatient. For emergency detox in York County, call White Deer Run at 1-866-769-6822.

And we all know that there is also a tremendous benefit to those in recovery gathering with others in various stages of sobriety, to hear their stories and garner the spiritual, emotional and psychological support from those meetings. Currently, such meetings have been limited to ZOOM-type online meetings, which for some might not be enough. Many of these groups have other helpful ideas and ways those who are struggling with the social isolation can occupy themselves and even give back to others on the front lines of the pandemic. Here are just a few samples of such meetings:

  • AA, NA, Celebrate Recovery, SMART Recovery are just a few of the resources providing online support groups.  
  • RecoveryLink has daily recovery meetings, physical activities, medication and more.
  • WEconnect app helps with scheduling routines to stay active
  • Sober Grid Mobile app provides individuals the opportunity to track and share progress with others and receive peer support
  • Practice self-care by eating healthily and walking or getting some other form of exercise on a daily basis right now
  • If you are seeking faith-based on-line services, there are many local churches who are hosting on-line meetings and live-streaming church services

If you or a loved one is seeking additional help, call 1-800-662-Help or visit https://apps.ddap.pa.gov/gethelpnow/

The RASE Project also offers recovery support for the family. Call 717-900-1930 for more information.  

The Department of Drug and Alcohol Programs has additional resources available at https://www.ddap.pa.gov/Get%20Help%20Now/Pages/Coronavirus.aspx

Finally, we want to remind those who may be struggling to acquire sobriety or maintain their recovery at this time, that there is a strong and distinguishing parallel between the pandemic and the epidemic in our community. Just as we see many recovering from the COVID-19 virus and going on with their lives, we know that we will continue to have many examples of hope and recovery among those who have struggled with substance use disorder here in our own community — and some of those inspiring stories will come out of this time of adversity. Most importantly, remember that some day, together we will be on the other side of both this pandemic and epidemic.

Pam Gay, York County Coroner, York Opioid Collaborative board member

Brittany Shutz, executive director, York Opioid Collaborative

Dave Sunday, York County District Attorney, York Opioid Collaborative board chair

Dr. Matt Howie, York County chief health strategist

Kyle G. King, York Opioid Collaborative, board vice chair