Under Coronavirus Threat, Patient Connection Will Take on Different Form

Given the adage that addiction is a disease of isolation and recovery is about connection, how should individuals in recovery maintain progress during a health crisis that is subjecting many people to mandated or self-imposed exile?

Clinical professionals contacted this week by Addiction Professional suggest that as developments with coronavirus (COVID-19) continue to unfold, individuals in early recovery likely will need to access alternative means of the recovery support on which they depend. Arguably the most directly affected entities in the addiction field at this time have been the major recovery support organizations such as Alcoholics Anonymous (AA) and SMART Recovery.

“I'm hearing about many AA meetings being shut down, largely because the venues (churches mostly) don't want to risk coronavirus contamination,” says Brian Duffy, LMHC, LADC-I, a counselor at community behavioral health organization SMOC Behavioral Healthcare in Framingham, Mass. “This'll probably bring about an increase in online meetings and email relationships.”

Likewise, SMART Recovery founding president Joe Gerstein, MD, says most of SMART's 2,700 weekly meetings likely will have to be suspended, since many are hosted by hospitals that are excluding visitors at this time. Gerstein says 40 weekly SMART meetings are hosted online on the ZOOM platform.

Jamie Marich, PhD, a private-practice clinician, author and trauma expert in Ohio who operates the Institute for Creative Mindfulness, says the uncertain times around COVID-19 will require a balancing act for people in recovery.

“While I understand many of the safety protocols that are being put in place, I also get concerned about the impact of social isolation,” Marich says. “Especially when staying connected in a deep human way can be vital for people in recovery to survive and thrive.”

Environment at facilities

Sources tell us that individuals currently in residential treatment or receiving ongoing care in a community clinic are likely not as laser-focused on media reports about COVID-19 as much of the general public remains.

“They're here to work on themselves and get better—they don't have the same access to media,” says Joseph Garbely, DO, chief medical officer at Caron Treatment Centers.

Duffy adds, “We're a community mental health clinic, with many patients living rough, couch-surfing, in shelters, group homes or sober environments. Frankly, most of my clients are aware of but not anxious about the coronavirus—perhaps because they're not watching the news like the rest of us.”

That doesn't mean treatment facilities aren't equipping their patients with relevant health information or preparing staff members to answer patient questions that may arise. Duffy says his workplace has been distributing written guidance to patients in several languages, though he adds, “I'm not seeing the level of [patient] anxiety one might expect.”

At Caron, Garbely says staff is drawing on its experience in addressing past public health emergencies as well as the annual threat of seasonal flu outbreaks.

“It is important that we lead through science, and stay calm about this,” he says. “We need to explain to patients exactly what this means to them.” For the young and largely healthy, contracting the virus likely would result in experiencing relatively mild symptoms, he says, while those who are susceptible to respiratory illnesses or are otherwise at risk will have to utilize technology to stay connected.

“If you do go to meetings, this is not a good time to hold hands or hug,” Garbely says. “Try to put a little space between yourself and others, a couple of arm lengths. This is all common sense that we all need to exhibit.”

Garbely this month was featured in a Behavioral Healthcare Executive podcast in which he discussed healthcare partnerships that have enhanced his organization's ability to meet the needs of patients in times of public health crisis.

Enhancing connection

Marich believes the method used to maintain connection also carries great importance. She suggests that individuals should “consider actually talking on the phone or using a video platform, as texting can create even more of this sense of disconnection.”

Duffy would like to see payers play a role in enhancing treatment opportunities during this time of uncertainty. “I hope insurance companies will move quickly to authorize telephone therapy sessions,” he says. “We certainly don't want patients to be riding in taxis and buses, then sitting in our large reception area waiting for their therapist—coughing and sneezing upon each other.”

Also, this is a good time to be mindful that those who have the capacity to be of service to others can do something meaningful for the less fortunate, boosting their own recovery in the process.

“For those of you who are healthy and even more altruistic, offer up grocery shopping and pharmacy runs for elderly/sick people that don't have family members or other people,” says New Jersey clinical social worker Frank Greenagel. “This is something I am trying to coordinate with organizations that employ recovery peers in a few counties in New Jersey.”