Undoubtedly, sustaining your recovery from substance addiction is challenging enough, even in the very best of times. To continue with your own addiction recovery, perhaps in its early stages, when living during harder times – for example, in the middle of a serious pandemic that has cut you off from the vital social support network you have been constantly relying on – then avoiding a relapse rapidly becomes a seemingly Herculean task, one that you may begin to believe you cannot manage of your own.
In the last few days, the Centers for Disease Control & Prevention (CDC) has announced the alarmingly high record number of fatal drug overdoses the U.S. witnessed last year. During the entirety of 2020, 93,331 lives were lost to overdoses triggered predominantly by opioid use (particularly, fentanyl), as well as other illicit drug use, such as methamphetamine and cocaine.
Within that huge figure, you can more than guarantee that there were many, many cases of addiction recoveries that couldn’t bear the isolation and the imposed distance to others, that ultimately broke and relapsed, lives beginning to learn how to be lived afresh, yet sadly brought back to one of the worst and most dangerous coping mechanisms of all – substance use.
2020: A Year Like No Other
2020 was a year like no other. It was a year of lockdowns, quarantines, “stay-at-home” orders, and social distancing when the doors of many healthcare organizations, community centers, medical clinics, and substance use treatment centers were closed and then locked, doors that would remain shut for months and months, and not all of them would reopen.
People were forced to confront the first and inaugural stage of an unknown “new normal” – the movement away from face-to-face contact towards a new, distanced, virtual presence online, where we all became our own real-life avatar – a moving, talking face on a computer screen.
Let’s not forget that today, in the middle of 2021, the pandemic is still not over, either. In fact, with new variants of the coronavirus appearing reasonably regularly, it will probably never be fully over, and we’ll be picking up our COVID shots every year just like our flu jabs.
Perhaps, one day, sooner rather than later, 2020 will actually become officially known as “The First Year of COVID-19.”
Drug Addiction: The Other U.S. Public Health Crisis in 2020
Instances of drug overdose mortality were rising in number even before the coronavirus pandemic arrived in the U.S. In fact, although far lower than the rates seen in 2020, in 2019, the mortality rates still showed a considerable increase in fatal overdoses over the previous year.
Obviously, once the coronavirus began making the real health impacts many addiction experts feared, with more overdoses and relapsing recoveries, drug rehabs closing their doors, and a stronger, more unqualified drug supply, it was too little too late for too many.
Dave Marlon, the CEO of Crossroads, a drug and alcohol treatment center in Las Vegas, Nevada, a licensed alcohol and drug counselor, and a recovering addict himself with 16 years of sobriety, agrees with the experts – addiction recovery would go on to suffer terribly during the pandemic, and it’s not over.
Marlon cited the stretched healthcare system, in-person counseling programs being suspended, and those who were struggling with addiction unable to continue any treatment, counseling, or group support online. The loss of jobs, income, and addiction support networks left far too many recovering addicts feeling overwhelmed and, in many ways, cut off.
He summed up the situation last year with the opioid crisis perfectly during an interview when he stated, “I had no idea how many funerals I’d be going to. Including this weekend. Isolation – it’s one of the key symptoms of addiction. And suddenly, everyone is told, ‘Isolate!’ Opiate withdrawal is painful, [too]. People struggling to recover need real care, and human connection.”
So what does all this mean for someone who is currently in recovery from substance addiction?
Or someone, perhaps, in the early stages of their treatment, wondering what their drug-free life is now going to look like once they finish all their therapy and counseling appointments?
Or the “someone” who is still actively using, still getting high, and still addicted, but who’s now thinking, “I really can’t keep doing this… I need an ‘out’ and a way to stop. I need help!”? What about them? Is now really the right time – the very best time – to find a treatment program and start the journey to recovery?
How Did The Pandemic Affect Substance Addiction Treatment in 2020?
The vast majority of drug rehab treatment centers around the U.S. are businesses, pure and simple, like any other enterprise out there, with employees and ground rent to pay, with real customers, and with numerous state regulations to abide by.
And, like every other business in whatever U.S. city or town they’re located in, whether it’s up in Anchorage, Alaska, or down in Paris, Texas, they all had to obey the new regulations that came into force sporadically across the nation during the spring of last year – 2020.
“It’s hard to underestimate the effects of the pandemic on the community with opioid use disorder. The pandemic has profoundly disrupted the drug markets. Normally that would drive more people to treatment. Yet treatment is harder to come by.” – Dr. Caleb Alexander, Professor of Epidemiology & Medicine, Johns Hopkins’ Bloomberg School of Public Health
Whether it was the increasing financial pressure and concerns endured by many businesses last year, predominantly forced on them by the socio-economic effects of the virus, or whether it was people coming down with the virus itself, many of these addiction treatment centers had to close their doors or limit their operations in some way. Many never reopened.
Drug Addiction Treatment Centers Soon Faced Financial Collapse
The pandemic meant severely reduced client numbers. More and more professional rehab staff were furloughed, even laid off, and, as time went on, other hard decisions also had to be made – and made quickly. The non-profit drug and alcohol treatment centers that were solely focused on providing the poor with the help they needed were hit particularly hard. Many of these never opened their doors again, either.
In April 2020, the National Council for Behavioral Health surveyed its 3,400 members, with many being non-profit community treatment centers. Nearly all of them – a huge 92.6% of both residential and outpatient centers – had reduced their programs, which meant fewer employees, and, in turn, led to countless furloughs and lay-offs.
Only a single month into the pandemic, two-thirds of these centers said they probably had enough existing capital to remain open for only another 3 months or less.
COVID-19 Infection Fears: How Drug & Alcohol Rehabs Adapted
As you can imagine, when people are living through a stressful event such as the current viral pandemic, a real major concern is a possible infection. Along with employment and childcare worries, possible food insecurity, and a whole host of other concerns, the additional stress of being fearful of coronavirus infection can make many people simply hunker down, put their hands over their heads and wait for the worst to pass.
However, for someone in desperate need of addiction treatment, and possibly with their own additional mental health needs, the option to simply carry on as they are doing is a dangerous one – one they really need to avoid. As we have seen from the record numbers of fatal drug overdoses, many of those who took that option – to delay treatment – found out first-hand just how dangerous that decision was.
In early 2020, for the thousands and thousands of drug rehabs around the U.S., the choice was a clear one – adapt quickly to new and ever-changing circumstances, or turn the “Open” sign over and lock the doors firmly shut.
“In the 80-year history since addiction treatment began, we’ve never experienced anything as challenging as this. You have to put people in social settings to heal, and Covid conspires against that.” – Marvin Ventrell, CEO, National Association of Addiction Treatment Providers (NAATP)
Those drug addiction treatment facilities that successfully managed to keep their doors open did so by adopting hospital-like measures. These measures included removing the commonly shared environments of typical drug rehabs, such as shared spaces, double-occupancy bedrooms, and group therapy sessions. Additionally, COVID-19 testing for all incoming patients became one of the centers’ new admission procedures.
Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, stated at the time, “There’s not going to be anything that’s zero risk, in the absence of a vaccine. But this is in a different category than going to a birthday party. You don’t want to postpone needed medical care.”
Eventually, for any progress to be made, something transformational had to happen. It did – telehealth services arrived, and they quickly became the new big thing in behavioral health treatment, including substance use and mental health disorders.
The Rapid Emergence of Telehealth
Telehealth (or telemedicine) is a broad term used to describe the delivery of healthcare, health education, and health information services via remote technologies, and, prior to the coronavirus pandemic, it was not used for mainstream healthcare. However, as we have all witnessed ourselves, the pandemic changed many aspects of daily life.
Hazelden’s New 100%-Virtual Intensive Outpatient Program
A prime example of the rapid emergence of telehealth occurred in mid-March, 2020, when one of the largest addiction treatment organizations in the U.S. – the Hazelden Betty Ford Centers – completely switched all of their outpatient services over to online telehealth treatment and care.
Having been researching the validity of different types of telehealth services themselves in recent years as one possible future avenue for the organization, they decided, given the restrictions COVID-19 was placing on in-person appointments and group settings, the time was right to make the leap in that direction there and then. However, the proposed switch then presented Hazelden with a number of major issues:
- To identify a virtual platform that was compliant with substance abuse confidentiality regulations
- To assist patients who did not have internet-connected devices or stable Wi-Fi connections, and
- To specifically assist clients who were struggling with the loss of their in-person support groups
With these issues addressed, within months, Hazelden was in a position to release data and findings on the positives of telehealth that had come out of the move to their virtual addiction treatment program. In a preliminary report, Hazelden’s own Butler Center for Research’s analysts found little to no difference between on-site and virtual intensive outpatient program (IOP) patients when it came to the following common issues:
- Reported cravings
- Symptoms of depression or anxiety
- Confidence in staying sober
- Mutual-aid support group attendance (eg. Alcoholics / Narcotics Anonymous)
- Psychological well being
- Quality of life
As Nora Volkow, the director of the National Institute on Drug Abuse (NIDA), remarked last year,
“The way we deliver treatment is likely to be changed after the epidemic. Now everyone uses [telehealth]. And that is a game-changer.” Since telehealth’s emergence, it has provided healthcare services cheaper and more efficiently, in part because there are fewer “no-shows” for medical appointments.
For addiction treatment, there’s another benefit, too. Remote substance use therapy, for example, can feel far more discrete and confidential. “When you can do this via telehealth, including use of a telephone, you take away that stigma,” stated Elinore McCance-Katz, head of the federal Substance Abuse and Mental Health Services Administration (SAMHSA).
Finally, the emergence of telehealth could help to redress the balance in an age-old problem experienced by the addiction treatment industry – historically low numbers. In fact, according to federal data, only 1 in 10 people with a substance use disorder will receive special treatment. Telehealth, which ensures better appointment attendance numbers, confidentiality, and, to a degree, the removal of stigma, may possibly be the best solution to this problem.
How Can I Make the Most of My Telehealth Appointments?
Regardless of how you might think telehealth is the new healthcare, it is important to remember this – a medical emergency is still a medical emergency. If you or a loved one suspects that you or another may have overdosed, especially if, for example, your loved one is exhibiting signs of an opioid overdose, eg. respiratory problems and loss of consciousness, call 911 immediately – as you would normally do.
Remember – the hospital is still by far the safest place for a real medical emergency.
“We don’t have a vaccine for our mental health like we do for our physical health.” – Lisa Carlson, MPH, MCHES, renowned public health expert, 2020
However, for someone in recovery for substance addiction who is undergoing an outpatient program via telehealth, you need to make the most of all of your appointments. Here’s our advice on how to do this:
- Make a list of anything you wish to discuss during your appointment. For example, if you are experiencing symptoms or specific issues with your physical or mental health, be sure to address these. Start with your most urgent symptom first, eg. cravings or anxiety, and explain how long it has been going on, and what has changed. Alternatively, make notes about a situation or event that threatened your sobriety.
- Ensure the appointment will take place somewhere quiet and without interruption.
- Although it may sound too obvious, always check your internet connection.
- If you’re using a video chat app instead of being in front of a computer, give it a try before the appointment, so you can troubleshoot any problems.
- Always make sure you are prepared to answer the video call at the appointed time.
- Relax and speak honestly – be open.
Aftercare FAQs: Additional Counseling / Therapy by Telehealth
For those who have completed their addiction treatment program, whether by traditional means or by telehealth and are now trying to sustain their newfound recovery from substance use, there are additional options to consider for further counseling and therapy, especially when the pandemic may have restricted your access to normal channels. Here are the most common questions answered:
- Is Counseling & Therapy Covered by My Health Insurance?
It all depends on your health insurance plan, so check your policy carefully. To verify your insurance, get in contact with your provider. Your insurance company should be able to give you a list of options. If you already have a therapist, ask them how you can continue your sessions and if anything changes with the copays.
- What If I Don’t Have Health Insurance?
Many people may have lost their employee health insurance because of the pandemic. If this is the case, ask prospective counselors and therapists for their sliding-scale rate (where fees are based on what you can afford). Additionally, Medicare coverage currently includes 3 types of virtual services: telehealth visits, virtual check-ins, and e-visits.
- Are There Any Other Options Available?
There are apps specifically designed for online therapy that use text and video messaging. Examples include BetterHelp, Talkspace, and Larkr. Furthermore, many usual mutual aid support groups offer extensive online meetings, such as Alcoholics Anonymous.
Telehealth at SpringBoard Recovery
SpringBoard Recovery’s own Telehealth Recovery Program allows patients to receive a high level of personalized care without ever having to leave their homes. We understand that there’s no one-size-fits-all treatment for drug and alcohol dependency. Treatment should be tailored to your individual needs and include a well-rounded balance of evidence-based programming.
With our Telehealth Recovery Program, you can participate in a variety of therapies to help you work through the underlying causes of your addiction, while developing healthy coping skills, and building a network of support. Here are the main features of the program:
- Individual & Group Counselling
- Case Management/Coaching
- Nutrition Services
- Family Services
- Drug Testing Services
- Life Skills & Vocational Assistance
- Psychiatric Medication Management
Main Benefits of SpringBoard Recovery’s Telehealth Recovery Program
- Get access to treatment regardless of your physical location
- Services are provided online through a secure HIPAA compliant teleconference platform
- Clinical services are provided by master-level clinicians & behavioral health technicians under the supervision of a behavioral health professional.
- Receive the same high level of personalized care in virtual treatment as our in-person care
- Additional support to maintain long-term recovery after completing an inpatient/residential treatment program
- Reduce barriers to treatment like time off work, child and elder care, transportation, and travel
- A better option for those with social anxiety disorders and/or physical limitations
Our virtual treatment takes place after work/school hours, so there is little disruption to your regular schedule. You can engage in your telehealth sessions with our clinicians and rehab professionals using your computer, tablet, or phone. Contact us today for a free and confidential assessment.
Please remember, recovery from substance addiction is challenging, but it is possible with the right program, the right people, and the right tools. There are millions living healthy and happy lives today to prove a long-term, sustainable recovery can be achieved. Become another, by starting your journey today.
- U.S. Centers for Disease Control & Prevention (CDC): Provisional Drug Overdose Death Counts” System. July 2021. Available at CDC.gov.
- National Council for Mental Wellbeing. July 2021. Available at TheNationalCouncil.org/.
- NEJM Catalyst. What is Telehealth? February 2018. Available at Catalyst.NEJM.org.
- Substance Abuse and Mental Health Services Administration (SAMHSA). Substance Abuse Confidentiality Regulations: FAQs. July 2021. Available at SAMHSA.gov.
- Cision PR Newswire: “Virtual Outpatient Addiction Care Produces Promising Outcomes.” October 2020. Available at PRNewswire.com.
- National Institute of Drug Abuse (NIDA): Director’s Page: Nora Volkow. 2021. Available at DrugAbuse.gov.
- Substance Abuse and Mental Health Services Administration (SAMHSA). Available at SAMHSA.gov.
- U.S. Surgeon General: Addiction homepage. July 2021. Available at Addiction.SurgeonGeneral.gov.
- Medicare: Telehealth Insurance Coverage. Available at Medicare.gov.
- Medicare: Virtual Check-ins. Available at Medicare.gov.
- Medicare: E-Visit Coverage. Available at Medicare.gov.
Alcoholics Anonymous. July 2021. Available at AA.org.