Treatment centers are reducing capacity, leading to longer wait times for new admissions.
The worldwide pandemic, while creating an environment that promotes addiction relapse for some, also makes it more difficult for addicts to get adequate treatment. This is the perfect storm for increasing the overdose rate, according to experts, and Michigan’s drug and alcohol treatment centers have had to drastically limit intake.
“If we can’t get them in on the same day, we already know they’re going to go out and use again,” said Lisa Cottaneo-Boska, who admits addicts into Michigan’s rehab facilities. “And with so much heroin laced with ultra-powerful fentanyl – users often don’t know what they’re buying – the odds of overdosing are high. It’s just like going out there and playing Russian roulette.”
Part of the problem coincides with the new social distancing guidelines which require patients to be at least six feet apart at all times. Whereas, traditionally, patients could be in the same room detoxing alongside two or three others, this is no longer the case. They’ve had to be more spread out, which means less room for any incoming clients.
Michigan’s Oakdale Recovery Center in Canton used to be able to accommodate a total of 45 patients. “It now limits its patient population to 32,” said Carol Zuniga, Oakdale’s executive director.
“Ascension Eastwood Recovery Center in Southfield, a drug and alcohol detox and rehab facility for men, usually has space for 40 inpatients,” according to Gwendolyn Bammel, clinical supervisor. Now the center can only accommodate single occupancy in each room, leaving space for 18. “There’s a very small window in which people both recognize (their use) is a problem and are willing to do something about it,” said Bammel. “We are going to miss that window for a lot of people.”
“It’s just been very challenging to try to keep them coming back to us and asking for help when we’re having a hard time finding places to put them,” said Cottaneo-Boska, who works for Hope not Handcuffs in Macomb County, one of Michigan’s leading programs for keeping addicts out of jail by providing treatment. “We’re trying to give them hope, but by the same token, our world is shutting down.”
Dr. Sheba Sethi, an addiction medicine doctor at Packard Health in Ann Arbor, said telehealth may be an option, but not for those who do not have access to a phone. While some outpatient programs are continuing via Zoom or Skype, it can be especially difficult to reach clients without internet accessibility or those who are not comfortable with using technology.
“I did a call with a patient earlier this week and he didn’t have a phone,” Sethi said. “He was borrowing someone else’s phone. He missed my call three or four times. had another patient earlier this week who had a minute phone. She kept saying, ‘Dr. Sethi, are we done? Dr. Sethi, are we done?’”
Even if someone is able to get to a phone, telehealth won’t work for everyone. “For your long-term alcoholic who typically has to drink in the morning to stop the shakes, they will not be successful in (outpatient),” said Bammel, as an example. “They need a residential level of care.”
“For people in recovery, it’s the fear and anxiety and stress that most people are feeling right now, coupled with that risk for relapse,” said Monique Stanton, president and chief executive officer of CARE of Southeastern Michigan, which provides outpatient substance abuse treatment. “People who are typically in recovery have been impacted by some sort or trauma (which) magnifies, I think, the stress that everybody is already feeling.”
These sentiments are shared across the treatment community. “I’ve always said that the opposite of addiction is not sobriety, it’s connection,” McHenry County Outreach Coordinator Alex Mathiesen. “And it’s difficult to make connections when you’re not in person.”