After 40 years of sobriety, Roy Kearse of Amityville no longer worries about relapsing into the black hole of heroin addiction that once landed him in prison and nearly cost him his life.
But for those still grappling with their recovery — and who rely heavily on the structure of in-person meetings and group sessions — the forced isolation sparked by the coronavirus pandemic is a nightmare scenario that some experts fear could lead to a public health crisis.
“People are afraid,” said Kearse, who serves as vice president of recovery at Samaritan Daytop Village, a Queens-based drug treatment center. “During times of crisis we always have to worry about people relapsing … So will some people fall through the cracks? Probably so. And will some people relapse? Probably so.”
A ‘perfect storm’
As fears of the COVID 19 outbreak spread in recent weeks, many on social media posted memes facetiously asking how much wine or tequila would be needed to make it through the quarantine. News stories with instructions on how to make the “perfect quarantini” cocktail flooded the internet while thirsty Americans flooded liquor stores to stock up on supplies.
For others, though, the federal guidelines that recommend limiting social gatherings to 10 or fewer people is no joking matter.
Across Long Island, Alcohol Anonymous and Narcotics Anonymous meetings have been canceled or moved into online settings, limiting vital in-person options for substance abuse addicts struggling in real time to adapt to a new reality of social distancing.
Treatment experts fear the worst.
Even for those not in recovery, the coronavirus has many concerned about their health, along with the safety of their loved ones. Anxiety about a cratering economy is natural, experts say, while fears about job loss can serve as a trigger that causes many who are thriving in recovery to slip backward.
Addiction expert Jeffrey Reynolds, president and chief executive of the Mineola-based Family and Children's Association, calls the coronavirus a “perfect storm” for the recovery community.
“It’s a doomsday scenario and something that’s really, really difficult for folks to manage,” Reynolds said. “I am already seeing folks that are struggling to maintain their recovery.”
Steve Chassman, executive director of the Long Island Council on Alcoholism and Drug Dependence, said the primary concern is for individuals in recovery or treatment who have become disengaged from their self-help routine and seek relief in a bottle or a needle. Experts also expect a steep decline in new patients seeking treatment for substance abuse addictions.
"There are heightened levels of fear, and self-medication is often part of that,” Chassman said. “For people new to the recovery process you bring a heightened sense of fear and anxiety. Coupled with a lack of social, if not moral support, it does put people at risk.”
With churches and nonprofits canceling 12-step meetings, treatment providers have transitioned to an array of remote services to treat clients.
The state has expanded telehealth options, allowing many organizations to expand their ability to conduct video and phone conferencing with patients. Many groups already had 24-hour hotlines in place.
Residential drug treatment programs have transitioned from group sessions to more one-on-one meetings, experts said. Some self-help meetings are being broadcast online while pockets of smaller AA or NA groups are arranging ad hoc meetings in outdoor settings. A recent AA meeting, for example, was held in a Northport gazebo, Chassman said.
“It can seem like an interruption for people in self-help which is not helpful for people in recovery,” he said. “But I think you are going to find that the [AA] message of recovery will prevail and that for 84 years the concept of one substance abuser looking after another is unparalleled.”
A 48-year-old East Meadow resident who has been sober from alcohol for the past four years said he is not particularly concerned about his own recovery. The man, who asked for his name not to be used to respect AA’s tradition of privacy, said he has signed up for several virtual meetings on Zoom, the videoconferencing app.
But he is concerned about individuals who are new to the program and who rely on the security of in-person meetings.
“I am concerned that this is a perfect excuse for newcomers not to continue with their sobriety and not go forward because if there are no meetings, well the liquor store is open,” said the man, who sells security equipment for a Manhattan company. “I am not as concerned about people in the program for a long time. But everyone is concerned for the newcomer.”
Transitioning to a remote treatment process is not without significant challenges.
Nurses who would typically be needed to dispense medication at residential facilities are in high demand at hospitals. Emergency rooms are likely to become so inundated with coronavirus patients, providers fear, that doctors and nurses will have limited time and resources to treat only the most severe substance abuse cases and overdoses.
“A crisis like this brings to bear weaknesses in the system,” said John Coppola, executive director of the New York Association of Addiction Services and Professionals. “The addiction field has been underfunded for years and has barely kept pace with inflation.”
Treatment professionals say the coronavirus outbreak could not have come at a worse time, just as Long Island appears to have finally turned the corner on the opioid crisis.
Opioid-related deaths in Suffolk dropped a projected 26% last year, from 380 in 2019 to 283 in 2019, according to the county’s Heroin and Opiate Epidemic Advisory Panel. Nassau officials have said 147 people died of overdoses in 2018, a 20% dip from the 184 fatal overdoses in 2017, according the county’s most recent data.
The two counties saw a combined 617 opioid-related deaths in 2017, largely driven by the introduction of inexpensive but highly potent drugs such as fentanyl, according to data from area medical examiners.
Treatment providers say they have made too much progress in combating the opioid epidemic to allow the virus to take them backward. They are embracing technology, spending more time on calls and video conferences with patients and finding creative ways to stay in touch.
Reynolds said telemedicine is not perfect “but it’s better than nothing. We are making the best of it. There will be fallout, no doubt about that. But I think it will force a new way of delivering behavioral health … It’s a seismic shift for people in recovery.”
While treatment options may change, Kearse said it’s essential that society’s most vulnerable do not feel abandoned during this crisis.
“We in the provider community feel strongly that social distancing does not have to translate into social isolation,” he said. “They may not be able to come into centers but we want them to know there is a lifeline for them.”
Substance Use and Mental Health Resources
- LICADD 24/7 Substance Use Hotline: 516-747-2606 or 631-979-1700 (secure video counseling sessions available), www.licadd.org
- DASH (Diagnostic Assessment and Stabilization Hub): 631-952-3333 , www.fsl-li.org/help-services/diagnosis-assessment-and-stabilization-hub-dash/ (mobile services available)
- Long Island Crisis Center 24/7 Crisis Hotline: 516-679-1111 , longislandcrisiscenter.org
- Family & Children's Association: 516-746-0350 , https://fcali.org/
- RESPONSE Suffolk Crisis Hotline: 631-751-7500
- Central Nassau Guidance & Counseling Services: 516-822-6111 , https://centralnassau.org/
- Phone and Online AA Meetings: https://aa-intergroup.org/directory_telephone.php
- NA Meetings Online: https://tinyurl.com/NAonline
- Nassau AA Intergroup: 516-292-3040
- Nassau NA: 516-827-9500
- Suffolk AA Intergroup: 631-669-1124
- Suffolk NA: 631-689-6262