Recovery in the Age of a Pandemic

For those who are in recovery the challenges of the times we are living through may feel amplified. Recovery and staying sober often are linked to having a strong, supportive network. The coronavirus has disrupted and displaced so many ways of everyday life. For those in recovery, this shift may mean not being able to attend in-person support meetings and lacking connection with a social network. These are losses that can amount to feelings of isolation, grief, and loneliness as well as increase symptoms of anxiety and depression, which are risk factors for a relapse.

Mental Health Missions talks with Martha Scarborough, the Regional Resource Director for Caron Treatment Centers to discuss how people who are in recovery and newly sober can cope through these trying times, navigate social distancing, and seek out available supportive aids and services.

Mental Health Missions: Can you describe your role and how you help individuals and families locate treatment for addiction? What types of addictions do you provide treatment for at Caron?

Martha Scarborough: I am a Regional Resource Director for Caron Treatment Centers, which means I help anyone looking for resources for addiction and other co-occurring mental health issues. I often work with families, individuals, clinicians, physicians, and other treatment providers to educate them about the programs at Caron as well as other resources available in their communities.
At Caron we treat any substance related addiction, and we also screen, assess and treat any addiction interaction disorders such as gambling, sex, eating, work, or Internet addiction.
MHM: A lot of times there is a great deal of fear and trepidation for people to enter into treatment in the first place. Why is it important that the coronavirus and everything that is going on not be a deterrent for people to get the treatment they need?

MS: Social Isolation fans the flames of addiction and because so many people are isolated and social distancing, the potential for relapses are becoming more common.

We also have to look at the situation we are in; in many places bars, restaurants, and liquor stores have been closed. If someone is physically dependent on alcohol and they do not have access to it, they could be at risk for life threatening withdrawal. So, I would say this is a time to say yes to treatment rather than focus on reasons to say no.

Before the pandemic a lot of the reluctance people would have about entering into treatment was due to missing school or work. Because school and work are on hold for so many people right now, that disruption actually would be more minimal than it would have been otherwise. If you think about it, there’s very little people are missing out on right now because so much in our world is on hold. From that standpoint, it seems like an optimal time to focus on getting help for an addiction. People who are active in their addition can always think of reasons why not to go to treatment. Addiction has a very strong hold on people and from that angle people can always find reasons not to go. But, the reality is, if a person is in need of treatment that is what’s primary.
MHM: What about the financial cost of treatment? If a person has lost their job and/or insurance coverage what are their options for seeking out treatment?

MS: This is a difficult time for so many people. A lot of people have lost their jobs, income, and health benefits. I would urge people to look into unemployment benefits in their state. Also inquire about flexible payment arrangements for rent and other obligations such as credit cards and cell phone bills. Many utility companies are suspending disconnection orders for non-payments. Everyone is challenged during the pandemic, so creditors understand that people are struggling and many are willing to work with customers. Financial stress can put someone at higher risk of using or abusing substances, which is something to be mindful of.

For those who are seeking treatment and financially challenged, this actually happens quite frequently, even before the pandemic. Most treatment centers and providers are sensitive to the fact that cost can be a barrier to treatment for many people. Because of this, a lot of treatment facilities including Caron offer scholarships in some form that can assist with cost of treatment. And, most communities offer a treatment option of some kind; usually those resources can be accessed by contacting your state or local community crisis line or 311 in the area you live in. If an individual or family is looking for resources, most treatment centers offer some sort of outreach assistance to help people navigate and learn about available resources and supports. It’s always a good idea to ask what assistance is available.

MHM: What happens if someone is seeking treatment right now and the program(s) they are considering are not taking any new patients because of COVID-19? What would you suggest in those scenarios?

MS: This is happening often.  Many treatment centers have had to increase their admissions criteria in order to keep their patients and staff safe and healthy. Some programs have implemented criteria such as requiring patients be transported by car to treatment and are not admitting anyone who has traveled by plane [because of possible exposure to the virus].  If the admissions criteria is causing a delay in a patient getting admitting to treatment, I would recommend connecting with a clinician, treatment placement specialist, or interventionist who has clinical training and is well versed and familiar with treatment centers throughout the country.  Those kinds of professionals can provide up to date and appropriate referrals to multiple programs. They usually can help patients find the best program fit for their needs.

If there is a program that you really like and they have stopped admitting patients right now because of the pandemic, connect with a staff member there. They likely will be able to make a referral to another quality program. Or perhaps the patient is in a position where treatment can be delayed, of course this would have to be verified by a clinical expert but if treatment can wait, keep in contact with the treatment center where you would like to go in order to stay informed about when they will once again start safely accepting patients.

MHM: Do treatment programs need to change and adapt because of what is going on [with the pandemic]? What are some ways in which programs are pivoting to meet the needs of patients during the pandemic? 

MS: Yes, being able to adapt to the current culture is important. Most programs that can be offered on an outpatient basis have moved to a virtual platform.  For example, virtual intensive outpatient, individual sessions, and family sessions are being offered online.  At Caron we have moved to telehealth for all of our outpatient services and many other facilities have made similar shifts in their treatment models.
Our residential campus at Caron is still fully functional and accepting patients but we have implemented guidelines for the safety of patients and employees. Our staff has been screening patients multiple times a day for fever and symptoms. We have the capability to socially isolate patients in our medical center if they have symptoms.  Those patients who are isolated are given an iPad, so they can stay connected and engaged with groups, therapy sessions, and treatment while staying safe and remaining isolated. Staff visits those patients daily to connect and they wear PPE [personal protective equipment]. A lot of other treatment centers are taking similar precautions. Sanitary practices are up across the board, meaning increased hand washing, disinfecting common areas, plentiful hand sanitizer, limiting outside visitors, etc.

I also think it’s important to remember that the facilities providing treatment are committed to keeping patients safe and minimizing exposure to the virus. If a person is in need of treatment, that is a paramount need. It’s important that there is a balance with people being cautious about health and safety [regarding the virus] and still make sure they are getting the much-needed treatment for their addiction.

MHM: A huge part of success in recovery is having those necessary supports. At Caron you have a very robust family support group. During this time of social/physical distancing, how can you ensure and encourage ongoing family involvement & support?

MS: The changes that have come about as a result of the pandemic have happened so quickly, really without much time to prepare. In some ways, this quick shift to doing everything online has resonated in really positive ways. Now more than ever, families can connect on virtual platforms. Although doing things this way resulted from unforeseen circumstances, it seems a natural shift for many families and patients.

Being actively involved in a loved one’s recovery suddenly is easier, families can connect and provide support from the comfort of their own home, in some respects that is a motivator for involvement. In our parent support group, we are seeing an increase in the numbers of parents who are attending because there are fewer barriers—for instance, no traffic, not having to take off work, or arrange for childcare. It’s ironic that this unexpected change has in some ways boosted family support and involvement.

MHM: For many, there is a sense of community that has been established in their recovery. It can literally be a lifeline for so many. With many groups like AA [Alcoholics Anonymous] and other 12-step programs moving to online platforms, how can people continue to cultivate a meaningful sense of community? How important is it for people to stick to a routine during this time?

MS: I truly believe in the process, joy, support, and camaraderie of Alcoholics Anonymous and other 12-step programs.  Now that meetings have moved online, I think it gives an opportunity for more people to access meetings across the world and really find a fellowship that they resonate with.  It might even allow more people to access 12-step meetings because gone is the fear of pulling into a parking lot, possibly seeing someone you know, and deciding not to go into the meeting. I thought this New York Times article offered some good insight about this topic.  
Establishing and maintaining a routine is critical to maintaining mental and physical health during this time. Plan time for things that are good for you– exercise, meditation, nutritious meals, support meetings, and other activities. This way you can continue to have as normal a daily routine as possible. Even simple tasks like making your bed or doing laundry can help you feel grounded and more positive in isolation.
MHM: Many people are feeling isolated right now due to guidelines to stay at home and calls to social/physical distance from others. Isolation can often be a trigger for those who are in recovery. What do you say to people who are worried about relapsing during this stressful time? Can you offer any good recommendations or supports that people can access to stay on track?
MS: Living through this pandemic can be traumatic. Some people feel numb, some are more apt to feeling hyper vigilant or anxious, and some may become hypoactive or depressed.  Either way, I think it’s important to talk and process through it.  There are so many therapists who are available online and doing telehealth appointments so people can get the therapy and support they need without having to leave their homes [and be exposed to the virus].  Some providers have reduced their costs or are even offering free sessions to workers on the frontlines. It’s a great time to reach out for connection and support! Whether that is friends, family, people who you want to reconnect with after being out of touch for a while, or with a mental health professional. Connection and support are protective factors for those in recovery.

There are also things people can do outside of themselves that can be helpful such as fostering or adopting a pet or getting into a good book or TV series. Taking advantage of all the opportunities online from museum tours to concerts. And, many universities and schools are offering free classes now. Yale is offering their most popular class online about happiness. So, it’s a great time to dive in and take advantage of all these virtual experiences. Distractions can be beneficial when done so in a healthy and productive manner. These virtual experiences don’t replace in-person connection but it’s still meaningful and has purpose, which will help people and can serve as a way to protect those who may be susceptible to relapsing.

Martha Scarborough is the Regional Resource Director for Caron Treatment Centers, which offers addiction treatment with locations along the East Coast. Ms. Scarborough is active in Caron’s Parent & Family Support Group. She is also a member on the Board of Advisors for RED, a nonprofit organization dedicated to keeping people out of the criminal justice system. Ms. Scarborough is based in Atlanta, GA. Photo courtesy of Ms. Scarborough.