Building community and positive habits are two vital pieces of recovery from substance abuse disorder. But the COVID-19 pandemic has thrown patterns of recovery into disarray, and treatment facilities in the southwest metro have quickly pivoted to compensate for those changes.
“So much of what it means to be in recovery and to be sober is to create daily habits to set yourself up for success,” said Lucas Miller, director of business development at the PRIDE Institute, a substance use disorder recovery center for LGBTQ+ people in Eden Prairie. Social distancing measures to slow the spread of the coronavirus have disrupted that, he explained: “Generally speaking, it’s really hard for everybody.”
John McGinnis, program director of the substance use disorder treatment services at NorthStar Regional, which has locations in Chanhassen, Chaska and Maple Grove, noted that social connection is vital to recovery as well.
“People in early recovery, they need to be talking to other people about what they’re thinking about,” McGinnis said. “Their brain is still not healed, so some of their thinking is skewed.”
While both PRIDE and NorthStar are accepting new clients, their staffs have made changes in policy to accommodate safe work practices. All non-essential staff at PRIDE are working from home, including Miller. He said that leaves 10 staff members and 30 clients in the facility in Eden Prairie.
PRIDE’s clients come to Eden Prairie from around the region as well as from both coasts, mainly California and New York. That’s changed as the Centers for Disease Control and Prevention (CDC) and state health departments warn against travel, particularly air travel.
“We’re obviously a niche program, but we have seen a decline in our out-of-state clients,” Miller said. “It makes sense.”
At NorthStar, the center’s 70 clients get the message to social distance and stay at home daily, McGinnis said. That’s been successful, he said, and the vast majority of his clients are abiding by the state-recommended guidelines.
The health and safety precautions required to slow down the transmission of COVID-19 mean that NorthStar is doing some additional screening for new clients, namely checking if they can abide by social distancing norms and perform the personal hygiene tasks necessary to keep themselves and others safe, like washing their hands correctly and often. If they can’t do that, “we’re going to have to take a look at whether they’re self-responsible enough to be in the program,” McGinnis said.
People who have had substance use disorders may be at higher risks for severe cases of COVID-19 as well, according to a news post on the National Institute on Drug Abuse website by Dr. Nora Volkow. The lung damage caused by smoking or vaping nicotine or cannabis, or from opioid or methamphetamine use, puts a person at higher risk for a severe case of the disease, Volkow wrote, which can cause pneumonia in some people.
People who have substance use disorders are also more likely to be homeless or have been incarcerated, which pose challenges in preventing transmission of the virus, she added.
Like many other health care facilities, PRIDE is running low on personal protective equipment like face masks, gloves, throwaway thermometers and hand sanitizer, Miller said, and it has turned to the public to ask for donations of those items.
Many mental health services − including PRIDE and NorthStar − have switched to telehealth models where therapists and counselors video-chat with their clients to maintain social distancing. While it may feel strange to transition to an online care relationship, the fundamentals of talk therapy aren’t different whether in person or on a screen, McGinnis said. While some people resisted the idea of online meetings, many have come around and actively participate in the virtual sessions.
“They’re doing the same things, it’s just that their scenery isn’t changing very much,” he explained.
All the video conferences in the world won’t erase the triggers for relapse that the pandemic has stirred up, though.
“A lot of people turn to alcohol because they feel alone or because they feel isolated, and they’ve basically been asked to return to that state of loneliness,” Miller explained. Previously, one of PRIDE’s clients might have been able to visit a gathering place for LGBTQ+ people to find connections, but many of those are bars or cafes, which were ordered temporarily closed to dine-in customers by Gov. Tim Walz on March 17.
“Now we’ve found there’s not any safe havens for the LGBTQ community,” Miller added.
Other, more immediate results of the pandemic also threaten recovery’s successes. As people get sick and die in Minnesota, the odds rise that someone in recovery will lose a friend or family member, and grief can be a trigger for substance abuse, McGinnis said. As of April 6, 30 Minnesotans had died of the virus, according to the Minnesota Department of Health.
“Some of these clients are going to lose people, potentially, more than likely,” he said. “As we go along, we’re probably going to have to create some groups that deal specifically with how having the illness is affecting them, or has affected them.”
Counselors at NorthStar are advising clients to avoid reading too much news or spiraling into fear about possible worst-case scenarios by focusing on the things they can control.
“We tell the clients, ‘you’re in a safe place. You’re surrounded by medical staff, you’re cleaning constantly and you’re following the four basic things you have to follow,’” McGinnis said.
While prior to the pandemic, some treatment plans had the stability necessary to plan for the future, some of those gains have been erased by anxiety and fear around the crisis.
“We know that relapse is a higher possibility than normal with all this,” he said. “Much of our therapy now also has to include this daily plan of, ‘how are we going to keep these guys sober and clean today?’”