Addiction services more important than ever during quarantine

The coronavirus health alert message on the front door at Connections/Community Support Programs center in Seaford. (Delaware State News/Glenn Rolfe)

A new era has dawned on addiction during COVID-19.

Shelter-in-place orders and restrictions limiting gatherings have put a technological twist on meetings, support and counseling.

Zoom video conferencing has replaced traditional gatherings of Alcoholics Anonymous.

Drug treatment facilities are allowing take-home medication, reducing in-person contact and enhancing safety of clients and staff.

Modifications in the current health crisis include temporary lifting certain state telehealth restrictions, through which patients are no longer required to see a health care provider in person before they can receive telehealth services.

And while casino doors are closed and all bets are off with the shutdown of the sports world, like the roll of the dice, gambling rolls on via online, Delaware Lottery and Keno.

And it’s a good bet gambling may increase online during the pandemic, says Steve Gonzer, director of downstate services for DEProblemGambling.org.

While there were noticeable decreases in revenue from such sources as Powerball and Keno, casino-style online iGaming net revenue rose by 78 percent in March compared to the same 2019 time period.

“It’s a little inconvenient, but we know that there is lots of gambling going on right now. Maybe even more so than usual for the addicts, because there is nothing else to do,” said Mr. Gonzer. ‘There are people – and we know this from some of the calls we get – that they are doing like gambling games in their homes; poker games, setting up all sorts of gambling activities. And without a doubt, they are online. That stuff is alive and well.”

Restrictions in Gov. John Carney’s State of Emergency modifications have brought change to facilities addressing drug addiction.

“The issues around substance abuse disorder and mental health have never been more pressing than they are today with our COVID pandemic,” said Lt. Gov. Bethany Hall-Long in a video conference on COVID-19 last week.

“We recognize that this all a big change in our lives and … we worry a lot about the mental health impact of social distancing, and what is ongoing on in the world around us,” said Dr. Karryl Rattay, director of Delaware’s Department of Public Health. “We are also very concerned about the impact on those who are struggling a substance abuse disorder and their families.”

At substance abuse treatment centers, such as Connections, which has more than a half-dozen treatment facilities in Kent and Sussex counties, clients undergo brief screening for coronavirus before entering the facility.

In efforts to reduce potential exposure to clients and staff, Delaware’s Division of Substance Abuse and Mental Health (DSAMH) is allowing qualified clients take-home options. Take-home medications can range from six to, in some cases, 30-day supplies, said Elizabeth Romero, director of Delaware’s Division of Substance Abuse and Mental Health.

“One of the things DSAMH did immediately was help us do take-home,” Ms. Romero said.

In the new norm of stay-at-home orders and social distancing, recovering alcoholics are increasingly turning to online meetings in efforts to remain sober. With the use of Zoom or other platforms come some precautions to safeguard anonymity and manage participants who may disrupt the meeting.

Southern Delaware Intergroup (SDI) of Alcoholics Anonymous (A.A.) offers help and information through its 24-hour helpline at 302-856-6452 as well as https://sussexaa.org/.

Central Delaware Intergroup of Alcoholics Anonymous, whose meetings presently are all marked “temporary closure,” offers information and help, too, via its website – http://www.cdiaa-de.org/cdiaa/ – and 736-1567 helpline.

Substance abuse

To further help persons with mental health/addiction disorders care and understanding during this critical time, DSAMH has rebranded its HelpIsHereDE.org crisis line – 800-65202929 – to “Crisis and Care.”

“Folks feel isolated. They feel lonely. They feel like they don’t know who to talk to … especially because of the stigma,” said Ms. Romero. “Maybe you find that you begin wanting to go back to doing some of the things that you were doing before that helped you, whether it be alcohol, drinking or using. Those self-medicating things are things that we worry about. We know it’s OK to not be OK.”

The HelpIsHereDE website has numerous resources, including connections for groups to join.

“Maybe you don’t want to talk to a counselor. We know that people sometimes just need to pick up the phone and talk to someone. Maybe you want to go to an online support group. So many providers across the state are setting up things just like this,” said Ms. Romero. “So, there is different types of things going on across the state to support people, so they don’t feel alone.”

“We want individuals to not suffer alone in isolation,” said Lt. Gov. Hall-Long, who chairs the Delaware Behavioral Health Consortium, an advisory body created to improve addiction and mental health in Delaware. “We are in the midst not only of a pandemic, but we are still continuing with the opioid epidemic. We are losing every 22 hours a loved Delawarean – a parent, a child,” said Lt. Gov. Hall-Long. “It is never too late to not pick up the phone.”

Telehealth is a great way to get help, Ms. Romero said.

“We find that all of the providers have quickly moved to being on Telehealth. You can set up a tele-video appointment telephone call in which they will go through all the different things you are used to going through with your counselor. And on top of that, you don’t have to drive,” said Ms. Romero. “You can just go to a quiet part of your house. It is so easy to do. What we’re getting feedback on is, once people try it, they really like it.”

Additionally, Ms. Romero said the state is discovering “that providers are finding that when people do the tele-health appointments, they are actually more likely to keep the appointments. They have better no-show rates.”

Jim Martin, director of The Shepherd’s Office in Georgetown, hands Randy Thornton bottled water Friday during the free “grab and go” dinner, that included chicken barbecue. A total of 150 meals were served on April 17.

Take-home medication keeps the chain of treatment unbroken for addicts in recovery.

“That’s one thing the federal government and Delaware’s Medicaid worked very hard on. On top of that adding that Telehealth component … and following up with people to make sure they are Ok” said Ms. Romero. “So, no one was dropped. No one was falling through cracks. It took a little time for our providers to get up and running. Obviously, they had to order certain types of supplies that they needed and get used to having a new procedure and protocol. But I have to say our providers rose to the challenge. They have been really there to try and help people.”

Alcoholics Anonymous

Video conference settings enable Alcoholics Anonymous, a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem, continue helping others recover from alcoholism.

While disturbances can happen in physical meeting rooms, the anonymity of the Internet provides a shield for the predators. While absolute security is impossible, there are several features available to handle the more disruptive participants.

Zoom encourages participants to “turn on maximum security settings” to prohibit those who may break into meetings and cause disturbances.

Gambling

According to Mr. Gonzer, data indicates that 85 percent of population of the United States has gambled at one point.

“They don’t have a problem. But take the baseline 350 million to 380 million people living here, and you take 2 to 5 percent of it, there are millions of people that have serious problems,” said Mr. Gonzer. “Most people we deal with are not singly addicted. They are either dual addicted or have co-concurrent addictions.”

In normal times and perhaps even more so amid the COVID-19 pandemic, Delaware Council on Gambling Problems Inc. is there to help. There is a 24/7 confidential helpline – 888-850-8888.

“There is always a live person on that line,” said Mr. Gonzer. “You’ll never get a voice on a machine or a recording – ever. We’re there at three in the morning, four in the morning.”

Confidential accommodations can be made, Mr. Gonzer said. Anyone wishing to attend any online or Zoom meetings should call the DCGP helpline.

“We have all the info,” said Mr. Gonzer. “If somebody wants to call, if they’re having a problem at home, we are on those lines 24-7. We should be able to direct people to meetings if they need to. It’s a little more complicated than usual but we can definitely refer them.”

Established in 1979, DCGP is an affiliate of the National Council on Problem Gambling, a nonprofit group that strives to increase public awareness about the issue and help develop services for compulsive gamblers and their families in Delaware.

The coronavirus health alert message on the front door at Connections/Community Support Programs center in Seaford.

“We are gambling neutral. We do not tell people to stop gambling. We do not say to start,” said Mr. Gonzer. “Our agency is here solely to provide information and raise awareness that there is help and there is treatment and there is counseling for people who do have the addiction. We never talk about anything other than that. A lot of people think we are anti-gambling. We are not. We’re kind of like going to a specialist, a doctor, to get treated and he is not going to try to sell you the Brooklyn Bridge.”

Compulsive gamblers, like others with addictions, will try to feed the need.

“Like with any addiction, with or without the casinos being open, people having a disease of addiction are going to find a way to feed that addiction. So, it doesn’t matter what is open, it doesn’t matter what’s closed,” said Mr. Gonzer. “It’s pretty much the same as the other addictions, with a few differences. People who are stuck in isolation, in their homes that are alcoholics are going to find a way to drink. It is the way their brains are. I guarantee people who have the addiction will be betting online, betting on their computers, going to the liquor stores. It’s very bizarre.”

Television advertisements, he says, plays into the hand.

“It’s kind of interesting. Everything is changing. There are a lot more advertisements on TV for the casinos. Even though they are closed, people are inundated with the stuff on TV all day long: ‘Sign up online and we’ll give you an extra $500 …’” said Mr. Gonzer. “And actually, the reality is there are a lot more now than there were because they know people are home.”

Gambling in some way mirrors addiction to alcohol, heroin or opioids, Mr. Gonzer said.

“What’s different is with gambling you don’t have a substance. You don’t have something tangible in your hands. It really kind of proves that the disease of addiction is a brain disorder. It is pretty much proof because it is coming from the inside out. It’s in your head,” Mr. Gonzer said. “The gambling is something where you’ll be sitting in your computer room doing that all day long. You don’t have to run out on the street looking for a joint. You don’t have to go for a liquor store.”

Homeless

Jim Martin sees all kinds of people in need at his Shepherd’s Office in Georgetown, where he is director. While the primary goal is feeding the homeless, the staff there also provides free bread for anyone needing supplemental nutrition and also works to direct those struggling with addiction to services and resources. While doors to The Shepherd’s Office, a Georgetown gathering hub for the homeless, hungry and lonely, are closed to the public, volunteers help feed the needy.

“For the past five weeks we have been offering “grab and go”-ready to eat free meals. Every week it has been about 500 of brown-bagged meals, right from our front porch,” said Jim Martin, The Shepherd’s Office director. “We’ve been using our front porch ever since the guidelines came out. People just walk by and we hand it to them. Sometimes they just drive in, like curbside.”

Efforts are made to keep everybody in compliance with social distancing measures. “The six feet apart stuff is really strict now,” said Mr. Martin.

“The way it has impacted us is we cannot use the inside of our building to serve the public, but we can have up to 10 volunteers in there practicing social distancing. We have to be careful what we do in the building and stay away from each other,” said Mr. Martin.

“We have to coach them and tutor them and get them on the same page. And the typical thing they give is, ‘God has got me protected.’ I say, ‘Well, God has you protected but he still wants you to be smart about what you are doing. Plus, you could be spreading the virus to other people.’ That is the piece they fail to realize.”

“We’re getting the word out. Our program has been impacted. But we’re still trying to serve the people as best we can,” said Mr. Martin. “And it is the worst time to be homeless I think in the history of civilization, with this COVID thing. Everyone is freaking out. Even myself, I have a very long tolerance for people that are homeless. I’ll hang out with them and all that, but now I’m getting freaked out.”


Helpful Coronavirus links

Delaware Division of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage
Reopening Delaware: Resources for Businesses
Delaware Phase 2 guidance

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