The opioid epidemic may not be in the spotlight these days, but it’s still very much present in our local community. Hospitals continue to see overdoses and the coronavirus pandemic is making the situation even worse.
The Community Hospital of the Monterey Peninsula (CHOMP) saw more opioid-related drug overdoses in the first four months of this year, compared to the last four months of 2019. This is despite emergency department visits being down at the hospital by as much as 50 percent in recent months, during shelter-in-place orders.
“We're seeing more. Polysubstance is the norm,” says Dr. Reb Close. She is an emergency physician and the lead clinical physician for the Monterey County Prescribe Safe Initiative, an initiative that was born out of the opioid epidemic.
When she says polysubstance, she means overdoses from counterfeit street drugs that contain a variety of substances such as opiates, heroin, meth, or fentanyl.
“They're not getting pills from us. They're using whatever they find on the street or whatever they buy from their friends,” said Close.
Dr. Close says she’s also started noticing a trend among patients who’ve recently overdosed. Many were giving the same reason for turning to drugs - the loss of a job, losing a home... basically, the widespread impacts of the coronavirus pandemic.
“It's the fear, the isolation, the frustration. And in some of the kids, more mentioned than in the adults, the boredom,” said Close.
And to make all those worse, the treatment centers that help people suffering from drug and alcohol addiction had to essentially close their doors because of the pandemic and go virtual.
Lena Allen is the clinical director at Door to Hope, a drug and alcohol rehabilitation center in Salinas.
“The clients that are seeking treatment and who are being admitted post COVID-19, there's been a lot more difficulty with just being able to engage. To build that relationship and the rapport with those clients is a lot more difficult to do that over the phone or over Zoom when there's not already a prior relationship,” said Allen.
All intakes, referrals, individual and group counselling had to move to 100 percent telehealth.
Allen says in normal times, social services, probation department and court referrals make up 75 percent of their patients. But the initial partial shut down of the courts meant many clients were not reaching them.
“Substance abuse is just one layer of what the majority of these clients are going through. So they're in, you know, poverty. They're in domestic violence relationships. They're reliant on other people,” said Allen.
But the transition to virtual recovery hasn’t been a barrier for everyone -- actually the complete opposite for some, especially those who already were in treatment.
“I’m a homebody. I love being home, it’s my safe spot. And having to do the meetings on Zoom, I thought it was amazing. I thought it was cool,” said Ashley. We’re only using her first name to protect her privacy.
She’s been sober for almost two years. Door to Hope has been a part of her recovery from opioid addiction, for many years. She especially appreciates the option of not using video on the consults.
“Especially because you could do it without the camera. It gave me more confidence in what I was able to say. Like everyone has their little insecurities sometimes. And I'm a burn survivor. So I guess that's why I was able to speak up more,” Ashley said.
Without the virtual options, Ashley said she might not have been able to attend meetings. That’s because, like many parents, she’s had to homeschool her daughter while schools are closed.
And even as communities across California begin to reopen, it looks like treatment centers will have to continue to find new ways to work with those suffering from substance abuse. Experts don’t know what the long term implications will be for those who haven’t thrived with virtual help.
“We will see the consequences, I believe, six months from now, nine months from now,” said Lena Allen, Door to Hope’s clinical director.
Emergency physician Dr. Reb Close has accepted the reality of increased abuse during these stressful times, but she also has some advice.
“Maybe I don't have the coping mechanisms to call a friend, to go for a jog, to pet my dog, whatever is going to make me feel better. And the heroin is going to make me feel better. So I'm going to use that. Then fine. Just have a buddy. Have a system. Have a plan. Have something,” said Close.
She says we don’t want to keep losing people to this epidemic.