18 May Five Tips to Help Someone Struggling with Substance Use Disorder Cope During the COVID-19 Crisis

For patients battling substance use disorder, each day brings new challenges as they manage their addiction and take small steps towards recovery. Coping with sobriety during a pandemic, with social distancing orders in place, adds a whole new set of obstacles individuals must overcome to stay the course.

People suffering from severe opiate and other substance use disorders are uniquely vulnerable to COVID-19. Following the CDC’s social determinants of health, those who have underlying health conditions or have a predisposing factor such as homelessness, smoking, low income or being uninsured, carry markers that indicate poorer health outcomes. They are also at higher risk of catching and developing more serious COVID-19 symptoms. 

If you add the challenges of limited social contact, job loss, and financial strains that many people are facing as a result of the pandemic, and it’s easy to see why the COVID-19 crisis hits especially hard for patients managing substance use disorder. So…what is the best way to support these patients?

1. Ensure your patients’ basic needs are met. Food, housing, adequate medical care, and medications are basic needs that may depend on access to health clinics and other community resources. A quarantine impacts every aspect of daily life. Our patients may face job loss, a decrease in family support and other obstacles that interfere with their abilities to meet these basic needs. This is where case managers, staff volunteers and other outreach systems are critical in helping clients with substance use disorders during COVID-19. For MAT patients, have staff identify which patients are able to manage take-home medications and in what doses, then give them a 30 day supply to use at home. Other staff members can be allocated to help homeless clients find appropriate housing so they can safely maintain social distancing measures. Just be sure to equip outreach staff with masks and necessary personal protective equipment (PPE) as they interact with patients. 
2. Maintain individual and group therapy sessions with patients using teletherapy. Social connection and community support are powerful tools for those battling substance use disorder, however the COVID-19 crisis has changed the way support groups come together. When in-person meetings are no longer practical, teletherapy sessions may be a lifeline for patients coping with substance use disorder. Since stay at home orders have taken place across the country, teletherapy has helped behavioral health providers maintain connections with individuals and groups engaged in their own treatments. It’s an especially practical tool for increasing access to care for those who are parents, caregivers, elderly, or otherwise unable to meet in person. Clinics may also consider setting up closed off areas in their own facilities and inviting patients with technology limitations to access the software free of charge. 
3. Take advantage of telephone outreach. Some patients may simply have older technology or limited access to computers and smartphones, so they are unable to make teletherapy sessions work. If this is the case, frequent phone calls, coupled with “drive-by” outreach services for high risk individuals are additional ways to check in consistently as a support system. 
4. Encourage patients to create structured routines. Patients facing substance use disorders may struggle with prioritizing and creating healthy behaviors, however, navigating recovery during a pandemic makes it even more challenging. This is why a structured environment is the key to successful recoveries in rehabilitation centers and treatment programs across the globe. During a time of such uncertainty, encouraging patients to create structure on their own gives them some control over daily life.  Assist patients in mapping out daily responsibilities and goals, then help them prioritize and set schedules ahead of time. Routines will look different for each individual, but may include scheduled times to wake up, exercise, perform job responsibilities, prepare meals and make phone calls. Staff members can also teach patients to meditate, journal and engage in other mindfulness practices. 
5. Connect clients with resources if they do become ill. Many patients with substance use disorders use emergency rooms as the first step in care when they are sick. However, health officials have discouraged individuals from doing so due to the risk of contracting or spreading the virus. If patients become ill and feel like they can’t manage their own care from home, they should know who to call and where to go. In this case, have phone numbers and addresses ready to help them track down a local facility, health clinic or hospital that offers testing and quarantining protocols in their community. 

Behavioral Health EHRs Can Help 

Behavioral health EHRs make information readily accessible as you support patients remotely while managing their care. Individuals battling substance use disorder during COVID-19 may find it helpful to schedule upcoming appointments online via a patient portal or teletherapy module. When used in conjunction with an EHR, HIPAA-compliant teletherapy allows patients to sign documentation before video chat sessions and also lets clinicians create measurable treatment plans, all while maintaining client relationships and offering support. Using an integrated EHR system, therapists and providers in different departments can also collaborate for improved client care and increased efficiency in treatment. 

With the right support, patients facing severe substance use disorders can maintain recovery during COVID-19. As behavioral health practitioners, it’s vital to adapt your support services to best meet the needs of those facing addiction during COVID-19. A combination of virtual meetings, outreach and encouragement of structured routines can help ensure patients’ physical and mental needs are met during the COVID-19 pandemic.

Lynn M. Morrison, Ph.D., is the Chief Executive Officer at Brandywine Counseling & Community Services, Inc., an organization known for its innovative prevention and treatment programs in behavioral health and substance abuse. She has worked with a variety of populations including adolescents, dual diagnosed, severely mentally ill, HIV case management, pregnant women, mothers, and criminal justice. Dr. Morrison has a Master’s Degree in psychology from Washington College and a Doctorate in Psychology with a concentration in organizational systems from Saybrook Research Institute.