Name: ‘I am alone’: Opioid relapses on the rise as COVID-19 interrupts drug addiction recovery in Dallas
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‘I am alone’: Opioid relapses on the rise as COVID-19 interrupts drug addiction recovery in Dallas

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7:00 AM on Aug 13, 2020 CDT — Updated at 5:06 PM on Aug 13, 2020 CDTNorth Texas addiction treatment centers are working hard to keep facilities open during the COVID-19 pandemic. The goal: to give some of the highest-risk patients access to medications that treat opioid addiction.The opioid epidemic hasn’t been supplanted by the pandemic. Rather, the pandemic has worsened an already existing crisis. In the Dallas area, the pandemic is resulting in an increased number of people in recovery who are relapsing, local clinicians say. At the same time, the pandemic is making it harder for clinics to provide patients with the support they need.“Social distancing to prevent the spread of the coronavirus may lead to more individuals using drugs alone,” Dr. Nora Volkow, the director of the National Institute on Drug Abuse, said recently in a blog post. “Social distancing has also made it harder to access behavioral treatment and recovery supports.”At several Dallas clinics, managers say they have been overwhelmed by cases involving overdoses and relapses. But experts believe that the — a medication used to help recovering patients with withdrawal symptoms — might prevent overdose deaths.Methadone interrupts the cycle of withdrawal, craving and relapsing use by blocking proteins in the brain called “mu” opioid receptors. And patients who take opioids — like heroin and certain painkillers — won’t be able to feel those drugs’ effects while on methadone because synthetic opioids bind to these receptors.Even still, some patients treated with methadone begin to use other drugs.At the start of the pandemic, most patients getting treatment at the Anti-Aging and Longevity Center in Dallas had clean urine samples. But over time, more of the samples came back positive for other drugs, including opioids, benzodiazepines (or tranquilizers) and methamphetamine, said Veronica Reyes, one of the center’s counselors.An estimated “88% to 95% of patients are clean at any given time [normally], and with the pandemic, it [has fallen] to 40% to 50%,” said Dr. Candace McDaniel, a family physician and the founder of the center.Staff members at the Anti-Aging and Longevity Center have also seen a significant increase in the number of calls for intake appointments. These calls include new patients and previous patients who are relapsing, said Reyes.At Life’s Second Chance Treatment Center in Dallas, “we had an influx of clients coming in, because a lot of people that were clean for years relapsed,” said Lakisha Henderson, the director of the center.Henderson, a nurse, estimated that the center saw a 25% increase in patients just over the last month, including a significant number of returning clients who detoxed years ago.Trauma increases substance use, and patients with opioid addictions report more trauma throughout their lifetimes than people without opioid addictions, according to published in Psychological Reports. Other studies in and suggest economic downturns that reduce house prices, like the Great Recession, also lead to more opioid use and opioid-related deaths.Related:Some people use drugs even when life is going well, so when life gets more difficult, more people use more drugs, said McDaniel. During the week of April 11, alcohol sales were up 27% compared with last year, according to a . And both men and women seem to drink more often when they are feeling stressed from the pandemic, according to a published in Addictive Behaviors.This points to an increase in pandemic-related substance abuse. And patients with opioid addictions are highly susceptible to the stress of the pandemic because they tend to have fewer coping skills than others, said McDaniel.Stress related to fear of COVID-19 itself is compounded by the pandemic’s effects on a set of traits known as “PERMA,” said Dr. John Talmadge, a Dallas-based psychiatrist who specializes in addiction therapy.PERMA stands for “positive emotion, engagement, relationships, meaning and achievement” — five traits that constitute a theoretical model for happiness in positive psychology. “Those are the areas that the pandemic impacts across the board,” he said.Local psychiatrists think some patients are relapsing due to disruptions in their “engagement” and “relationships” during the pandemic. The crisis has limited in-person counseling and group meetings that ordinarily provide patients with the stability, support and connection they need for recovery.Anne, 47, is a Dallas patient who has been clean from opioids for five years. But she can understand why access to in-person counseling is important for preventing relapses. “The loneliness is hard for me. I struggle because I am alone,” said Anne, who asked that her full name not be used for privacy reasons.Due to social distancing protocols, many clinics are only allowing one patient in at a time. And because of recent federal changes in methadone regulations, more patients than ever are being sent home with a week’s worth of medication, called “take-homes.” These measures are great for mitigating the spread of the virus. But social distancing measures prevent in-person support groups.“Group meetings are essential to the recovery process,” said Anne. Four years ago, when she was starting her recovery, Anne sometimes attended two or three meetings every day for the camaraderie and support. “If I showed up there, I stayed clean,” she said.Leaving the house is important for some patients. “I know people who are just struggling. In a time like this when you’re not supposed to get out of your home, it’s easy for them to justify staying home and staying intoxicated,” said Anne.Most clinicians and organizations, including Narcotics Anonymous, now offer online support, but some say that online support may not be as effective. “A lot of the recovery programs in addiction are based on connections with other people. Some of that can be done virtually, but virtual connection is not the same,” said Dr. Lee Spencer, a Dallas-based psychiatrist who specializes in addiction therapy.And psychiatrists can’t pick up on some of the subtleties in body language that guide their questioning and help inform their treatment when chatting virtually, said Talmadge.Clinic staff members are still meeting patients in person for the brief check-ins required to pick up their medication, but these encounters are shorter and less frequent. Some staffers are even meeting patients at their cars if the patients are at high risk for contracting the virus or if they are showing any symptoms.Henderson, McDaniel and Spencer have all been busy — treating more patients than usual without any additional staff to help out. “We don’t have a lot at our disposal to help people right now,” said Spencer. “I’ve had a few patients overdose and it’s tough to watch them suffer.”Despite the influx of relapsing patients, there hasn’t been a change in the number of opioid-related deaths compared with this time last year, said a spokesperson for the Dallas County medical examiner’s office.That might be because more people are seeking treatment during the pandemic. “We do see a trend that when drugs are hard to obtain and the cost is high and the quality is poor, people do come into treatment,” said McDaniel.Experts hope that the COVID-19 pandemic sparks long-lasting changes that help end the opioid epidemic. Increasing the availability of psychotherapy or improving the accessibility of medications like methadone may prevent deaths from opioid overdoses.Staff at addiction treatment centers say they are doing all they can to help the influx of new and returning patients during the pandemic. “We work sort of in the trenches,” said McDaniel. “We would like for the community to know that we are here to help.”Alyssa Fernandez, a staff researcher, contributed to this report. Gina Mantica reports on science for The Dallas Morning News as part of a fellowship with the American Association for the Advancement of Science.Related:Get email alerts on breaking news stories as soon as they happen.By signing up you agree to our

7:00 AM on Aug 13, 2020 CDT — Updated at 5:06 PM on Aug 13, 2020 CDTNorth Texas addiction treatment centers are working hard to keep facilities open during the COVID-19 pandemic. The goal: to give some of the highest-risk patients access to medications that treat opioid addiction.The opioid epidemic hasn’t been supplanted by the pandemic. Rather, the pandemic has worsened an already existing crisis. In the Dallas area, the pandemic is resulting in an increased number of people in recovery who are relapsing, local clinicians say. At the same time, the pandemic is making it harder for clinics...

‘I am alone’: Opioid relapses on the rise as COVID-19 interrupts drug addiction recovery in Dallas

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