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Health care providers, counselors look to close gaps in addiction treatment amid pandemic

  • “The opposite of addiction is connection, you know?” said Zach Labelle, about adjusting to social distancing requirements while continuing to attend recovery meetings via video conferencing Friday, April 3, 2020. Labelle is an alum of Turning Point, a transitional home and recovery center in Springfield, Vt., where James Ribeiro, right, has lived for 14 months and become a recovery coach, Friday, April 3, 2020. (Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Valley News — James M. Patterson

  • Painting with her sister Lilly Pavila, 3, at their home in Lebanon, N.H., on April 3, 2020, Sienna Pavila, 1, waves to another child while their mother Brittany Smith participates in a video conference about breastfeeding for women in recovery at Dartmouth-Hitchcock Medical Center. Smith is in long-term recovery from an opioid addiction and sits on an advisory committee for the Recovery-Friendly Pediatrics program at the hospital. (Valley News - Geoff Hansen) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Valley News — Geoff Hansen

  • Laura Byrne, executive director of HIV/HCV Resource Center, loads supplies for their needle exchange program into the center's van on Friday, April 3, 2020, in Lebanon, N.H. The nonprofit bought the van late last year when they could not find a permanent location in Windsor. Following the COVID-19 pandemic, “we didn’t realize how much we’d be using it,” Byrne said. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Valley News — Jennifer Hauck

  • Wayne Olney, of Springfield, said he plans to call in to his addiction recovery meetings, but if he can’t get the technology to work will rely on his books and connections at the Turning Point in Springfield, Vt., April 3, 2020. (Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. James M. Patterson

  • Wayne Olney, of Springfield, has continued to work in his maintenance and grounds position at St. Mary’s Catholic Church in Springfield, Vt., during the COVID-19 pandemic, Friday, April 3, 2020. Olney is a recovery coach and volunteers with the Making Recovery Easier program at Turning Point. (Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. James M. Patterson

  • ">

    After doing hand-painting at their kitchen table, Brittany Smith washes hands with her daughters Sienna Pavila, 1, and Lilly Pavila, 3, at their home in Lebanon, N.H., on April 3, 2020. The family is self-isolating after Smith was laid off from her new job as a server at the downtown Lebanon Salt hill Pub and the children's daycare closed due to the COVID-19 crisis. "Everybody's doing the best they can," she said. "It's a tough situation." (Valley News - Geoff Hansen) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Valley News — Geoff Hansen

  • Brittany Smith's children Lilly Pavila, 3, and Sienna Pavila, 1, jump on and off of a bed in Lilly's room in their Lebanon, N.H., apartment on April 3, 2020. In long-term recovery from an opioid addiction, Smith is a volunteer recovery coach and said she's worried what will happen to vulnerable people when stimulus checks start arriving in mailboxes. (Valley News - Geoff Hansen) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Geoff Hansen

Valley News Staff Writer
Published: 4/4/2020 9:57:07 PM
Modified: 4/4/2020 9:57:04 PM

The HIV/HCV Resource Center was having trouble finding a permanent location in Windsor to offer its syringe exchange service, so the nonprofit purchased a van late last year to bring sterile supplies to people who inject drugs.

The timing happened to coincide with the emergence of COVID-19, which was first identified in Wuhan, China.

“We didn’t realize how much we’d be using it,” said Laura Byrne, the Lebanon-based group’s executive director.

Out of concerns about COVID-19, the organization can no longer provide services at its three regular sites at Good Neighbor Health Clinic in White River Junction, Springfield (Vt.) Health Center and Valley Regional Hospital in Claremont. Instead, Byrne and two employees are providing supplies to people by appointment.

Syringe exchanges are a form of harm reduction that aim to keep people alive as they navigate the disease of addiction. In addition to sterile needles, Byrne’s group provides clients with the overdose reversal drug naloxone and fentanyl testing strips to help people identify the powerful synthetic opioid often mixed with other drugs. They usually also offer testing for HIV and hepatitis C, but aren’t able to do that now. They continue to connect people with treatment providers and other resources they may need.

While it’s too soon to say how COVID-19 and the efforts to mitigate it will affect Byrne’s clients and others struggling with addiction, service providers and those with past experience say they’re worried that social distancing may lead to relapses and overdoses.

“This is such a nasty recipe for people,” said Brittany Smith, a Lebanon resident who is in long-term recovery from an opioid addiction.

Smith said she worries that social distancing and anxieties either directly or indirectly related to COVID-19 may cause “new addicts to be born right now.”

Officials in both New Hampshire and Vermont have worked to curb the rate of death due to drug overdose in recent years. Service providers said it’s not yet clear whether those efforts can be maintained amid the COVID-19 pandemic.

Vermont health officials last month launched a new website to help people with addiction, vthelplink.org. New Hampshire continues to operate The Doorway, the state’s hub-and-spoke system for connecting people struggling with addiction with treatment that can be reached by calling 211.

The launch of Vermont’s new site, which had been in the works for three years, was moved up due to the COVID-19 crisis, according to Cynthia Seivwright, director of Vermont’s Division of Alcohol and Drug Abuse Programs.

“When people’s routines are changed, it can put people at higher risk,” she said.

Dr. David de Gijsel, an infectious disease specialist at Dartmouth-Hitchcock who serves on the board of the HIV/HCV Resource Center, said he worries that people who use drugs might not qualify for unemployment because they may do odd jobs or otherwise “hustle” money to pay for drugs.

Without savings and with tenuous relationships with their families, “many are really hitting rock bottom that way,” he said.

People struggling with addiction may also be particularly challenged by being stuck at home with children or partners at this time, he said.

“Stressful times prompt relapse,” he said.

People who have experienced stigma in the past might find the various bureaucracies they’re now navigating — unemployment, school districts, employers, COVID-19 testing — to be a challenge, he said.

Physically, people with addiction may also have underlying health conditions that aren’t well-controlled such as lung disease or asthma that might make them more prone to serious complications from COVID-19, and which could heighten their anxiety during this time, he said.

Melinda Lapine, an administrative assistant and emergency department recovery coach for Turning Point Recovery Center in Springfield, Vt., said that she has seen an increase in relapses and overdoses in recent days.

“It’s tricky for us to get services to people,” said Lapine, who is in long-term recovery herself.

But she’s hopeful that more and more people will tune in to group meetings via videoconferencing programs like Zoom and also check in with the center’s staff by phone. The center continues to provide Naloxone to people by appointment, she said. Though some clinics have instituted screening procedures for COVID-19, Lapine said people on medication-assisted treatment can still get the doses they need.

Providers at Springfield Hospital and Mt. Ascutney Hospital and Health Center have started giving patients iPads so that Turning Point’s recovery coaches can continue to provide “face to face” support to patients.

Mike Johnson, Turning Point’s director, said two of the seven beds at the center’s transitional housing facility are vacant because he’s concerned about adding someone new who may have the virus. The five current residents are allowed to go to work, but are required to shower and change their clothes when they return, he said.

While some of the center’s clients have used their extra time at home to give Johnson or other staff members a call, he said, “There’s people who aren’t reaching out. People who are isolated. People who don’t have access to internet. People who don’t have phones. How do we reach them?”

Like Turning Point, others in the fields of addiction treatment and recovery support have in large part moved to telemedicine.

De Gijsel, who also serves as medical director for the Hanover-based addiction treatment provider Better Life Partners, said nine of 12 people showed up to a recent group he sits in on that was held via Zoom instead of in-person. He found that some participants who don’t talk at the in-person meetings were chattier in the Zoom format. And people also seemed more relaxed than usual because they were in their homes and could do things like smoke or play with their phones if they wanted to, he said.

He described it as an “amazingly positive experience.”

De Gijsel has also found that some introverted clients enjoy being home alone and don’t mind that social distancing is now required. Others who have qualified for unemployment don’t mind having time at home with family or for chores.

But he couldn’t be certain why the other three group members didn’t participate. It could be a technical problem, a sense that a Zoom meeting isn’t worth the time, or a relapse, he said.

“The ingredients are all there for more overdoses,” de Gijsel said.

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.




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