Addiction Recovery Services Navigate Social Distancing

Mar 25, 2020

With the coronavirus pandemic sweeping across the globe, everyone is being urged to isolate at home and distance themselves from one another. But what happens if you’re in recovery for substance use disorder and isolating yourself is detrimental to your health? We discuss how recovery centers are providing care remotely and how those in recovery are coping.

Air date: Thursday, March 26, 2020

GUESTS:

The state of NH offers an alcohol and drug treatment locator to search for treatment options at nhtreatment.org. If you or someone you know is experiencing a substance use or addiction-related crisis, call 2-1-1.

Transcript

  This is a machine generated transcript and may contain errors.

Peter Biello:
From New Hampshire Public Radio, I'm Peter Biello in for Laura Knoy, and this is The Exchange.

Peter Biello:
With the coronavirus pandemic sweeping the globe, everyone is being urged to isolate at home and distance themselves from one another. But what happens if you're in recovery for a substance use disorder and isolating yourself is detrimental to your health? In this hour, we're talking about coronavirus, addiction and recovery. And we want to know about your experience. Do you have a substance misuse disorder? Do you work in the recovery field? What is your experience? Let us know.

Peter Biello:
And joining us this hour, John Burns, director of SOS Recovery Community Organization. He's with us by Skype today. And Kerry Norton, co-founder and program director of Hope on Haven Hill. Thanks to both of you for joining us for this conversation.

Kerry Norton:
Thanks for inviting us.

John Burns:
Thank you for having us.

Peter Biello:
So let's talk about people in recovery. This is a critical time for them. What makes them particularly vulnerable during this coronavirus pandemic? So I'll start with you, John. Yes.

John Burns:
OK. I mean, I think so. One of the most effective recovery supports out there is is connection.

John Burns:
So for four individuals who have struggled with substance use disorder, isolation, as always. And it's usually a result of stigma. But isolation is is always a huge challenge. And people tend to isolate due to shame. And so coming into recovery, it's important that we maintain those human connections, which is which is the whole model of recovery community organizations that we've established over the years. We've seen it really effective. And all of a sudden, so to speak, the rugs been pulled out from under us on this.

Peter Biello:
Kerry, do you agree?

Kerry Norton:
I do. You know, at Hope on Haven Hill our women without COVID-19, are some of the most vulnerable population. So we have women that are pregnant and newly postpartum. So they have some additional concern. And the lucky thing is that. SOS has worked really well with Hope on Haven Hill, because we're able to provide support ourselves and then we've been able to add extra support, think that's less than what they've kind of deployed virtually.

Peter Biello:
And so when people are usually being more social during their recovery process, where where are they gathering and what are they doing? I mean, we know about AA meetings. Is is it more of the more of the like or are there other things as well? John?

Kerry Norton:
There's so much more.

Peter Biello:
Oh Kerry. Go ahead.

Kerry Norton:
Well, John is a good one to answer it so much more than he can answer about what the recovery organizations are able to do besides just meetings.

John Burns:
For recovery community organizations. We we provide an array of services. So that includes one on one peer assisted recovery supports for individuals, which often centers around recovery planning and wellness planning for them, removing barriers to their recovery, whether it's housing or finding employment or educational pursuits or just day to day challenges. There's a lot of barriers out there, especially when you're an early recovery or trying to find recovery. So the whole recovery community organization model is built around removing those barriers. We also do a lot of telephone recovery supports, which fortunately we've been able to continue. There are the meetings, but it goes beyond any one pathway that we do everything from yoga to art to music for people in recovery as well as 12-Step meetings and all kinds of other pathway meetings. So there's there's just a lot more to it than that. A lot of times people will come in and do art on their own separately at the recovery centers. There's just a whole lot of communication and connection that goes on. And then there's also advocacy and outreach and all of that that we do combined with all that.

Peter Biello:
Yeah. Jhohn, SOS Recovery does seem, has been doing something called telephone recovery support. This was in place, I believe, before the COVID-19 pandemic. Has it been used more frequently since the pandemic began?

John Burns:
Yeah, so we've always had a pretty robust telephone recovery supports. We haven't seen a huge increase in it, but we're definitely doing more with it. In our biggest our biggest shift has been towards virtual supports, particularly around meetings. We've been really fortunate that we connected with two or three other organizations. And if it wasn't for them, you know, they really got it started. And we kind of jumped in and we're able to provide additional capacity. So there's an organization called Unity Recovery down in Philadelphia. That's another recovery community organization. We Connect Health Management, which is a which is a company that does a lot of virtual stuff with peer assisted recovery supports. And they have a platform that they do that through that we've partnered with, as well as the Alano Club all the way up in Portland, Oregon. So we were able to jump into a collaboration with those three organizations. And we're now hosting nine meetings a day that start at 7:00 a.m. Eastern and go till 11:00 p.m. Eastern. And just in the first seven days, we served nine thousand five hundred and ninety participants in the first week of it, and we're in week two and we've added two more meetings a day and some weekly meetings for people in the LGBTQ community, some weekly meetings for women in recovery.

John Burns:
I believe they're going to be launching a Spanish speaking one. So it's been really it's been an incredible thing all through virtual supports on Zoom.

Peter Biello:
Listeners, we want to bring your voices into the conversation as soon as possible today. If you are in recovery or you work in the recovery community, let us know your experience or ask questions if you've got them. And let's talk to Brooke in Durham. Brooke, thank you very much for calling. What's on your mind?

Caller:
Hi, I'm here. Can you hear me?

Peter Biello:
Yes, we can go for it.

Caller:
Hi there. So recovery for me is really been a difficult road. And and meeting in person and some of the meetings that I've gone to and really, really help.

Caller:
So I hear you with all the Zoom meetings and things that are virtual. I'm just wondering, you know, is there any point in time or is there going to be any sort of in-person support or or is that just on hold for for now? And we'll just have to wait and see.

Peter Biello:
I'd love to get their their insights on that, Brooke. But I did want to ask you, what does an in-person meeting do for you that maybe a Zoom or other virtual meeting could not do?

Caller:
It's really hard to put my finger on it, but there's been a couple of meetings where everybody goes around and shares what we're going through, it's been super supportive to see these people and hear their. Their anecdotal stories around what's helped them get through this time or through others. You know, any time leading up to this. And I just feel like these the virtual stuff just isn't quite as powerful. Where there might be some resistance to that. So that's that's pretty much all I can offer on that at this point.

Peter Biello:
Well, Brooke, thank you for your insights. Really appreciate it. Let's turn it to John and Kerry. Maybe start with you, Kerry. What do you think about Brooke's question about when will these in-person meetings that you have if you if you're if you're looking to get back to them, when will they start again?

Kerry Norton:
Well, I mean, I think that we have to look at the big picture and what the recommendations are for safety and health. I can give. I mean, of course, it's going to make a difference for people. I mean, connection and being together does help. But this is such a really good stop gap. I can give you a story. You know, at Hope on Haven Hill we're utilizing these actual virtual meeting. And I have a mom who's been with us now for two weeks. She has at the time a six day old baby. And three nights ago when we were taking watching her the virtual meeting that SOS has offered everybody. You know, she said it was the best. It was her birthday and it was the best birthday of her entire life. Because besides our own organization having a little small celebration for her birthday, people across the entire country including Washington state, saying happy birthday to her. And she you know, she sat there crying, holding her six day old baby, saying it was the best birthday that she has ever had. She's never had as much support that has been safe and supportive in her entire adult life. So although it's not ideal, feel just like everything that's going on for everybody. You know, there are tremendous, amazing support systems that we're using that we can do that the safest and healthiest right now.

Peter Biello:
And John, what do you think? When when might when might your group organization start start meeting in person again? I suppose it's the same right, you're waiting for, for guidance from on high.

John Burns:
That's right. I mean, if you would asked me that 10 days ago, I would have said we're not going to close because I didn't you know, I would have never guessed that we would that it really became a decision of the public health. And and we we just have to be mindful of the health care industry and the effect this has on on them and our own staff as well as our participants. With that said, you know, I can tell and answering Brooke's question, we do have a couple options.

John Burns:
So one would be virtual through one. So we have peer assisted recovery that can be one on one. So that can be a one on one video chat with with our peer assisted recovery specialists. It could be a phone call. It could be text messaging. We do have a platform called Recovery Link that we are able to access and use for that. And we've been able to do that with people across the country that are in the Zoom meetings. So we would be able to provide that for her. I don't have an answer beyond that. But I also think from a one on one standpoint, if somebody were feeling like they are in crisis and needed to see somebody one on one, we could certainly find a place in the community that could provide for like a one on one space for her to meet up with one of our staff and would just keep some social distancing and it might have to be pulling up in a vehicle or something like that. And it's not going to work for everybody. But I think in these times, people in treatment, recovery really need to be creative with solutions.

John Burns:
And if somebody is struggling and they really need that, you know, we certainly can't hug or shake hands out there. But I think we can find ways to connect with people. We've always been very grassroots. So I know she's in Durham we're in Dover Rochester and Hampton. And I still have staff staffing phones, a couple of people at a time at our center that is close to the public. But I have staff that's willing to bend over backwards and come out and we'll find ways to support her if she needs beyond that one on one virtual assistance. But I think that one on one is is goes beyond the meetings. And I don't know that a lot of people know that they can call us and get signed up for that and they can just call our center at 6 0 3 8 4 1 2 3 5 0 and we will get them set up with one on one virtual peer assistance beyond the meetings that we're hosting.

Peter Biello:
And I mentioned if people Google your company, your organization, SOS Recovery Community Organization, they can find that number or an alternate way to contact you.

John Burns:
Yup.

Peter Biello:
Yes. OK, we get this email from from Vinson who says I'm a person in recovery and have been sober for a few years now. I'm also a clinical mental health counselor in training and I'm working at an internship site that focuses on addiction recovery. For my personal recovery this time presents a great opportunity for self-care and for self-reflection. I am fortunate to have established relationships in the recovery community and my cell phone has become a great asset to discuss various difficulties with a process, emotions that bubble up to the surface. My concern isn't for myself, though. This is Vincent. It is for the people who are new to the process of recovery are in a fragile emotional and psychological state. We all know that to begin this process isn't easy. But it's also imperative that these individuals who are newly sober have the supports that they need. If treatment facilities closed down and go to telehealth modalities, these individuals must be given the online assets that can help them engage with sober communities remotely. Not having the resources could lead individuals to return to maladaptive ways of coping. So what about Vincent's comments about the newly sober people who are just starting out in the recovery community? John. Is there anything that they need that maybe someone in long term recovery would sort of not not really need?

John Burns:
Well, I mean, I think, yeah, there's different stages of recovery. And it's and that varies from person to person and certainly somebody in early recovery. It's much more fragile and it requires much more support. And this is one of the downsides of this, is that we can't you know, we do have all these virtual offerings. And I think those can help. They're not there are no replacement for coming into our center and spending four or six or eight hours or maybe just an hour every every day, which a lot of our participants do. So that's challenging. But again. So I think it's just like, what can we provide virtually and beyond just the people who are in early recovery? One of my biggest one of the things that I think weighs heavily on me is individuals who still need treatment and people who are not housed stablely and are and those experiencing homelessness right now. Traditionally, the system has failed them already. And with, you know, with that this is a healthcare issue and it should be an essential health care issue. But, you know, unfortunately, there's challenges out there for treatment centers that can't take new patients right now. And that's a big that's a huge problem and it's a huge barrier. I mean, me and Kerry have come up with some solutions between the two of us where, you know, she was struggling with some stuff on staffing. And so we've made a couple of our staff be able to work with her to be per diems to provide her some backup so that we keep these places open because workforce is a huge issue right now, keeping staff safe, keeping people who are already in treatment safe. There's a lot of challenges on the treatment side. And there's a lot of people that aren't able to access treatment right now because of. And I'm not seeing much for emergency funding coming out to to deal with people who are homeless and people who might need treatment or might need recovery right now beyond what has always been there, which has been lacking in the first place.

Peter Biello:
A lot of points that you raised that I want to turn that to to Kerry for a moment, Kerry. John mentioned, first of all, safety for staff. What would you say about about safety for staff and how Hope on Haven Hill is ensuring that?

Kerry Norton:
Yeah. So we started off the very first of March.

Kerry Norton:
I'm a nurse by trade, and so I began making new policies to go along with with the COVID event that we're about to unfold. So we begin immediately working with the public health network and making policies to ensure that staff stayed as healthy as possible and all of our clients did. We're committed to staying open and that is our biggest barrier is to make, you know, we're small but mighty complex organization that takes care of very vulnerable, you know, homeless and imminently homeless women who are pregnant and parenting newborns with substance use disorders. And so, you know, we don't have a huge staffing pool.

Kerry Norton:
And so when we have staff that has to be out based on a protocol that's much, much needed. You know, with showing signs and symptoms of respiratory illness of any sort. Then we get in trouble. So, you know, we have put in place we have moved counselors in to both programs as backup and SOS has graciously given us some amazing per diem backup as well.

Peter Biello:
Mm hmm. We've got an e-mail from someone going by the name of Sylvia in Carroll County. She writes, I work at the largest treatment center for substance abuse in the Northeast. We are admitting 5 to 10 clients every day from all over the country. We traveled to pick up people at their home or have clients transported by family or by Lyft or Uber. We are not practicing social distancing. It's impossible with over 150 clients. We have multiple packed 15 passenger vans taking clients to and from a lower level of care facility daily to programming at the center. Clients are sitting close together in groups because of space. Sylvia continues, I do wonder, though, if it's irresponsible and unfair to the clients we have now to be admitting unscreened people at a high rate at this time. What would happen if someone tested positive for COVID-19, and our treatment center? Is it mandated that we heard to be informed and would be a center be quarantined? And how with little available space, what would this look like? And I bring that up now because, Kerry, you were talking about your you know, your concerns about your staff and keeping healthy. So who knows what actually it's like in in Sylvia's neck of the woods. But what about yours? Like what would happen if someone on staff tested positive for COVID-19?

Kerry Norton:
Yep. So, yeah. So it's not even just testing positive. It's showing any symptoms at this point of, you know, respiratory illness. So fever over one hundred point four cough, sore throat, things that are concerning. We are having them out. So but I'm not. We don't have that number. So we're not a large facility. We have two residential program with eight women in each. But it would be that I mean, it can happen. We have been so we have we have shelter down at our treatment program only going through medical essential appointments for our clients. But we have followed the public health recommendation.

Kerry Norton:
And if we have a client that exhibits symptoms that's in the treatment program, they would be isolated to their room masked and provided food, you know, and all of their things to their rooms until they are either symptom free for, per the doctors or the state health recommendations. We would not admit somebody that was positive for COVID without clearance that they have already, that they are not infectious anymore. And we are screening clients the same way that we're screening staff every single day when they come in by taking temperature and doing the health screening. So we would be we would be requiring medical clearance for those symptoms.

Peter Biello:
We're talking today about substance use disorders and recovery in the time of COVID-19. And we want to know from you listeners, what changes are you seeing in the recovery community as a result of social distancing guidelines and encouragements to stay home and not meet in groups slowing the spread? But how does that impact your life and how does isolation that may result impact your path to recovery? Let us know. I'm Peter Biello. This is The Exchange. We'll be right back.

Peter Biello:
This is The Exchange on NHPR. I'm Peter Biello and we're talking about substance misuse disorder and COVID-19. If you're in recovery, what's it like for you to stay on a healthy path while also complying with social distancing recommendations? We're speaking with Kerry Norton, co-founder and program director of Hope on Haven Hill, and John Burns, director of SOS Recovery Community Organization. John is joining us by Skype. And John, I wanted to ask you, because you are in Long-Term Recovery yourself. To what extent has COVID-19, disrupted the routines that you use to stay healthy?

John Burns:
Well, believe it or not, now that our Who would have thought this? But with our three centers closed and all the virtual offerings we're doing. I was just talking about this yesterday. I feel like I'm working more hours than I ever have in my life with this.

John Burns:
And I already work quite a few. But just because we're going you know, we're starting our stuff at 7:00 a.m. and going to eleven and there's just a lot of moving pieces. And although where most of us are operating virtually a lot of the time, I'm also part of a you know, SOS is a program of Greater Seacoast Community Health, which are federally qualified health center. So I'm involved with some of the emergency operations stuff there, too.

John Burns:
So working at the health center, I have my staff kind of going back and forth, helping the health centers screen for patients coming in the doors there. So it's changed a lot of that. And then routine wise. Not a whole lot. I've tried to maintain a lot of like my exercise and things. So I can't go to the gym, which has been a struggle, but I've been able to it I have some I have stuff at home and I'm able to work out. I mean, a cool thing that we've been able to access, which I've been accessing, is if if you were to go to our Web site, which is SOS RCO dot org, we have a virtual meeting or virtual menu item that you can click on and one of it has an app or mobiles program called Recovery Link. And through that, they are they are streaming both yoga and CrossFit.

Peter Biello:
Is that something you do, John?

John Burns:
Yeah. So I do some of that. And then we also are linked up with Yoga in Action, which is a nonprofit here on the seacoast. So we're also streaming yoga resume through through also asked four times a week with yoga and action in partnership. So there's some stuff like that. Meditation is a big part of my recovery and activity.

Peter Biello:
So it sounds like aside from work, you've been working a lot. But other than that, it's not been terribly disruptive to your routine. But you've been in recovery for a while.

John Burns:
Right now, I think the biggest disruption has just been the lack of human connection that traditionally become, you know, I'm constantly on the go and seeing people, and that's changed. But I think that's for everybody. I mean, I'm also a family member, so I have a daughter who has struggled, who's currently incarcerated. And it's certainly changed her routines because, you know, there's just a lot of anxiety for individuals incarcerated right now. And it's a really high risk, dangerous area because, you know, the the jails are concerned about if it gets into the jail, it's just a mess in terms of how they manage that. So for people in recovery, which makes up probably some 80 percent of those people incarcerated, we have advocated for years to stop incarcerating people and start treating it as a health problem. And right now, the anxiety for those individuals I know from personal experience with my daughter, it's it's it's really high. And I'm you know, I've contacted a multitude of correctional systems around here to try and provide some virtual support since people can't come in from the outside. And that's not happening because some don't have Internet. And I think there's efforts being made. But, you know, it's a it's a it's a again.

John Burns:
I feel like the people who are most vulnerable, most marginalized right now are the ones who are really suffering the most through this because their traditional supports are drying, are going away, and the system just isn't doing much to respond to them.

Peter Biello:
Kerry, your thoughts are. Is the system not doing much to respond to the most vulnerable?

Kerry Norton:
I think that the health, the pandemic takes priority in everybody's mind because of the pandemic, but that is my worry, is that all of the most vulnerable are not going to have all of the services that they need and deserve.

Peter Biello:
We got an e-mail from Patrick. He writes, Listening to the program now, I'm truly grateful that there is a voice for us in recovery during such strange times. My biggest struggle is I already worked from home before this began, so in-person meetings got me out of the house and involved in my recovery. Remote meetings are helpful, but for me it becomes another isolation that keeps me in front of the same screen. I'm in front of all day, but the Seacoast community is large and active, so we will get through this. Thank you for shining a light on this. Thank you, Patrick. Appreciate your e-mail. Let's also talk to Erin in Manchester. Erin, thank you very much for calling. What's on your mind?

Caller:
Hi. I am a foster parent and I'm in Manchester, and one of the struggles that we've been having has been that supervised visits are basically suspended for the majority of kids in care right now.

Caller:
And. You know, that's a really difficult thing when you have a really little guy where you're trying to build those bonds and you're trying to support that relationship. And so people are falling off of their recovery. Because they're all of a sudden completely cut off from their children.

Peter Biello:
So parents in recovery were hoping to see their their child who is in foster care, can't see the child. It's very stressful for them. And that may cause them to steer off the healthy path that they were on.

Caller:
Right. And so I am wondering if anybody is doing anything to create creative ways of continuing these relationships and continuing those bonds and working with families on both ends of the biological family as well as the foster families to work on that problem.

Peter Biello:
Great question, Erin. Really appreciate it. Let's put that to Kerry. It seems like you wanted to weigh in.

Kerry Norton:
Yeah. That's a huge worry of mine. And we have we do have a couple instances of that in our program. So for us, we're able to help facilitate virtual visits, but it's crushing. So a lot of you know, a lot of women are very motivated in their recovery to for treatments and, you know, to get well for their children. Not going to it's not going to be what gets them well, but it's a motivator. And to be separated in any ways, to be separated from their children is a trauma and then to be doing well and then all of a sudden have it stop is heartbreaking. And so, you know, it's one of those other things where doing the best we can, but we have moms that are are now not having visits.

Peter Biello:
We got this e-mail from a listener who says, my spouse has to go to a meeting once a week as part of her medication assisted recovery. Living in rural New Hampshire, it ends up taking three to four hours out of her day, including travel time with the virus. They have gone to online meetings and she seems to really like it. They are small, a small, tight knit group, though they have been meeting together for a while now, which might make a difference in the group dynamic. So first, for some, seems like a virtual meetings are doing a good job getting the getting the job done.

Peter Biello:
But I did want to ask about one point that this listener brought up, which is medication, because sometimes recovery relies on a kind of medication. And I'm wondering if either of you heard. I'll ask you first, John, how people who need prescriptions to stay on their path to recovery are still getting them. Is there has there been an interruption by and large, John?

John Burns:
I think there probably has. I know that is one area. So it's a matter of how quickly organizations are able to adapt, because there has been a lot of relaxation on on the usual rules for people who are involved with medically assisted programs. So I know for those who may use methadone, they've relax some of the federal restrictions on that to allow more take home. Now, what I don't know is that's that's a model that's run by private providers. So I can only keep my fingers crossed and hope. And I haven't had any direct contact with any of them to know that they are actually using those relaxation and they're giving those take-home doses and being and being flexible about that. That's that's an answer I don't have. I I'm just really hopeful that they are. And then likewise, for people who are engaged with programs that involve buprenorphine or Suboxone, I know that relax some of that as well for telehealth. So being part of an FQHC, a federally qualified health center that has that offering. I know we're shifting over to telehealth so that we can do those some of those prescriptions and some of those some of those appointments via telehealth. And that's that's ramping up right now. But again, you know, you have a provider, you have an area where there's been a lack of capacity system wide. And, you know, you still have the same number of providers. So even moving to telehealth is great. And it's fantastic that they relax those, but that that shift to do it. You know, for instance, I know for hospitals that might do bridge treat. You know, there's there's bigger priorities in terms of the capacity that they're going to have. So what's going to happen with bridge? What? And for for those that don't know a bridge prescription, as some hospitals offer three to five day prescriptions for people who aren't in a maintenance program, but that need it for for detox and can do what's called an initial dose and carry themselves for three to five days to keep them, you know, to launch their recovery and then find programs.

John Burns:
And, you know, those are going to be challenging as we move forward. And I can only hope. But again, these are all areas that that when I look around at marginalized individuals, it's like those are the programs that we need to be really creative in. And hopefully we'll see some more mobile approaches to that, like individuals who are homeless, like how are we getting to them if they can't get to us? Those are all programs that I think as as as an industry, the treatment industry and the health care industry really needs to look closely at. And our policymakers really need to look closely at how we're facilitating that and what, you know, is there is there executive orders that can be made that can really help those marginalized populations beyond the standard stuff that we're doing right now for the core of our populations. And they're all challenging questions.

Peter Biello:
And let's let's talk to Joe, who's calling from Lee. Joe, thank you very much for calling.

Caller:
Morning.

Peter Biello:
What's on your mind?

Caller:
So full disclosure, I'm actually with SOS and Hope on Haven Hill.

Peter Biello:
Oh, okay.

Caller:
Morning, John. Good morning, Carrie. I'm also working with public health in Suffolk County to take care of vulnerable populations, specifically people with substance, these issues and homelessness. So I wanted to talk about some of the challenges we were having, like John alluded to earlier. A lot of the people there that are normally homeless or with substance abuse issues that are that are without homes there, they they already have a lot of things they're not getting, obviously, but it's actually much worse and compounded right now because people were able to use restroom facilities at a restaurant that are now closed. They're able to wash their hands in a lot area, use a phone or a computer in a library. Those are now closed, though, making connections and even getting on these online meetings. It's very difficult. So I'm really trying to see if there's ways we can get mobile hotspots for homeless populations. Also, I've done outreach with our syringe exchange programs that where we can't stop doing that, but we've done some of the things that the MAT providers, the medication assisted treatment providers have done. We're increasing the amount of supplies we give people so they don't come back as often.

Caller:
We're maintaining strict social distancing and no cont, no hand contact or close contact protocols. It's worked out really well. But the most important thing I think we've been doing on top of that with that kind of program is we are educating the people that are without homes and that are using I.V. drugs. The best way to stay healthy, not just for is for their drug use, but for the COVID-19 problem. So there's a lot of people I've encountered in Manchester and the Seacoast that had you know, they know what's going on. They've heard about it, but they didn't know, you know, what social distancing really means. So we're actually in we're educating them to stay healthier, not just for them, but for the population as a whole, because the disease can spread very quickly. If you have 40 or 50 homeless people who are always huddled together and hanging out might actually be able to spread them out more. But that's also dangerous because like John and Jerry were saying, you know, drug use can get worse when you're alone.

Peter Biello:
Well, let's put those comments.

Caller:
Isolation is something we're trying to break down.

Peter Biello:
Sure. Well, let's Joe, let's put those comments to Kerry. Kerry, because you've been working with homeless people for it for quite some time now. So. So what do you make of Joe's comments?

Kerry Norton:
Those are those are the things that are happening. Those are the things that we need that we need to try to troubleshoot on how to. The best help are vulnerable people. You know, there's a lot of people that care and have been working really hard behind the scenes to come up with. Especially Joe to come up with. What can we do? Where can they go? How can we? Socially, you know. Help these vulnerable people who. Are already isolated. Now we're gonna have them isolate more.

Peter Biello:
And you can't tell them to isolate at home. That's the root of the problem, right?

Kerry Norton:
That's heartbreaking.

Peter Biello:
Yeah. We get this note from Taylor who says I'm in recovery and coming up on three years clean on April 20th. During this time of crisis and social distancing it has become more challenging to not only succeed in my own recovery, but also in helping people I sponsor and recover my recovery family remain relapse free. We have turned to social media for meetings either through zoom or other means.

Peter Biello:
We call one another more frequently, and other than that, we do our very best to remain substance free. I know personally my providers are doing telehealth appointments, but also in office appointments if we feel we need them. OK, so that's the comment from Taylor. Thanks very much, Taylor, for writing in. And Kathleen in Dublin wrote to us as well. She says, My husband is a recovering alcoholic, more than seven years sober. He usually attends AA meetings in our area five or more times a week, nights and mornings, usually as he works full time. I think my husband is doing OK, given his time in sobriety and his comfort with his personal program, which is faith based. He does rely on attending meetings and he has expressed more concern about people who are new to recovery, who are entering or re-entering after a relapse. This road is so difficult in the best of times. Many of the meetings in the Monadnock area have been cancelled because the locations have either closed or have ended the use of meeting rooms. And Kathleen also goes on to to ask whether or not it would be possible for places that have been shut down due to the Coronavirus outbreak could be reopened like churches, for example, or businesses with with unused meeting space. I don't know if that's something you've heard John or Carrie about places that have been closed, reopening to perhaps host in person meetings like this. Is that something you've heard, John?

John Burns:
No. I mean, I think I think it's discouraged just in terms of the social distancing. And we don't want crowds. And I mean, I know if I opened up my doors tomorrow, I would have 20 people there within 20 minutes. So that's a challenge. I mean, one thing I do want to put out about some of this virtual stuff, though, so there is a silver lining in all this and it's not all doom and gloom.

John Burns:
There's some really hopeful stuff when I look at these meetings that we're seeing. Fifteen hundred to two thousand people a day logging into what I do know and what I have identified as there is a lot of people connecting to them virtually that were in areas where whether it's social anxiety or transportation barriers or whatever that might be, they're connecting to these virtual meetings and they weren't connecting to any meetings prior. So the positive of this, as you know, and less in about a week's time, I know our organization has probably moved forward about three years with our virtual footprint. And and what we're able to do, along with Unity Recovery and and Alano Club and We Connect and we're connecting to so many people that we wouldn't. And I do know that one thing that's not going to go away is when we reopen our doors. It may scale back a little bit, but there's gonna be a lot more virtual offerings than we had before. So that's the the one silver lining that's coming out of this is we're really getting skilled at virtual recovery supports. And I think you're going to see those expand. And I think those are going to those are here for the long haul now that we've been able to jump into them out way in a way that we never did before. And I think that's going to be really powerful, even for a one on one peer assisted recovery support where we're now accessing a different platform than we've ever had.

John Burns:
And I can do secure video messaging and I can give that to one of my volunteers and be HIPAA compliant and have them doing a one on one video chat with somebody who may not be able to make it into a scanner, who may not have otherwise met with them. So we are seeing a big increase in that. I think that's here for a long time to come through like platforms like Recovery Link. And so that's very powerful. And and that's you know, it's not all doom and gloom. There is some hope out of us had more. More importantly, I think what we're seeing is we're seeing where we're putting a spotlight on the service factor that's around recovery. So one thing that people don't recognize that aren't part of our recovery communities is that people in recovery are super, super grateful and provide a lot of service to the community. And they're stepping up in ways right now, you know, like no one I've not had a complaint from any of my staff, despite the fact that we don't know what's happening from one day to the next as things change so rapidly. So. So there are some positive in all this.

Peter Biello:
And Kerry Norton of Hope on Haven Hill. Before we let you go, I want to ask you if it's a similar experience for you. Johnson just said that, you know, the the increase in telehealth might signal that telehealth may play a greater role in your organization going forward. Is that the same for Hope on Haven Hill in your view?

Kerry Norton:
It is, you know, like most places in New Hampshire. Hope on Haven Hill has struggled with workforce shortage before this happened. And so, you know, having the ability to provide services in a virtual way. And now we're. We've become fast experts at it. It is priceless.

Peter Biello:
Well, Kerry Norton, co-founder and program director of Hope on Haven Hill, thank you very much for speaking with us. Really appreciate it.

Kerry Norton:
You're welcome. Thank you.

Peter Biello:
This is the Exchange on NHPR. And still to come. Some people convicted of nonviolent drug offenses participate in diversion programs. This this is instead of being incarcerated. But lots of these diversion programs require things like classes that aid rehabilitation. How are those classes functioning during the COVID-9 pandemic and social distancing guidelines?

Peter Biello:
This is the Exchange on NHPR. I'm Peter Biello, and today we're talking about COVID-19 and how those with substance misuse disorders get the help they need. COVID-19 has slowed down or stopped completely so many areas of daily American life. If your path to recovery has been disrupted by the Corona virus pandemic. Let us know how. John Burns is still on Skype with us. He's director of SOS Recovery Community Organization. And joining us for this part of the program is David Croft, director of the Merrimack County Diversion Program. David, thank you very much for joining us. Really appreciate it.

David Croft:
Good morning. Thank you for having me.

Peter Biello:
David, we brought you here to tell us a little more about people in recovery who are participating in a diversion program. Can you explain to us a little bit how the diversion program works and what it is?

David Croft:
Certainly so. Diversion has been around the Merrimack County since 1992, and we've been involved with all kinds of challenges that have come since then. We're certainly dealing with the challenge like everybody is now with the virus. But the version is in place for folks that have committed a nonviolent crime. They get an opportunity to come to us and we give them necessary skill to hopefully turn their lives around and make them law abiding, taxpaying citizen, and they won't get convicted of the crime. But one of our biggest struggles, obviously, is the most folks that are in the criminal justice system are suffering from a substance use disorders.

Peter Biello:
And do these diversion programs require regular court appearances? And if so, are those still happening in the age of this COVID-19 social distancing era?

David Croft:
Once people are referred to us their court hearings are kind of suspended until, you know, they're not successful with us or until they are, but they are required to come and see us on a weekly basis. And that's really been a problem because we've closed down our operation as far as allowing the public in. And so our face to face conversations with our with our clientele is now gone to either email or phone.

Peter Biello:
No, no virtual conferences in the same way that we've been talking about this hour.

David Croft:
We started discussing that at staff meeting in the last couple of days. And that may be something that we're going to look at down the road. We actually have also thought about going and doing home visits with our clients, meeting them at a distance in the in their place of abode. We have access to county vehicles. And so we have a lot of things on the drawing board right now. This is new water for everybody, regardless what we do.

Peter Biello:
Yeah. And so how long do people generally stay in a diversion program? You said it's weeks upon weeks. How many would you say?

David Croft:
So are we see somewhere around a thousand defendants a year. We have all types of programming under our umbrella, but I'm most serious. In the most difficult program to get through is anyone who's alleged to have committed a felony. And most of those folks take up to a year or longer to get through our program. The biggest struggle with the majority of our folks in our felony program is, is sobriety. We're very fortunate that we have a committed clinician on staff that does a tremendous job. And we've actually started utilizing her a lot more now, doing things where the phone and virtual or with our clients because he needs to still be in contact with them.

Peter Biello:
And depending on the offense that this person has committed, they have different things that they have to do. One of them is life skills classes. Some some folks have to take life skills classes. Are those suspended right now?

David Croft:
They are. And what we've done as an alternative is we've been on the Web trying to find all life life skills that we possibly can for free eye and make them available to our clients. So that seems to be working out quite well right now. But it's the difficult part is not the face to face with our clients, folks that are struggling with substance use. They need that. They need that structure. They need that day to day or that week to week contact. And quite honestly, one of the requirements that when someone with us that they have to submit the urinalysis testing, that's not happening now. So anyone who's struggling with substance misuse is out there without without a check and balance.

Peter Biello:
Without like accountability, regular check ins to make sure that they're not using.

David Croft:
That's correct.

Peter Biello:
I see. So some participants in these programs have to also pay restitution. Is there any leniency right now for people in the program who may have lost their jobs and can't really pay the restitution at the moment?

David Croft:
There is. We've cut back all our requirements of what we require folks to pay on a monthly basis. I'm understanding that these are hard times and we don't want to set people up for failure.

Peter Biello:
I see, OK, listeners, we'd love to hear from you on this or anything else related to recovery in COVID-19. So David Croft, concerns about coronavirus for your participants who may have compromised immune systems or be at higher risk. Is that is there anything being done for those folks?

David Croft:
You know, it is it is very difficult for us to try to address this right now. A lot of your guest speakers earlier kind of hit it right on the mark. A lot of our folks are homeless, a lot of folks don't do the social separation like we're asking them to do. A lot of their immune systems obviously are a lot more fragile than ours because of their use. So it's been a very, very difficult road for us to try to get everybody online and to do what they have to do. We will say that we've seen a great increase at our metro clinic in, at the Boston clinic, where they're really trying to get much help to these folks if they can. We're trying to send so many more people to do medical treatment, to try to try to address any issue that we can with that.

Peter Biello:
And what about your staff? This is already a stressful and confusing time for so many people. Staff might be asked to put in more hours since participants are in crisis. How how are folks in the Merrimack County Diversion Program being encouraged to take care of themselves or how is the program taking care of staff?

David Croft:
Well, you know, I'm I'm blessed because I have a wonderful staff. And, you know, you as a supervisor, you're only as good as the staff is. And I'm so blessed to have a great. We've closed down the building to the public. We've taken all kinds of precautions here that we possibly can. We're always going around the clock like wiping everything down and washing our hands. My staff has been great. You know, they've tried to deal with the issues that they have at home and they'll come in here every day with a smile on. So right now, today, we're doing quite well.

Peter Biello:
And are there any special precautions being taken when staff have to enter someone's home? As you mentioned earlier, that that's part of some employees jobs there. Do they have masks and gloves or is there something else happening?

David Croft:
We have all the safety equipment that we need and we're probably not going to go directly into the client's home. We're going to try to meet the client out in the yard and maintain a six foot distance.

Peter Biello:
Out in the yard, maybe it maybe a public place like a park or something.

David Croft:
That's what we're working on.

Peter Biello:
All right. Well, David Croft, director of the Merrimack County Diversion Program, thank you very much for speaking with me. Really appreciate it.

David Croft:
Thank you. And have a great day. Stay safe.

Peter Biello:
You, too. We're still with John Burns, director of SOS Recovery Community Organization. We got this note from Michelle who says People in recovery, the silent pandemic. May we continue the discussion? Thanks, Michelle. Really appreciate your comment. We also got an e-mail from Jonathan who says, I was really active in the Concord AA community. And now that we aren't able to have in-person meetings, it's certainly more difficult for the newcomer who knows nothing about recovery to find what they need. There is a good Zoom meeting room that stays open 24 hours a day and has usually 25 to 100 people in attendance. One positive also is that hopefully the barrier to entry is a little lower with virtual because new people can log into a meeting without feeling like they have to physically walk into a room of people and not know what to say or do. John, what do you think of that? People, you know. Maybe they don't have to feel so, so much social anxiety. Now, if they can just log into a virtual meeting and say, hey, I'm here, what's this all about?

John Burns:
Right. I couldn't agree more. And that, you know, that is that's what I was speaking about with the Silver Line. And we know social anxiety is prevalent in our community. And for for people who are new to recovery and it's always been a barrier. It always will be. So creating that lowering those barriers to a virtual approach is important. And likewise, you know, on the topic of diversion, one of the things that SOS does, we run a couple different probation and parole programs in Strafford County, where we provide coaching for individuals who are under supervision and drug court.

John Burns:
But we also run a different diversion program, which is a pre-arrest diversion program called Law Enforcement Assisted Diversion. It's the only one in New Hampshire. We do it with Dover and Farmington Police.

Peter Biello:
Pre-arrest. What does that mean?

John Burns:
It means somebody who is in a in a, so if a patrolman runs into somebody in an hour that has committed an arrestable nonviolent offense, such as drug possession, which could be a felony, they and they the patrolmen have the discretion to divert them and not arrest them. And instead they call us and we're on call 24/7 And we dispatch to them and then we put those individuals into an intensive case management. So rather than the traditional church diversion where those charges hang over their heads and they're told they have to do X, Y and Z. Our expectation is only to give them what they identify as their basic needs and provide ongoing case management. So far, for instance, for us, our criminal justice recovery manager Ashley runs that program. Yesterday, she met up with one of her clients in person and brought them close because that individual is homeless and she went out, met him in a public place, dropped off some clothes that she went out and purchased for them, did some on, did some case management with some social distancing and allows people to be self-directed.

John Burns:
There's no expectation of recovery in that program. It's a harm reduction model, but it does give some flexibility. And now we're able to also do some of that ongoing case management because we have that connection virtually through some of these recovery platforms that we have like Zoom and like the recovery link program. So it's a really powerful. I'm hoping to see that it will go beyond two police departments in the entire state, because, you know, the recovery community and the harm reduction community as well are really good at meeting people where they're at and connecting with people. Even in times like this where corrections is, it's an expensive system that's not ideal for individuals in recovery who have who are struggling with substance use. It tends to be very directive. And and we know that lived experience can be very powerful for the individuals we connect with. And and now they don't have a felony. So when they do find that recovery, they no longer have a big criminal. You know, they hopefully don't have an additional arrest that they have to overcome to get a job or to get housing. So hopefully we'll see more of that one way. When we talk of diversion, pre-arrest diversion will become more of a conversation point.

Peter Biello:
And John, on the Zoom meeting question or meetings for AA that happen online, how would you find out about something like that? The person who wrote in said they're up to 100 people at some of these meetings. That seems like a lot of people. But if if you wanted to attend one of these things, how would you find out about it? Is there a is there a link somewhere or are there many places you can go to find such links? What do you think?

John Burns:
There's a lot of different resources. Google actually, I think has a recovery on a virtual recovery database that they're kind of forming. But for I know for our meetings, you can go to our Web site, which is which is SOS RCO, dot org. You can go to SOS's Web site on the menu, you'll see virtual meetings. Click on that and we have a whole whole group of them.

John Burns:
And then if you scroll to the bottom, there's also a link to this platform called Recovery Link, and that has a 24/7 chat room and most of the meetings. So these nine meetings that we're collaborating with, unity, recovery, we can act and Alano on, we're averaging anywhere from 100 to 250 people in each of these meetings and those run nine times a day as well as like, for instance, we had our first LGBTQ plus meeting yesterday at eleven. Every Wednesday we'll be doing that. They had our they had the. We've got a women's meeting weekly. So, I mean, the best place right now is to go to our Web site and there is enough to keep you busy all day long. I think as well as our streaming yoga, you know, that would be my first place that I would go. It really doesn't matter where you are. You can access those. And we've got we had people from 16 different countries log into those meetings last week.

Peter Biello:
Impressive. So SOS RCO dot org is the Web site. John Burns, director of SOS Recovery Community Organization. Thank you very much for spending the hour with us. Really appreciate it.

John Burns:
Thank you. Appreciate you having me.

Peter Biello:
John Burns joining us by Skype. We also spoke with Kerry Norton, co-founder and program director of Hope on Haven Hill, and David Croft, director of the Merrimack County Diversion Program.

Peter Biello:
If you've missed some of the you are that have been thrown out during this program. We're not putting links to all of these at our Web site, NHPR Dot org. So take a look there. And the conversation does continue about this, by the way, on Facebook and at NHPR dot org. The show's producers are Jessica Hunt and Christina Philips, senior producer is Ellen Grimm. Michael Brindley is our program manager. Our regular theme Music was composed by Bob Lord. Engineer is Dan Colgan. I'm Peter Biello, in for Laura Knoy today. Thank you very much for listening. And be well.

The views expressed in this program are those of the individuals and not those of NHPR its board of trustees or its underwriters. If you liked what you heard, spread the word. Give us a review on Apple podcasts to help other listeners find us. And thanks.