Understanding the Addiction Treatment Experience During COVID-19

The COVID-19 pandemic has and will continue to have far-reaching impacts beyond the immediate concern of virus contraction and related deaths. Current research has shown that vulnerable populations not only face a higher risk of COVID-19 contraction, but also repercussions related to economic stature, housing stability, food security, educational equity, and much more.1-4 These repercussions not only have devastating implications for widening existing disparities, but they also increase the risk for negative behavioral health outcomes, including both substance abuse and mental health challenges.5

OMNI staff are experts on substance use disorder (SUD) treatment and recovery. We know that individuals in SUD treatment and recovery can face considerable social, economic, and physical and behavioral health vulnerabilities. As the COVID-19 pandemic began to take hold in the United States this past spring, OMNI immediately began to hear warning signs from our SUD treatment partners and clients of potential impacts to patients' treatment and recovery.

These partners noted consistent challenges related to service provision and patient health, raising concerns centered around telehealth use, access to medication, and impacts to critical recovery supports (e.g., AA attendance). Upon hearing these concerns, OMNI developed a survey to more systematically evaluate these warning signs, seeking to provide data-driven insights into the pandemic's impacts on SUD treatment and recovery.

The Survey

OMNI created a brief online survey for patients currently in treatment for SUD, in both residential and outpatient settings. OMNI disseminated the survey to treatment/recovery facilities that were interested in participating across the U.S. The survey, administered in April and May of 2020 assessed the following:

• Participant demographics

• Telehealth – how helpful or unhelpful has using a telehealth platform been for therapy and recovery support services?

• Medication – in what ways has access to medication been impacted by COVID-19?

• Treatment and Recovery - in what ways have treatment and recovery been impacted by COVID-19?

• Substance Use – in what ways has COVID-19 impacted people’s substance use?

Findings:

The data represent an aggregate of 534 individuals receiving treatment for substance use disorder at 14 treatment facilities across the United States. The following key-takeaways emerged from the data:

• Broadly, telehealth is viewed as helpful for therapy services and slightly less so for recovery services.

  • Many patients find telehealth to be an important connector to support systems, while others surfaced challenges such as finding telehealth technology difficult to navigate and the platforms to be impersonal.

  • Differences may exist in how helpful telehealth is depending on patients' living situation. Patients living in a residential treatment facility or sober living community found telehealth-delivered therapy and recovery services less helpful than those that do not live in a residential treatment setting.

• Broadly, the average number of peer support meetings attended increased from 3.1 per week before COVID-19 to 3.5 per week during COVID-19.

  • Differences may exist in the number of peer support meetings attended depending on clients' living situation, with the average number of meetings attended per week increasing significantly only among participants not living in a residential treatment facility or sober living community (from 2.66 to 3.75).

• The majority of participants did not use substances in the week prior to taking the survey.

• The average recovery capital score was 50, higher than the score of 47 which predicts sustained remission.6*

 It is our hope that the survey results can help inform and improve the treatment and recovery services provided to SUD patients amidst this global pandemic. If you have any questions about the report, please contact our team leads, Holen Hirsh, PhD at hhirsh@omni.org or Charlotte Gray, MPH at cgray@omni.org.

Download the Report

*Recovery Capital was assessed using the validated BARC-10 assessment. Recovery capital refers to internal (self-efficacy, physical health) and external (social, environmental, cultural) resources that are supportive of an individual's recovery from SUD.

References

1. CDC. (2020, August 10). Do I need to Take Extra Precautions Against COVID-19. Retrieved August 24, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/index.html

2. OECD. (2020). COVID-19: Protecting people and societies (Policy brief version 31). Retrieved August 24, 2020, from https://www.oecd.org/coronavirus/policy-responses/covid-19-protecting-people-and-societies-e5c9de1a/

3. Nicola, M., Alsafi, Z., Sohrabi, C., Kerwan, A., Al-Jabir, A., Iosifidis, C., Agha, M., & Agha, R. (2020). The socio-economic implications of the coronavirus pandemic (COVID-19): A review. International journal of surgery (London, England), 78, 185–193. https://doi.org/10.1016/j.ijsu.2020.04.0184.

4. United Nations. (2020). Everyone Included: Social Impact of COVID-19. Retrieved August 24, 2020, from https://www.un.org/development/desa/dspd/everyone-included-covid-19.html

5. CDC. (2020, July 7). People Who Use Drugs or Have Substance Use Disorder. Retrieved August 24, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/other-at-risk-populations/people-who-use-drugs/QA.html

6. Vilsaint, C. L., Kelly, J. F., Bergman, B. G., Groshkova, T., Best, D., & White, W. (2017). Development and validation of a Brief Assessment of Recovery Capital (BARC-10) for alcohol and drug use disorder, Drug and Alcohol Dependence, 177, 71-76.