Jessica White used to attend two group meetings each week on Washington Street in Keene as part of her recovery from a substance-use disorder. But with the COVID-19 outbreak barring large gatherings and shifting the sessions online, her normal routine was stripped away.
“Everything you’ve created and built has been altered, and we in recovery don’t like change,” she said, “so the spontaneity of the situation, where this church closes and now all my meetings are gone, is overwhelming at first.”
A few weeks into this new normal, White — organizer of the group ELM Recovery Connect, formerly known as Keene Hates Heroin — said she’s back into a groove, despite isolation’s ability to feed into addiction.
Before being attached to the viral respiratory illness sweeping the globe, the word “crisis” was most often used to describe the nation’s longer-running drug epidemic. In 2019, at least 389 people died of overdoses in New Hampshire, most of them from the opioid fentanyl, according to the state health department.
And as reported by the Valley News of Lebanon, providers and people in recovery say they’re worried COVID-19-related social distancing might lead to relapses and overdoses.
Melinda Lapine, an administrative assistant and emergency department recovery coach for Turning Point Recovery Center in Springfield, Vt., recently said she’s seen an uptick in both, according to the Valley News.
But the past few weeks have also highlighted the promise of technology to help bridge these and other health-care gaps.
Unexpectedly, shifting meetings and doctor visits online has expanded area recovery organizations’ clientele, showing the need for telehealth services in rural states such as New Hampshire, according to Nelson Hayden, director of The Doorway at Cheshire Medical Center.
Telehealth, or telemedicine, refers to patients and doctors connecting virtually through video conferencing or telephone conversations.
Gov. Chris Sununu issued new temporary guidelines last month to expand access to these services, requiring they be covered by insurance providers.
“Telehealth is going to be a benefit that we realize out of COVID-19, in that we have increased access to treatment and care,” Hayden said.
The Doorway — part of New Hampshire’s “hub and spoke” system — launched last year to screen, assess and refer people to treatment and support services in the community.
Located at 640 Marlboro Road (the Curran Building on Route 101), Keene’s Doorway is still providing services in person, Hayden said, but telehealth consultations are available if they’re more convenient for the patient.
Those who do come to The Doorway are screened at the entrance, similar to Cheshire Medical, to make sure they aren’t showing COVID-19 symptoms, which include fever, cough and shortness of breath. Staff are also screened, Hayden noted, and employees and patients are given surgical masks to wear inside.
Referrals for lower levels of care, such as Alcoholics Anonymous or Narcotics Anonymous meetings, have switched to video or phone conferences, he said. But higher levels of care, like inpatient treatment, are still available at most facilities in the Monadnock Region, if needed.
“With this COVID environment, people aren’t going to court because they’ve suspended that, people aren’t going to work because they’ve suspended that, and people aren’t really going to the hospital as much,” Hayden said. “So, if you take [away] the biggest reasons people would come to treatment, you would think that we wouldn’t be doing anything here, but we are just as busy as were before.”
Phoenix House New England — a network of nonprofit substance-abuse treatment agencies with locations in New Hampshire and Vermont — has had “great success” with the telehealth transition, according to President and CEO Peter Mumma.
The agency was working toward using more telehealth services before the pandemic, he said, so the virus just sped up the process.
“Clients actually really enjoy this telehealth process, and some of them even enjoy it more than face to face,” he said. “It’s much easier for clients to engage in services. They can do so from the comfort of their own location. They don’t have to spend money to drive and spend gas money or [worry about] transportation issues, or if there are child-care issues or any other things that might be barriers to people.”
The Phoenix House location at 106 Roxbury St. in Keene offers medication-assisted treatment, residential care, partial hospitalization and outpatient services for behavioral health and substance-use disorders.
The site recently added intensive outpatient treatment for the latter.
Phoenix House also has a residential treatment program in Dublin for adults with substance-use disorders and two sobriety houses in Brattleboro — one for women and one for men — and a men’s home in Bellows Falls.
Mumma said doctor referrals aren’t required to participate in any of the programs, so people who are out of their typical recovery schedule because of the novel coronavirus can reach out to the agency for help.
“We want to maintain access and availability because, yes, we want to protect people from COVID, but people are still at risk from alcohol abuse and addiction and opioid overdose,” he said.
The Keene Serenity Center has also discontinued its in-person meetings and recovery services, according to Executive Director Kathy Mota.
The center’s staff is still answering the main line during business hours — Monday through Friday, 9 a.m. to 5 p.m. — and peer-recovery coaches will reach out to their peers at scheduled times for phone sessions when needed.
Staff have also been posting Facebook Live videos each day as a virtual check-in with their clients, she noted.
“It’s a struggle for everybody, obviously, but a little bit more for people who are in recovery,” she said. “Everybody is doing their best to maintain that human connection, which is super important.”
Mota added the center’s syringe-exchange program — which distributes clean syringes to people who use drugs and safe-disposal kits in exchange for used needles — is still running but has been slightly altered amid coronavirus concerns.
The program is typically administered in three homeless encampments in Keene, as part of the center’s regular outreach. But to keep staff healthy, Mota said they will be answering calls every Thursday from 11 a.m. to 1 p.m. to meet people who need supplies.
“We are really not trying to focus on setbacks; we are trying to stay positive for our clients,” Mota said. “We need to just keep coming together to be strong and be positive.”
For immediate assistance, Cheshire County residents can visit The Doorway at 640 Marlboro Road in Keene (the Curran Building on Route 101) Monday through Friday, from 8 a.m. to 5 p.m., or seek support through the state’s 24/7 hotline at 211.
The Phoenix House can be reached at 888-671-9392 to schedule an appointment.
The Serenity Center, at 34 Mechanic St. in Keene, is open Monday through Friday, from 9 a.m. to 5 p.m., and can be reached at 283-5015.