YORK, Pa. (AP) — The addiction recovery community is feeling the weight of changes caused by COVID-19, and the price to pay is life or death.
"I think initially there was a high rate of relapse and it seems to have kind of settled down now, but that's also the scary part of this whole thing is people are relapsing and it's a pretty dangerous time for them ...," said Julie Hess, co-owner of Keep it Green Recovery Homes in York.
It's especially scary because "addiction is a disease of isolation," as RASE Project's Director of Residential Services Chrystal McCorkel said.
"Do I think that there has been a lot of changes, absolutely. Do I think that I have seen a higher increase in relapse, yes. Do I believe it's because of isolation and it's because of routines that are off track and everything like that, absolutely," McCorkel said.
In light of the pandemic, recovery homes face challenges in providing the same routines for their clients while dealing with their own financial hardships caused by client lay-offs.
“Well, here we are in a pandemic fighting an epidemic, it's a lot, ... but we're doing the best we can over here," Hess said.
In time, financial woes, relapses and the challenges of building community are easing as those in recovery find ways to battle isolation and gain fiscal stability with community and government support.
"All the recovery houses are owned by somebody that's in recovery, that’s been there. So, they all are doing an amazing job taking care of their people and trying to stay on top of it, you can't help every situation and stuff does happen, but everybody's doing their best," said Alyssa Rohrbaugh, vice president of Not One More in York.
Relapses peak in isolation
In York County, overdose numbers tripled with 8 in January to 21 in March when the stay-at-home restrictions were first set, York County Coroner Pam Gay said. Preliminary overdose numbers for April are also in the 20s with 2 confirmed and 20 suspected overdose deaths.
In Franklin County, while there was only one overdose death in March, deaths seemed to peak in April at five, Franklin County District Attorney Matt Fogal said. In January, there were 3 overdose deaths.
In recovery homes, relapses aren't expected but they happen.
"Generally speaking, one or two a month is about right," said Mark Weitkamp, owner of The Last Resort Recovery Homes in York. "I mean unfortunately first of all we're dealing with human beings, right, and that's unpredictable enough, but when you're dealing with sick human beings, that just compounds the problems."
Weitkamp said he has not seen an increase in relapses at his recovery homes, but others in the region did see a slight increase with virus restrictions.
The RASE Project, which has three recovery homes in Carlisle, Harrisburg and Lancaster, had three relapses and one overdose death.
"It was when the structures were taken away so it's when their routines, their jobs, were taken away, their sense of purpose. And I think especially early on, that's really important to have a sense of purpose, because it just seems like every minute lasts an hour, every hour seems like eternity and you really feel like you're gonna feel like that forever," McCorkel said.
At Keep it Green Recovery Homes, there have been two relapses and one overdose death. Hess said the death came as a surprise because the individual who died was doing well for more than three months.
"My opinion is that it may have played a factor in how she might have been feeling or she might have felt isolated," Hess said. "Not being able to get with your sponsor, not being able to go out to meetings, your whole world changes overnight and I think we're creatures of habit, and we like the routine."
Hess said that she and her husband can usually tell if someone has relapsed when they break their routines.
Noah's House Recovery Homes Inc. in Franklin County had three relapses and founder John Lloyd said that individuals related their it to depression, isolation from family and employment struggles.
Starting recovery during the coronavirus pandemic
It is important for those with addiction to be cautious during the pandemic as their substance dependency makes them vulnerable to the virus. This can be especially critical as recovery homes attempt to accept new members.
"I also need to protect the residents that are there, and I wouldn't ever not take somebody, but I would need to get them cleared, first of all, because we are working with a population who has compromised immune systems, usually have some other stuff going on, hasn't been taken the best care of their health," McCorkel said.
Recovery homes have implemented their own precautionary procedures like enforcing stay-at-home restrictions, social distancing and mask wearing.
Not having that community foundation for those new to recovery makes things even more challenging.
"My heart definitely goes out to them and I would not want to be in this circumstance in early recovery because it's absolutely difficult so then when you throw on all the other uncertainty and ... when you're isolated, it is absolutely how (relapse) actually manifests," McCorkel said.
Accountability is a main pillar in preventing relapse because it builds structure in an individual's life. That means becoming self sufficient through work, going to meetings to learn from others with similar experiences, learning to take responsibility for mistakes, and more.
“Accountability kind of keeps us honest, and honesty is such an important part of recovery. ... If I'm like sneaking around or not where I say I'm going to be and then I can't answer, then I'm not being accountable and then, when I'm living like that my chances of relapse are sky high," Hess said.
Now that many traditional accountability structures are impeded, recovery homeowners are looking at innovative ways to help their clients succeed.
"What we're doing to force the accountability now? I think it's the communication," Hess said.
That involves talking to house managers before leaving the homes, mandatory regular Zoom meetings to enforce active participation in recovery and supporting one another in the homes by talking about what issues each individual is facing.
'It has been a pretty big financial burden on us'
In normal times, if a client is unable to pay rent there are consequences like back pay and possible evictions. These options are limited during a pandemic.
Each recovery home said that at least 50 percent of their members were initially laid-off because of the virus. This is not only detrimental for the person in recovery, but means that recovery home owners were unable to pay regular bills.
"A lot of our people are out of work and either ineligible or still waiting for unemployment so the rent stops getting paid now," Hess said. "It has been a pretty big financial burden on us."
At first, Weitkamp said that some of his people didn't receive unemployment because they didn't have enough qualifying weeks in the last base year. This is common for those in recovery as many spend extended time in rehab, inpatient treatment facilities and even jail before finding stable employment.
Yet, with the recent Pandemic Unemployment Assistance (PUA) his members are able to receive 39 weeks of unemployment benefits which has helped Weitkamp's recovery homes get back on their feet.
There is a challenge with the large sums of money these individuals are receiving though. Weitkamp said the main triggers for relapse are usually large sums of money and too much time.
"It's wonderful what certain companies in the world are doing to help everybody but unfortunately for the opioid epidemic inside the pandemic, it's the complete opposite" because some are now making more on unemployment than when they were working, Rohrbaugh said.
Weitkamp said so far there have not been any additional relapses because of these funds and he is "proud" of his members for making efforts to keep busy and find financial stability.
Most recovery homes also take in parolees out of state prison, but those that have been let out early because of the coronavirus are still ineligible to work and must remain in house arrest until they finish their sentence.
McCorkel spoke of one woman who got early release after two and a half years. She got a job the next day but had to go on furlough for another month because she's "technically still an inmate."
"It makes me nervous because even my boss, she said, ‘Are you worried because she has a month now to just sit around?’ and like, quite frankly, yes," McCorkel said. "Usually in the first two weeks, people get jobs and then you're on orientation and you're getting adjusted to the program, but it's really like this girl is literally in the house all the time now. ... It's definitely like the perfect storm to relapse."
Even in the midst of lay-offs and rising unemployment rates, most recovery home representatives said that members have gotten new jobs.
"Now the guys are becoming more employed at different essential employment agencies for like warehouse work and somethings like that as well as the ladies," Lloyd said. "So, on some levels that actually was a good thing because some of the clients went after something they didn't think they could get."
Lloyd said that 45 percent of their income comes from fundraising and his work at speaking events which are unavailable right now. Layoffs were initially made to keep finances healthy, but Lloyd is now looking into bring those two individuals back.
“We believe we're in a safe place, but we don't know what tomorrow brings so we're going to continue just to be diligent and be good stewards with the finances that have been blessed to the organization to keep these doors open for individuals to have a chance," Lloyd said.
Recovery home owners said that there is no current fear of closure so they have not delved into possible exit strategies for members.
If closures do occur, some possible outcomes include finding other sober living facilities for individuals, looking for families and friends that would be willing to take in a loved one or, worse case scenario, homelessness.
While there was much instability in the beginning of the pandemic, recovery home members seem to be doing better and adjusting to the "new normal."
"I think that they're all like adjusting pretty well at this point. I also think they think it's going to be over soon so like, there's that hope," McCorkel said.
And while outside interactions are limited, recovery home owners say that many members are getting closer and connecting in this shared experience.
"These homes have gotten a lot tighter, like these guys are working together, and they've gotten to know each other better. Before this, everybody was going in different directions, off to their separate jobs and off with their sponsors or whatever was going on in their lives, going on their overnight visits, and so everybody was just kind of doing their own thing," Hess said.
"It's been kind of a beautiful thing to observe, so like there's good coming out of it too."
Community supports recovery homes
Recovery homes are also receiving support from those in the surrounding community.
"We have an overload of individuals wanting to contribute on some way, and whether that's food, whether that's gift cards, whether that's paper products," Lloyd said.
From organizations like Not One More in York providing hygiene kits, masks and gift cards and to individuals donating food or money, people are stepping up to help the recovery community the best they can.
"I have gotten so many calls just from community members saying, ‘How can I help, like what do they need? Do they need masks, do they need gift cards, do they need coloring books?,’" McCorkel said. "It's really nice to see the community reach out and say like ‘Hey, what do your girls or what do your gentlemen need?"
And these basic necessities are even more critical in this time of instability.
"So people can't focus on recovering from a deadly disease, right, if your basic needs aren't met (like) if you're worried about where you're going to sleep ... if you're going to be hungry," McCorkel said.
Recovery homes provide that stability and are working hard ensure that these individuals have a safe place to live while they're battling the disease of addiction.
“Hopefully we’ll all survive and keep helping people when this is all over," Hess said.
Resources for those struggling with addiction
Pennsylvania Recovery Organizations Alliance has a list of online recovery support resources.
Alcoholics Anonymous has a general service website that they encourage people to use during the COVID-19 pandemic. Some AA groups are taking advantage of ZOOM, Google Hangouts or conference calls to do meeting. They also provide a list of resources like videos and books.
Narcotics Anonymous has issued a statement suggesting that groups temporarily stop common practices like hugging, shaking hands or offering refreshments. They also said that groups can do online meetings, but that is up to each group. Area groups can be found on the na.org website.
The Office of Mental Health and Substance Abuse Services lists these mental health resources in PA.
National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
Nacional de Prevención del Suicidio: 1-888-628-9454
Crisis Text Line: Text "PA" to 741-741
Veteran Crisis Line: 1-800-273-TALK (8255)
Disaster Distress Helpline: 1-800-985-5990
Pennsylvania's Get Help Now hotline is a confidential, 24/7 treatment and information service for those with drug and alcohol problems. The number is 1-800-662-HELP.
Pennsylvania's Department of Human Services has a support and referral helpline those struggling with anxiety and other emotions due to the COVID-19 emergency. To access the toll-free helpline, call 1-855-284-2494. For TTY, dial 724-631-5600.
Information from: The Evening Sun, http://www.eveningsun.com