Online Treatments, Virtual Check-Ins: Dealing With Addiction In A Pandemic
From NPR and WBZ BOSTON. I'm Jane Clayson. And this is on point. In the midst of the economic pain caused by the coronavirus pandemic there is growing concern that a mental health epidemic is giving rise to an increase in substance abuse and addiction across this country resources for addiction. Recovery have been depleted in towns communities and populations that need them. The most and physical distancing has constrained opportunities for the type of in person care. That's always been an integral part of effective treatment. This hour on point treating substance abuse during the pandemic with me. I from New York City. Dr Lippi Roy. She is a clinical assistant professor at the Nyu School of Medicine with a specialty in addiction treatment. She's also a medical contributor for MSNBC. Dr Welcome to one point. Nice to have you hygiene. I'm so honored to talk to you about this really critical health topic. It sure is important. let's start with the fact. That addiction was a huge concern before the pandemic how his covid nineteen created the the perfect storm with regard to substance abuse in this country. Here absolutely right. Before the pandemic we knew that twenty three of twenty three million Americans with substance use disorder only ten percent access treatment and according to the World Health Organization. Drug addiction is the most stigmatized social problem. Not even a health problem but social problem. Meaning that drug addiction is more stigmatized than poverty. Homelessness incarceration so we have a real uphill battle when it comes to getting access to treatment for people with various substance use disorders. So a lot of factors are putting people at risk right now from massive unemployment to these stay at home orders that have been keeping. Us SAFE IN. A lot of people are teetering on the brink of not only economic but psychological instability. How how does that contribute to addiction and substance abuse issues? I'm so glad you phrased it like that so to follow up on your earlier expression. Perfect Storm Covid. Nineteen pandemic has created an environment where everybody is under even more stress than normal and you mentioned environmental stressors such as unemployment food insecurity domestic violence. All of these issues were certainly stressors before. But now this pandemic has just amplified all of these These issues and we already know that stress. Environmental stressors Traumatizing experiences already. Risk Factors for drug use and addiction So we as a society really need to work harder to make sure that these vulnerable men and women get the care that they need deserve right. Because between the stigma that you mentioned the stigma of addiction And mental illness. For that matter. And the fact that you know you maybe can't pay the rent right now. You've lost your job. You can't buy food. You're struggling in so many areas like balancing act balancing. You called it balancing crystal vase on a high wire. It's such an important moment to have this conversation about addiction and what it means and what it's doing to people. Well you're actually writing and I in the medical profession like I. I'm very blunt when I give talks and lectures I. I was not trained in in doing medical school or during my medical training Everything I'm talking about now has made from on the job training so I am hopeful however that medical schools in students in residents are learning about addiction today than they were say five ten years ago. But this is you know I guess one of the positives of being the OPIOID crisis is it. It's shining a broader light on addiction more generally and if I may just take this moment to explain to the listeners. That addiction is a chronic medical disease of the rain. A relaxing and remitting disease that causes compulsive judge seeking in use to end harm to the person using despite harmful consequences to the person using bills Around him or her. It is not a sign of moral weakness or failure. Right which goes to the stigma that we were speaking of addiction is disproportionately impacting specific populations right now. People of Color Native Americans the homeless women a Leci-. Explain the demographics of this. Dr Roy Yeah. Glad you of freezed at like that. You're absolutely right on the director of night a at the National Institute of Drug Abuse Dr Newroz All cow she has been very open about stating that Certain populations as you pointed out are more vulnerable. In fact she said on her a regular blog called Nora's block. She states that individuals with substance disorder are more likely to experience homelessness or Carson than those in the general population and these circumstances pose unique challenges regarding covid nineteen transmission. A We know already that this particular virus it transmits. It's an infectious in a highly infectious pathogen. That's more likely can transmit person a person when people congregate and places like homeless shelters correctional facilities jails prisons. It's it's very difficult if not impossible to stay isolated and therefore it's you're at higher risk for getting the virus and you're already at increased risk for developing a drug addiction as well beyond those places you know speak to this. This idea that social social isolation is taking a real toll on our vulnerable. Po Vulnerable Population. A common model in the fetal field of addiction is that the opposite of addiction is not sobriety its connection so this time of isolation speak to that critical piece. Dr Roy Yeah when I learned that motto that that common phrase that's used in the addiction field. It's really not sobriety. It's connection in my my my mind just shifted and once. I started working with patients with various various stages of of substances. I really got it. I thought that those in-person Connections Building Trust which is a huge step to decreasing stigma. That's all getting disrupted now with the pandemic we in the public health community are actually telling people know stay home. Don't meet up with people. It's one thing to not do so socially but when it comes to clinical and health matters where people with. Suv addiction relied on meeting their counselors. Their doctors their nurses their care teams. Definitely now this is kkob. Nineteen isolationist is posing unique challenges. And we really need to work even harder to come up with creative solutions to make sure we're not neglecting again are vulnerable on men and women who really rely on medications in counseling to to get better. Let me bring another voice into the conversation now from Minneapolis. Minnesota Dr Joseph Lee. He is the medical director for you services at Hazelton Betty Ford one of the nation's leading addiction treatment organizations Dr Lee. Welcome to appoint nice to have you thank you. Thanks for having us on. He worked at a clinic in In Minnesota one of the largest recovery centers in the country. Give us a sense of what you're seeing right now on the front lines of addiction recovery. Well we see a lot I work with young people and young adults From across the country and we have a full continuum across the country over a number of sites where the largest nonprofit treatment organization in the country. And we're seeing a lot. We see a lot of demand we surging alcohol and other drug use and we see people paralyzed by fear. A lot of family members that I work with on the one hand at home through social distancing they're seeing the horrors and all the glory of their loved ones addiction people rummaging through their entire alcohol supply within a few days loved ones going through withdrawal leaving the house in exposing other people to risk and they. WanNa get help but on the other hand there paralyzed by not wanting to leave the home and possibly getting exposed to cope in nineteen. And so we're trying to communicate a message that there is an onramp to get help. There are various ways to get help. And there's hope and resiliency even in a dark time like this. Are you seeing patients. Dr Lee who are relapsing. Are you seeing more struggling for the first time we see all kinds and it's Incredible how covid nineteen has affected so many different people in different ways People who are pretty strong in their recovery actually have been incredibly resilient because as you Dr Roy have pointed out. Addiction is a disease that exist in isolation and loneliness and our mission is all about love and connection and healing through that and so there are people who've been able to patch together a communities and support who are strong in recovery who understand suffering and loneliness and those people are very admirable in this time but there are a lot of people who are new to recovery and They have to access virtual services or it's hard to get help. There are also people who are maybe on the warning zone for developing a substance use disorder and they relied on their jobs or an exercise. Routine or their social cliques. To kind of stay off a serious addiction and those supports are now falling apart and so we see people who are returning to use. We see people who have developed new use at are recognizing it for the first time we see people who have hidden their addiction for a long time. Due to shame and stigma and their family members are seeing it for the first time and so We're seeing all comers and covert has made it harder for many to access services like yours because so many have been laid off from their jobs right. They've lost their health insurance How do you see this manifesting itself doctor actually while manifest in so many ways and I think the two of you said it while you know one thing I say a lot is that a economic prosperity may not trickle down but suffering certainly does and it does affect certain populations disproportionately for example people? Who NEED MEDICATIONS FOR OPIOID use? Disorder are having a harder time getting it. People who need psychiatric services are having a harder time finding those services we've launched actually last year we started to work on virtual program. We've moved thousands of our patients to a virtual onramp to do intensive outpatient care group individual family treatment But you know we're a larger nonprofit. There are a lot of nonprofits who are struggling with the infrastructure and the platform. The stigma leads to a lack of resources. Both in terms of access and insurance for for people who WanNa get help but also just the infrastructure's net well-supported so people aren't finding a lot of venues to get the help so these times are making it hard for a lot of people in the community and the demand is huge. That man is huge on a lot of people are struggling Dr Joseph Lee In Minneapolis the medical director for you services at Hazelden Betty Ford one of the nation's leading treatment centers for Substance Abuse Addiction. Our other guests. Dr Lippi Roy Clinical Assistant Professor at Nyu School of Medicine Specializing in addiction treatment. Dr Roy Dr. Lee's stick with me Listeners were discussing substance abuse and addiction during the pandemic much more. Calm Jane Clayson. This is on point. We'll be right back WanNa add more positively to your podcast feed checkout kind world stories of extraordinary kindness and compassion. That's kind world. Subscribe now on Apple podcasts. Or wherever you listen. This is on point. I'm Jane Clayson. Were discussing the impact of the coronavirus pandemic on addiction. And how to find help during this period of physical and social distancing with me this hour Dr Lipa Roy clinical associate professor at Nyu the Nyu School of Medicine with a specialty in addiction treatment. Also Dr Joseph Lee Medical Director for Youth Services at Hazelton Betty Ford one of the nation's leading addiction treatment organizations. Let me play this clip from one of our on point listeners. Lisa who identifies as an alcoholic as an addict Has Eleven years sobriety. She left us a message about her experience. Staying sober during the pandemic in cross from other people have been really difficult I don't feel the need to use today. And have a great network of people through zoom but That is not the case for many people right now and one thing that is very difficult for me and I'm sure many of the rest of us is the constant joking at were home now. Let's get drunk in the middle of the day on twitter and on commercials and and it's sort of like was the pandemic joke on everyone's first sight fleeting that it's happy hour all the time at home. Raise your glass on Zoom Dr Roy. Blots jokes lots of twitter jokes Social Media Jugs Right now about you know quarantine knees and zoom happy hours drinking before noon But it's not a joke for a lot of people who are struggling with sobriety who are addicts. Speak to that piece. That cultural piece of this. Dr Roy Yeah I am. You're absolutely right at Jane. This is not a joke at all. This is actually a chronic illness. And as this caller pointed out The the struggle is daily. It's it's sometimes it's hourly and to Dr Lee's point we really do see a spectrum. People are all stages of their of this of this illness. But but I do congratulate this caller on her recovery. But Yeah it's been a lot of people get into side who just don't take this seriously But let me also just point out that vast majority of people who used to drink alcohol dussault recreationally and don't go to develop addiction but for those who do it's a struggle and we do need to take it seriously. I'm glad that Dr Lee brought up alcohol because what we've actually seen is at alcohol. Sales and consumption have substantially increased in most areas of the country during the pandemic and. I anticipate that we're going to find increased alcohol associated with fetal opioid overdoses as well as an increase in detox admissions. Dwi's and other alcohol related complications so we need to really be aware and address these issues. Dr Lee that's a really important point. Alcohol Sales Dramatically during the pandemic in this country is it possible for people who are drinking heavily and consistently During this pandemic develop a problem they didn't have before yes. There are many people in society who are at risk that may actually not develop any disease and that goes for hypertension and diabetes that genetically or otherwise they might be at risk for for whatever reason or simple luck. They don't develop the symptoms that are concerning so there are a lot of at risk warnings on people who have increased their drinking or other drug use and that could be a problem and we know through history that In Economic Downturns in difficult times in our country used as pick up constantly and we know that external triggers like stresses and difficult societal times Often caused a return to us or exponentially higher use. And so we do expect that as this covid nineteen course courses down a little bit. We're going to see an uptick in demand There may be a lot of lives lost and a lot of lives. Destroy- destroyed along the way I just want to also add for caller Just that I just admire so many people who are in recovery right now because if you heard her she also has a mind for feeling other people's cup and so even though she's talking about her distress she's able to empathize with how other people might be struggling with their plight. And NOT GETTING THAT RESILIENT HELP. That's really an important point Lisa thank you very much for your call and Dr Lee you talked about. And Lisa mentioned this. You know the being cut off from people the isolation the loneliness. It's one of the key risk factors triggers for substance abuse. What do you tell people about that? What do you tell your patients Dr? You I yeah you know. When would people should understand that as addiction develops? There's a lot of shame about the Houston. So people start to hide things in their secrets and so even if they're socializing with people they have a secret life in that double life and then who they are? There's a gap between that that really grows and stretches and then finally breaks. That's when usually people get help and I think in her covid. Nineteen pandemic lot of people are experiencing the same thing. They're experiencing similar levels of loneliness a lot of people in their homes and I hope that at the end of this. We don't take for granted. How important connection and how important we are to each other. Because I think we have taken that for granted and it's reflected in our social discourse and all the issues that we talk about these things so vital. A lot of people are trapped in their houses with anxiety and fear. There may be reading the New York Times way too much and wondering. Am I the only person like this? And there are a lot of people who see family members using or they're using themselves and they have no reference point. There's no ability to connect and say yeah me too and so it's so important for people like Lisa to share their story to show that. There's hope I keep hearing the words. Shame stigma shame stigma in this conversation. It such an important point to stop attaching these moral judgments to those who suffer with addiction and often an underlying mental health condition. Dr Roy Substance Abuse is is so often symptom. It's not the underlying problem. You're absolutely right Jane. One of the many lessons I've learned from my learning more about addiction and really from my patients who've just always been my my best. Teachers is that it's all these underlying stressors. In events traumatizing events stressful Difficult circumstances that really are posed there the roots of developing addiction. You know substances such as Alcohol Heroin. Cocaine even behaviors like the devices gambling. They're not the true cause of addiction. It's the events Traumatizing event like Pandemic Unemployment Divorce Hurricanes Abuse Physical Sexual Verbal Dis environments triggers. Dean can lead to people self medicating their pain and suffering. And that's why they sometimes resort to things like alcohol and other substances so but stigma really is a barrier to care Jane and we need to really address. That in one way at all of us can do so as just by our vocabulary studies by people in. Boston suggests rich states Boston medical and John Kelly and read Sarah Wakeman at mass general have shown that when we just change vocabulary and instead of saying drug abuse or substance abuser say a person with a substance use disorder or instead of saying your urine as dirty senior year in its positive studies show that we use less judgmental more compassionate language people are more likely to get care and it improves the therapeutic relationship between clinicians and patients so interesting well. This conversation has touched a nerve with collars round the block here. Let's get I To Janesville Wisconsin Laura's on the line. Hi Laura Welcome to the program. Our y'all today. I wanted to touch base on the OPIOID use. Travel that this country's experiencing I was on Methadone for many years in Baltimore Maryland I was able to get onto a drug called suboxone which has been very helpful for me. I'm very upset that this country is unable to provide those drug essentially free of charge to people. It's been out of study now long enough. I mean And I just it concerns me greatly that That people that are running into financial issues in the span make are now not able to get this job because it is a very expensive drugs. It's expensive and it's hard to get Laura. Thank you so much For that call an stay. Well Dr Lee speak to that point these drugs that are so helpful to those who are struggling. Not only did they cost a lot but you can't get them especially now that's right. It's downstream problem. Also rooted in stigma. Stigma isn't just about personal shame or judgment from other people or your friends. Stigma has to do with resources and infrastructure. If you walk into a beautiful hospital and you want to get care for mental health or addiction issues for your loved one and you walk into this beautiful hospital and beautiful building and you ask for Mental Health Addiction Services. You're going to get sent to the Bat Back Annex. And that's what most people in America experiences that or the basement right. That's right that what they suffer with is a second class disease for a second class citizens right and when you have that kind of infrastructure as we're all vigilant about Kovic and we're planning around what to do for this emergency and that people with addiction and mental health issues fall through the cracks and so the callers absolutely correct. We have to do more to make it easier for people to access these medications and other routes for Recovery Dr Roy so. I'm so glad that Laura brought up this important point. I will stay that I. I'm hopeful that now. Because of the pandemic federal agencies have actually loosened some restrictions which were always archaic to begin with so samsa substance abuse and mental health services. Administration now allows patients to take home treatment courses. Have Methadone for two weeks or longer and rather than making them go every single day to again to Dr Lee's point at the fact that we have Methadone treatment problems where people have to go. We don't make people go every day to pick up their insulin for their diabetes. So why are we doing this for over use disorder and the DA has also allowed for a federal rules have loosened in that they do not require an in-person consultation to initiate Buprenorphine suboxone. That's again movement in the right direction. I mean upbringing. Another voice in here from New York City. Mj GOTTLIEB he's cofounder of Lucet. An APP created to help anyone in need of resources in community to navigate addiction and substance abuse. Mj Ali Welcome to point. Thanks so much for having me so eight years sober. Congratulations I t t your mind. has the coronavirus created new challenges to two attics and new challenges to staying sober one hundred percent. You know when we enter early recovery. The one thing that we say not to do is to ever sell self isolate and here we are so you know. There's a saying those amongst us. No explanation is necessary. Those not amongst us no explanation as possible. The challenges within the addiction community right now self-isolation is just astronomical right now and so to that point you have created an APP which is especially useful now. The APP called Lucid L. O. D. Tell us what you were trying to accomplish in how it's being helpful right now. Well you you hit it right on the head when you said kind of. The opposite of addiction is connection. It's all about connection and engagement and knowing that you're not alone so what we've seen since. Kobe is a dramatic increase in specific sections of the APP That catered to our hotlines and groups I think it was one thousand nine hundred and seventy percent increase in the first three weeks because people suddenly weren't able to have that connection so they had to move virtual now you could go to twelve step groups which. I'm a huge advocate for. But you can only go to so many per day so we have over a thousand routes within Lou said whether it's Sobriety anxiety and depression or daily gratitude or hotlines I'm having a bad day just relapse and need advice and meaningful conversations can happen and it's just so important to have that connection engagement. Show people that they are not alone. So thousand different groups on Lucid MJ GOTTLIEB. And as I understand it. Hospitality workers especially came to your APP in large numbers after restaurants closed by the hundreds by the thousands of people lost their jobs. So there was a direct correlation. You can see it. Mj right away right away so very sadly hospitality being hit I. We saw people coming into the hotlines. Unfortunately looking to Overdose and kind of put themselves out of their pain and it was. And so you here you had this about sixty three thousand people on the APP coming in when someone would share. Hey you know I just I don't know what to do. I can't take it and then people would jump in and say. Hey I understand. I lost my job to. Here's what I'm doing and so it's all about you know surrounding yourself with a community who gets it and has that identification because Also in the hospitality industry. You know the the addiction rate is so high that they were going into a lot of the treatment centers and the treatment centers. Didn't know whether or not people were coming in. Because they were dope sick or they had corona so there was a bit of a bottle neck there. So it's been a very very big challenge. So are these technology tools as effective. Mj Are they as effective treatment. Options for for staying sober for recovery treatment as in person as sitting in a meeting as being in a treatment center vay are Let me tell you why I think they're complementary but in my eight plus years of sobriety. What high found is when you relapse when you feel like using Nine Times out of ten the EGO gets in your way and you don't WanNa call your sponsor. Do you don't want to call your friends. You don't WanNa call your network because you're ashamed. We talked about shame right and we need to kill that stigma. And so what you're able to do is you're able to tap into a group of you know Dow's tens of thousands of people who don't know you but they understand exactly what you're going through and you're saying hey I just relapsed and there's no judgment because you're not into being afraid that your friend or your family member or your sponsor or member of your group in a twelve step fellowship is GonNa Judgy Open So yeah unfortunately. That's the case. I'm Jay last question. What do you want people listening to know about the struggles of addiction especially during this time of pandemic? Let's we may be physically distance right now by you are not alone. the The level of connection is there you just need to reach out and find it used virtual communities. We have virtual events that you can attend in the APP. There's incredible things that people are doing. We bring anything and everything that we can for people that are doing things in the sober sobriety and wellness space into our APP to give things you know people things to do and to connect and engage and one other thing is service keeps you sober so one great thing is go. Call your friend who may be struggling. Call Your aunt your grandmother your mother. Someone that may be vulnerable to cove Ed and reach out and you know show service keeps you sober and Jake gottlieb eight years sober and Co founder of Lucid. An APP created to help anyone seeking help for addiction and substance abuse. Mj great work. Thank you so much. Thank you very much Dr Roy. Dr Lee's stick with me listeners. Were discussing the treatment options and resources available for Substance Abuse and addiction during the pandemic and Jane Clayson. This is on point. We'll be right back. Need to escape the news for a moment checkout endless thread a podcast from wb you are and read it from mysteries to histories two stories that will remind you of our shared humanity. Subscribe to endless thread on Apple podcasts. Or wherever you listen. This is on point. I'm Jane Clayson on Monday on point. We're discussing the historical forces behind George Floyd's killing by the police in Minneapolis. What conversations are you having around these incidents in your house holder in your community would love to hear your story one eight one six one seven three five three zero six eight three and we'd love to hear from you today. We continue our conversation about substance abuse and addiction during the pandemic and how this period could be an opportunity to improve long-term care for those struggling with us. Dr Roy Clinical Assistant Professor at the Nyu School of Medicine with a specialty in addiction treatment. And Dr Joseph Lee Medical Director for Youth Services at Hazelden Betty Ford one of the nation's leading addiction treatment organizations. Let's go to the phones. Chris's in Glencoe Oklahoma. Hi Chris Welcome to appoint hello. I just had a comment. I wanted to point out I don't feel being an alcoholic Recovery now for nineteen years makes me a victim. I know by using the tools of the program. I think I'm in a lot better shape and I think that Relying on medication and lots of meetings and frequent contact is very helpful. You know for six months a year. Maybe even up to two or three years in the program but for but individuals sooner or later all of us addicts alcoholics. We need to Start getting some emotional and spiritual tools to life on life terms and if we do that You know two years. After they came out diverse book on twelve step programs our country went to a war and and we found that you know. Alcoholics were did at least as well as any other group and combat and they were white from meetings for a long period of time. So if we if we reach out to people if we do our own personal step work at home if we if we pray and meditate and stay in service Take life on life's terms. We're going to be just fine. Thank you so much for the call. Dr Lemme turn Chris's point to you. There's Chris cleaned nineteen years. You've said people who are early in recovery. Maybe have a harder time connecting with the care that they need during Cova. Those in recovery. Longer like Chris Maybe navigate perhaps a bit easier. Is that right Don Dailey. That's absolutely right. There are people who are new to connecting in that kind of way in a personal way getting the spirit of volunteerism community empathy. And they're just learning the language and so for them sometimes. Virtual interface is good. It's certainly better than nothing and it's definitely going to be here to stay. It's a good thing for consumers and patients but it can be hard however I think the positive point is that people like Chris a beautiful in their recovery. Mj sharing their story in a Pre Cova Times. I'd give him Jane Chris a fist bump and a hug if they'd let me because what you hear over and over again is they're not victims people who are in recovery for a long time. They're part of the solution. They are willing to give it forward. It's like a big circle. Dave experienced suffering and loneliness. They've been steeled by their experiences and they WANNA give back and love the community. And that's what you hear over and over again and I hear that in Chris testimony and what. Mj's doing for the community and that's what recovery's about when we say he's in Betty. Ford Love Connection Empathy being humble passing on the gift of grace to other people. It's not hyperbole. It's something that we really try to live up to and that's what so many people are doing in. Mj Gut leaves apparatus going there and trying to support others. Not just going because you need help. But go in there to to to support others and I'm curious about These APPs about telemedicine about about that. During this time of social and physical distancing many state medical boards have loosened restrictions on telemedicine during this pandemic. Talk about that. Is this an effective option for addiction? Recovery Dr Roy. Yes absolutely of but let me just quickly add to that Collar Chris. First of all congratulations on his long term recovery. But just as I don't look at my patients with congestive heart failure and Lupus and kidney disease as victims nor do I look at people with addiction as victims. Either they have an illness which they are getting treatment for and that's how it should be viewed. That's another way to reduce the stigma and to integrate it in mental healthcare into general medical care. Primary Care And right now in the in the era of Kobe end quote unquote isolation. We really need to utilize a telemedicine. Tele Psych Services But that also means making sure. That patients clients Have access to ipads in telephones and on the other on the provider side. We also need to make sure that insures including state Medicaid programs reimbursed clinicians for telehealth and telephonic services. The same way they did for in person visits telehealth telemedicine Dr Lee Effective Treatments Especially during pandemic absolutely. It's a great on ramp for people. There's so many cultural variables that change you. Know How like when we learned about the rules of social media and how it influenced people's behaviors Virtual care is here to stay and that's a win for America because there are a lot of people who don't have transportation who are rural areas. I see a lot of young people. I never thought I'd be the old guy who didn't know how to use technology but these young people are so good at it and I work in brick and mortar. I see really acute sick patients on a residential side in person with our nurses psychologists and other doctors but I also do virtual care and there are introverted. Shy anxious people who feel tremendously empowered. Actually by the virtual experience. Now I'll say as a clinician. I like to read all the body language and the micro expressions because I'm a child psychiatrist and that's what I do and so for me. It's a little bit different than the virtual care from the patient side. I hear some empowerment day like a little bit of a barrier in their pajamas and the comfort. They're living room. They're much more assertive. Because we take for granted. Also related to shame and stigma. How difficult it is for some people to come to somebody's office. Meet with Dr Clinician. That can be very intimidating and those thresholds have been lowered so there's all these winds along with the tragedy that I think virtual care will help with our recovery. Go Platform is privacy. Law compliant were not doing zoom or skype But a lot of other places could use help in that infrastructure both for on the reimbursement side but to get it launched as they're underfunded a lot of clinics have to rely on zoom skype and other things because they don't have the infrastructure to build the privacy compliance services people desperately need right many treatment centers Dr Lee Across his country are at a disadvantage this period because they're already under resource they're already underfunded and less able to adapt and sort of pivot to this crisis moment right absolutely. They're already under resource to start with. They can't find mental health professionals to work there. The talent pool the resources. They're under fire. All the time and I work in the nonprofit sector so I understand this very well and so when something like Kovic hits their underwater far more than other people and so you talk about p. even for example you know people in a treatment setting hospitals are having a hard time getting P P imagine what. Treatment centers are going through to try to screen and keep people safe. It's really hard back to the phones. Stephanie in Kingsborough Massachusetts Hi Stephanie. Welcome to the program. Hello thank you so much. Thank you go ahead. I had called Just in response to the last caller Chris I believe and You know he'd been talking about trying to find that spiritual connection and you know my comment was especially during this pandemic being outside for me and to connect to fix something other than me and get out of my own head has been probably the biggest health and think we've been nice though So you know and I did end up Having a little bit of a relapse during this epidemic. And it's been it's been difficult but that's the nice weather has started You know that's been helpful. And you know so. I think if anyone can connect spirituality or whether that is just going outside and connecting with something that is beyond you bigger than you. I think. That's helpful Stephanie. Thank you good luck to you. Dr Roy what are you say to Stephanie? Well thank you Stephanie. For calling and sharing that I a common motto actually amongst the harm reduction community is meet people where they're at so when I find meet people like Stephanie or other patients or clients asked what do you enjoy what would what brings you calm It could be going outside going for a run. It could be going to your favorite pizza place which may not be an option now. But it's about meeting people where they're at asking them. What can I do for you? You know giving back. What's you know patient autonomy and kind of working as a team? Unfortunately the field of medicine is can be a little hierarchical. You know. I'm the doctor. You're the patient you need to do what I say. But that that type of philosophy isn't effective So listening to patients in what they need and helping them get get to that point especially now in this Pandemic era when we just need to be more creative and innovative. Here's a listener from Saddle Borough Vermont Who told us she wants to remain anonymous but she left us a message describing her struggle with Polonia disorder with bulimia disorder during the pandemic. Here she is being isolated in quarantine has in many ways than I really terrible experience because the loss of my daily structure of work of exercise and Seeing my partner since I'm isolated without him has really made it much harder to Manage a disorder that I've been able to manage in the past without it taking over my life Dr Lee another important Point about the loss of structure and routine for anyone who struggling with addiction or a behavior disorder. Actually that's right. It's exactly what we talked about. And what you find with Hypertension is that it often comes along with high cholesterol and so a lot of diseases coming together and believe it or not addiction and mental health issues come together sometimes have similar sources and so a lot of people who struggle with mental health issues are eating issues struggle with addiction and vice versa and And these are the people who fall through the cracks when they're structure their support steamed seems to fall apart. They have a harder and harder time as I want to thank the caller for sharing their story because what it does for people is there are other people who are alone and trapped in their houses and in their minds wondering is this struggle mind to bear alone and it isn't and even Stephanie who called in. It was a beautiful and resilient message because what? She's basically saying I heard from her is. There's no shame in return to us. You just get back on track. There's a lot of love and connection for you. That's right back to Beth in Ellicott city Maryland. Hi Beth you're on the air. Hello I I really have enjoyed the show today and Dr Lee. I could really relate to what you said about the secret life. I had one of those I'm in recovery. Fourteen years from the disease of alcoholism and Started a nonprofit here in Alex city called so bar. It's a play on the words sober and bar and one of the things that we do in taking non alcoholic bars to public social events and creating alcohol. Free events is to try to break that cycle of shame and stigma So many times like when I would be early and not drinking people would say to me when I wouldn't take a drink of alcohol. They say what's wrong with you and that's like the it's like a that's part of what's going on in our society people are almost shaming you for not drinking so. I really appreciated the show today and Word trying to find creative ways to do our work during the pandemic selling so far in a box and creating virtual happy hours alcohol-free thank you thank you very much for the call really important what. Beth and others are doing doctor. Roy Dr Lee. You have said both we should not let this pandemic go to waste that. This is a golden opportunity to actually make some some changes. What do you mean by that actor Roy? You're absolutely right You know there's nothing like a pandemic to expose the existing cracks in the US healthcare system. We've already talked about a few of the areas. Such as some the rather archaic laws and policies which now federal agencies are are are loosening restrictions for access to medications. So that's one another one is really really utilizing telemedicine virtual care. I love the line that Dr Lee said which is virtual cares here to save. He's absolutely right and really using this opportunity to connect in ways that are creative of that are innovative and for for all of the different parties from policy makers to healthcare providers the social services housing criminal justice. All of us really need to come together to get people the care that they need and deserve. I think this pandemic is showing that Dr. Are there permanent changes to regulations that have been temporarily suspended by by the Drug Enforcement Administration? That that you suggest at this time. Yeah I think making it easier for people to access medications opening up services in greater access so that people can get help making sure that insurers and other people are accountable to parody that that they really offer the same level of services that if somebody didn't take care themselves in at heart disease they go beautiful hospital and they get taken care of really well but you know if you have an addiction in your genetic loading and you had a lot of adversity and trauma and you go to an Er. You're given the stink eye and that's not right and I think culturally speaking. There's tremendous optimism for change in my heart. Because I know there's a lot of tragedy but we've had a lot of in America and I think we've come out better for it. I think we know pre-coded what the issues are Economic disparities racism lack of parody and treatment. We know what the issues are but I hope the how changes and I think people in recovery are leading the way because willing to give back and showing again I keep using the word love but it keeps showing it with love and empathy had a guide people through this so that we don't take each other for granted each other's narratives that we walk individual lives in that we heal together not just as the recovery community but as a society and I hope that something that we never lose from the code pandemic and wouldn't it be nice if the medical conversation about the pandemic could broaden out to a mental health discussion and by extension addiction in this country. Doctor Roy. You're actually right. Jane know I think the only way to move the needle forward When it comes to Both addiction and mental health care is through science and storytelling provide the most updated data in research and science. But also have people like j like Stephanie. Chris all your callers. Share their stories of recovery resilience return to use a relapse is expected. That's okay but we need to share those stories. Sharing Stories is the most important thing to do the only way Dr Lee. I'll give you the last word here in our last minute To remember about this conversation about Substance Abuse About addiction during this time during this pandemic and moving forward you know. It's not lost on me that today. It's a very tragic time for Minneapolis with the with the killing Mr Floyd and everything that's going on and that added on top of Kogo Nineteen people struggling with addiction or mental health issues. My heart goes out to you. I have such love for the recovery community and my message is basically that. We're GONNA come out better for this. I think because covid nineteen can affect everyone. There's the potential for us to have greater empathy for each other's journey and to really start taking care of each other and I think there was something that was fractured in our social dialogue prior to Kobe. And I hope we fix it. I hope we do things with greater love and empathy for each other beautifully said Dr Joseph Lee Medical Director for you services at Hazelton. Betty Ford. Thank you so much for your time today. Dr Louis. Thank you Dr Roy. A clinical assistant professor at the Nyu School of Medicine with a specialty in addiction treatment. I appreciate so much your words Dr Roy. Thank you for being here with us today. It's been a pleasure. Jane thank you and listeners. Thanks to you for your calls for your input for your stories. Thanks for listening. Continued the conversation. Get the endpoint podcast at our website. On Point Radio DOT ORG. Follow us on twitter. Find US on facebook at on point. Radio had good week and Jane Clayson. This is on point.