When the pandemic shut down the country in March, many were shuttered inside their homes, unable to work, and unable to spend time in person with their family and friends. For those with substance use disorder (SUD) and in recovery, it’s been especially difficult.
“We found that the people who were periodically relapsing were relapsing more frequently,” Robert Cropper, a recovery coach and supervisor with Martha’s Vineyard Community Services (MVCS), said. “It just increased dramatically.”
Martha’s Vineyard has seen an increase in relapses and overdoses throughout the coronavirus pandemic, as people with SUD are more isolated.
Cropper has been a recovery coach for four years, guiding and supporting people with SUD through recovery. He received his training on the Island, and is now the MVCS recovery coach supervisor. He’s lived on the Island for the past 30 years, and got sober in 1990. He’s been a baker for the Black Dog, a retail store manager, and a life coach — the job that would lead him to recovery coaching.
Cropper said in April he was fearful that people trying to stay sober would struggle. In May, Cropper said the recovery community began to see more relapses when many people had extra time on their hands, were at home, and, for some, not working. The number of calls from family members seeking help for another family member also increased “dramatically” during May, June, and July.
“I think originally it was like everyone was at home, which is not a good place for alcoholics to be,” Cropper said. “I think it was sort of novel at the beginning, people were sort of like, ‘Oh, I can do this,’ and by mid-May, it was definitely a problem.”
Before the coronavirus pandemic began, Cropper said MVCS fluctuated between 30 and 40 clients at a time — in June, the program was up to 70 clients.
Brian Morris, Island Health Care’s mental health and substance use disorder access coordinator, said this summer he sent 18 people to detox in July, and 21 to detox in August — compared with four in July and five in August 2019.
“That’s a precipitous spike, and that’s problematic,” Morris said. “People are disconnecting, people are dropping out to their own rhythms, and often resorting to default mechanisms, such as compulsively doing what they’re obsessively driven to do, which is drink and drug.”
The silver lining is that IHC now has five community health workers, four of whom are peer recovery coaches. Morris also recently trained three coaches who speak Portuguese, expanding IHC’s reach into the Island community.
“I think recovery coaches — I know at [IHC] and I’m sure the same can be said for [MVCS] — are busier than they ever have been,” Morris said.
Charles Silberstein, a local psychiatrist and the medical director for the MVCS Island Counseling Center, said there are people who refer to addiction as “ritualized compulsive comfort-seeking” which is the idea that those who grow up in a traumatic world will go through life seeking comfort, and if that comfort-seeking starts early, and with drugs, it’s the natural go-to.
“A cornerstone of recovery is finding new tools to comfort yourself with,” Silberstein said. Those new tools include being with others, 12-step meetings, family, and love. “All of those things have been interfered with by the pandemic, so people are more isolated, more alone, more disconnected from other people than ever before.”
It’s not just people with substance use disorder (SUD), but also people struggling with mental illness, which Cropper referred to as a double diagnosis: “[They’re] tougher cases. It’s just really getting to people, it’s really affecting them. I’ve seen more of those cases in July, August, and September.”
One of the most important parts of recovery coaching is meeting clients “where they’re at.” Recovery coaches work with clients to develop a wellness plan. Clients tell their coaches what their needs are, and create realistic goals.
Normally, coaches meet with clients in person. Since the pandemic hit, recovery coaching has been via phone calls and Zoom, which Cropper said works for some more than others. Some of Cropper’s clients have even excelled.
“It’s really good to be able to see them and sort of gauge what state they’re in,” Cropper said of the coachees. Toward the beginning of summer, recovery coaches started meeting with their clients by taking socially distanced walks in the woods or on the beach, and keeping masks on.
“It started making a difference being able to have contact, because we can tell them to get out of the house, but we can actually encourage them to get out of the house by meeting them somewhere outside the house,” Cropper said. “We just had to start thinking outside the box, how are we going to do this, we need to get these people engaged.”
Morris said the vast majority of his work has been done through digital platforms, which has required him and other coaches to be creative. “There’s an art to it,” Morris said. “It’s not hugging, it’s not meeting for a coffee at Mocha Mott’s and going to a meeting together. It’s an entirely different dynamic at work, but the same thing holds true. We’re talking about inclusion, humility, and open-mindedness.”
Someone currently using alcohol or drugs and who is physically unwell should go to the Martha’s Vineyard Hospital and be evaluated. Hospital CEO Denise Schepici said the hospital’s SUD team is available 24/7, and can discuss treatment plans, referrals, and placement in treatment programs.
Speaking to reporters during a conference call Wednesday, Schepici said she was worried about the coming winter months. “We’ve seen a leveling of some of the opioid numbers year over year, but we’re really worried about the behavioral health and mental health issues that could exacerbate that, considering the isolation,” Schepici said.
She encouraged people to reach out to the hospital and seek help if they need it. Dr. Karen Casper and Diane McKeller, the hospital’s substance use disorder counselor, were two of the hospital’s staff Schepici highlighted and thanked.
The Martha’s Vineyard Hospital SUD team can contact MVCS or Island Health Care, if needed, for recovery coach training.
In an email to The Times, Casper said the hospital has seen fewer ambulance calls for overdoses this year from January through July, totaling five, with no deaths. Last year during the same period, ambulance calls included nine overdoses, including two deaths in July. “From my perspective, many people have naloxone which is a good thing,” Casper wrote. Naloxone, also known as Narcan, is the medication that can quickly counteract the life-threatening effects of heroin or opioid overdose.
She added there has been an uptick in patients requesting help with opioid use disorders in the hospital’s emergency department, and seeking help from primary care teams for medication. “Subjectively, I can say COVID has contributed to higher levels of use and more isolation,” Casper wrote. “We like to increase the circle of people around someone who’s struggling, because that connection is what gets them through.”
MVCS offers an array of services to help those struggling with substance use disorder, such as Suboxone treatment, off-Island detox programs, and socially distanced recovery support groups at their main campus. Cropper said another difficulty during the pandemic has been the scarcity of available beds for detox treatment off-Island. “There’s just more stress in southeastern Massachusetts, so a lot of the detox facilities have been full,” Cropper said.
MVCS does have a memorandum of understanding (MOU) with Gosnold that allows Island clients to be put at the top of the list for detox beds.
“With recovery coaching, the biggest thing is we’re dealing with people, like myself a long time ago, who have pretty much alienated most of the people in their lives — their parents, their friends, their employers — and a recovery coach is the person who can actually be there to listen to them, and for the first time in a while, it can be the first time someone listens to them and their problems,” Cropper said. “That connection can be a lifesaver.”
One of the places to connect that is now available is the Peer Recovery Support Center. Located at the Red House next to the Martha’s Vineyard Hospital, the support center is run by Martha’s Vineyard Community Services, and provides a safe space for those seeking help with drug and alcohol addiction. It allows people to get support from peers, get help pursuing education or employment, and utilize a number of other programs.
Opened in February, the facility was closed down during the pandemic, but reopened in August after getting the go-ahead from the state.
Program director Jeremy Norton said the support center is able to host 10 people at a time, including staff, under state guidelines.
Norton said the Island community has suffered during the pandemic with a number of relapses, overdoses, and some deaths.
Kelly McCarron, the program coordinator for the support center, told The Times there will be a vigil event at Red House on Tuesday, Sept. 29, at 5 pm, in honor of National Recovery Month. The event will also be streamed online via Facebook Live. Those who attend in person can decorate a luminaria bag, and those who want to dedicate a bag to someone can contact McCarron at firstname.lastname@example.org.
Another service available through MVCS is the New Paths Outpatient Recovery Program, a structured outpatient addiction program, run by Kathy Burns Powers, that offers support for substance use and mental health disorders.
On the outreach front, the Island’s Substance Use Disorder Coalition has been working on a public health campaign aimed at moving the Vineyard away from a culture where drugs and alcohol are taught to adolescents early on, to a culture where there’s more caution. Silberstein has been heavily involved with the campaign, which looks at how and why substances are used on the Island.
“If you don’t engage in substance use until your early 20s, your chance of developing a substance use problem is almost zero,” Silberstein said. “Our vision is to see if we can influence the culture of the Island so that the use is delayed, and people use fewer drugs and have other tools of comforting themselves.”
With winter right around the corner, people spending more time inside, and the pandemic still keeping many people from work, there’s apprehension in the recovery community that things could get worse.
Speaking for himself, Silberstein said he’s talked with his clients about the coming months. “Being aware of the risks minimizes them,” Silberstein said. “We talk a lot about finding ways of finding comfort, and predicate [that] the winter is going to be hard. I think it’s going to be a tough time for a lot of people.”
A list of resources for those seeking help can be found on the Coalition’s website.