Perspectives on Recovery Month from Community Voices

Perspectives on Recovery Month from Community Voices

Dr. Robert Coker, Medical Director, Hudson Behavioral Health

Last week I had the opportunity to join a professional panel gathered for Recovery Month at the Salisbury Area Chamber of Commerce’s General Membership Luncheon. Participants came from several different perspectives within the community, and each seemed to honestly share a feeling of compassion for those in recovery, especially those with mental health challenges.

You may not be aware that 35% of addicts have unaddressed mental health issues. We see these as co-occurring conditions that can spur addiction and/or trap people in it. These are often the people least receptive to recovery programs and most susceptible to homelessness and other challenges.

All participants agreed that during COVID-19, the challenges for addiction have risen greatly. In my role on the panel I spoke about our efforts to remain open, even when other programs could not. People already in the program when COVID hit formed their own “bubble” and were allowed to stay until they completed their programs. (Many of them are completing their stay at our Recovery houses now, working and ready to go back out into the community.)

I spoke about how we have had to be creative because so many people still need treatment. As testing has improved, we have been able to add more patients, but we still have a waiting list. We have been creating “cohorts” within our main campus program, where people can safely wait to find out their test results while they go through detox. We have begun asking referrers to test patients before they send them to us, if at all possible.

 Some restrictions on how people can be prescribed medications to treat opiate addiction like suboxone and methadone have eased, allowing patients to see their doctor in person or by remote, which has helped us bring more patients into the program, and to graduate them safely. Our ability to provide mental health care within the residential programs has benefited many greatly. In fact, for many, coming to treatment was the first time they had been accurately diagnosed and treated for their mental health issues.

We do worry about relapse. For many, it is very hard to be committed to recovery if they cannot see their support team in person. Many are uncomfortable with video chat for therapy, doctors’ appointments and group meetings. We are working hard to make their sobriety maintainable. We have the only seven-month program on the Shore, and that definitely helps.

Lori Brewster, Health Officer for both Wicomico and Somerset Counties, noted that the region was doing well pre-COVID, with overdoses and death by overdose trending down. Now we are seeing an “uptick” in both across the counties.

She said that the Community Outreach Addictions Team created by Wicomico County – which is now a model for other health departments across the county – sees these patients firsthand as members respond to overdose cases at hospitals and in the community. Before COVID they were doing ride-along drives with the Sherriff’s Department, which she hopes to resume soon. She believes that catching people at the right moment with the right information can prevent future overdoses. Their Safe Station at the Recovery Resource Center is available 24/7, even now.

And these are by far not the only issues the community is facing. Wicomico States Attorney Jamie Dykes talked about the rise of domestic abuse cases – often committed by people who had no previous history. It seems that COVID has created a breaking point for some people who are suffering from depression, worry, despair, fear and a kind of “emotional claustrophobia” from having to remain isolated with their spouse, partner, and/or children for such long periods of time.  She also referenced that the courts are extremely backlogged as jury trials have been extremely limited. She hopes that the use of the Wicomico Youth and Civic Center for jury selection (which will begin soon) will help speed the process along safely – and she appealed for anyone who receives a letter for jury duty to comply so the wheels of justice will turn more quickly.

Wicomico County Sheriff Mike Lewis spoke about the rise in burglaries and breaking-and-entering arrests, and about the challenge landlords – many of whom have not been paid rent for six or more months – face due to the suspension of eviction procedures. No one, he noted, wants to see people out on the street. There are, however, significant repercussions for landlords who will lose their properties if they cannot make their mortgages.

He also spoke about a problem we don’t hear much about in addiction dialogue but is critical: getting dealers off the street. The Department’s Community Action Team works daily to get drugs out of the hands of dealers. Just last week they broke up a significant heroin ring.

Mrs. Brewster commended her team of employees who have been running testing sites twice a week, including the biggest testing event in the state – a two-day drive-through at Perdue Stadium that served 2,500 people. She noted that the departments get five-to-ten tips per day about businesses that are not complying with health department requirements.

And by the way: I must give credit to UMES and the work they did to keep us safe and comfortable. From screening at the door to socially distanced tables and chairs, from excellent pre-boxed lunches to pre-packaged dessert from their Culinary students (who are working on this jarred dessert project as a potential saleable product), the experience was excellent. 

Dr. Robert Coker is an internist with admitting and consulting privileges at Peninsula Regional Medical Center in Salisbury, Maryland, where he served as Chief of the Department of Medicine from 2005-2007. Dr. Coker is Board Certified in Internal Medicine and is a Diplomate of the American Board of Addiction Medicine (DABAM). He is licensed to practice medicine in both Maryland and New Jersey.