Depression can be fueled by the feeling of loneliness and the inability to see friends and loved ones. If there ever was a time where a person would feel shut off and alone it is now. As the novel coronavirus pandemic afflicts the country, everybody in the nation is feeling the effects. Lockdowns and social distancing enacted due to Covid-19 are having an impact on us all. One part of our population that has felt the effects more than some others are the drug addicted members of our society. The lack of in-person support group meetings (such as Alcoholics Anonymous and Narcotics Anonymous), along with limits imposed on the number of people who can attend the few physical meetings that are even open, have shut off many addicts from much needed resources in their recovery. The disease of addiction thrives on isolation after all.
The coronavirus pandemic is raising rates of relapse amongst substance abusers who were in recovery. This can be seen in the Boston area by the recent influx of addicts to the area of Melnea Cass Boulevard and Massachusetts Avenue, referred to by some as “Methadone Mile”. It is the center of the state of Massachusetts’ current opioid crisis. This is the area of the city of Boston that many struggling with addiction and homelessness flock to for various reasons. Some addicts come here to score drugs and get high. Some come here to find recovery from one of the many clinics and outreach services provided in the area. They all seek relief in some manner or form. It is a place where social distancing is not the norm where they are able to find a community and a deeply needed human connection, however distorted at times it may be.
In this small stretch of Boston, relapse and recovery are a balancing act. It is estimated that nearly half of the addicts on Mass Ave are not from the city of Boston but congregate here. There are many clinics and shelters in this area that bring those with substance use disorders in. The location of the various services as well as the Boston Medical Center has made it ideal for those residing in shelters and sober homes. Addicts seeking recovery need only walk a short distance for all they need. Unfortunately, with many drug addicted people congregating in a small area, it creates room for opportunistic predators in the form of drug dealers. They prey on those struggling with substance abuse. A person actively using, a patient just leaving a methadone clinic, or somebody in recovery departing from a Narcotics Anonymous meeting. It makes no difference to the dealers who shout out what they are holding and ask if people are looking to score. It is a perversion of the economics of “supply and demand”. Those in early recovery are especially vulnerable to those preying on one of our most vulnerable populations.
Those in the streets in the area of Melnea Cass and Mass Ave can be viewed as the forgotten during this pandemic. Due to restrictions stemming from the nations response to the coronavirus, the reduced number of beds available at detoxes, clinical stabilization service (CSS) facilities, and long-term treatment programs caused many in active addiction who could not find help head to the streets. In the early days of the pandemic, many shelters were not accepting new people through their doors. There is social distancing inside the walls of the shelters but outside on the streets it just does not exist for the homeless as they crowd together for warmth during the night.
The hospitals and health care programs across the state enacted elective guidelines and procedures handed down by the state that reduced the available beds by half in some facilities. While this was done as an effort to stem the spread of Covid-19, it had another unintended effect by displacing those seeking help who had nowhere else to turn. Massachusetts officials knew that they needed to take action to prevent the spread of the coronavirus but were also aware that some of the mandated closures of public and private services along with the guidelines that the addict population would be impacted. This is reason that they allowed the liquor stores to remain open. Officials knew that the number of beds for treatment would need to be reduced and the only means to prevent possibly life-threatening alcohol-withdrawals was to have the purchase of alcohol continue to be available. In speaking on how the impact of the coronavirus pandemic as it relates to substance abuse, Dr. Nora Volkow, the director of the Nation Institute on Drug Abuse (NIDA), stated: “Whenever there’s been a catastrophe like this, there is an increase in drug consumption across the board. Our alcohol drinking goes up, smoking goes up, and people relapse”. Dr. Volkow also spoke on using drugs and alcohol as a way people attempt to cope with the stress, fear and uncertainty in this unheralded time. The best of us have a hard time in a world upended by Covid-19 and for those trying to get clean from drugs and alcohol it poses an even greater hardship.
The addicted population already face risks of infection from intravenous drug use with shared needles. With already compromised immune systems, the coronavirus poses a large threat. Covid-19 is a highly contagious and opportunistic infection. It can ravage the respiratory system of a person with a compromised immune system such as an addict with Hepatitis C or HIV infections. Alcoholics are at a greater risk due to the effect that prolonged drinking has on the liver and heart as well. Methamphetamine use causes damage to the heart and lungs. When combined with Covid-19, these issues can cause serious health risks and even death.
Another overlooked populace is that of the mentally ill, who make up a large percentage of the populace of “Methadone Mile”. With restrictions in place, some services are harder to come by and therapists will often meet with clients through virtual chats/meetings such as Telehealth. There are clients dealing with psychiatric issues that find this difficult and struggle with this new means of counseling. Considering that an estimated half of substance abusers have a co-occurring disorder, this only increases the health issues that are plaguing the addict community during the coronavirus pandemic.
But this is not just isolated to the “Mass and Cass” area of Boston. Across the United States, those suffering from a substance use disorder are struggling with isolation caused by the coronavirus. It makes the need for self-care that much more important. Addicts in recovery have virtual support groups found on services such as Zoom. While these virtual meetings may feel unpersonal, for those struggling with substance use it is important to remember to seek help from those in the recovery community.