Clinical Q&A: How COVID-19 Has Impacted Addiction Treatment
To provide a more comprehensive understanding of addiction recovery for National Recovery Month, we spoke with Brenna Gonzales, Clinical Director at The Hope House, a luxury rehab in Scottsdale, Arizona. Brenna is a masters-level clinician with more than a decade of experience in the addiction field.
In our discussion we talk about how COVID-19 has impacted addiction treatment and what that means for those embarking on recovery in 2020.
1. How has COVID impacted day-to-day recovery processes? Has it become more difficult?
Yeah, for sure. I was not expecting to have this many people coming into treatment saying specifically that COVID led them to seeking treatment. So that’s been really surprising. I would say 75% that are coming in right now are specifically citing COVID as a catalyst to seeking treatment.
“I would say 75% that are coming in right now are specifically citing COVID as a catalyst to seeking treatment.”
Every single person that I’m interviewing about ‘Why are you coming into treatment right now?’ is telling me during quarantine they started using more because they were working from home or they lost their jobs. So, everyone is citing quarantine and the pandemic as a reason why their addiction has gotten worse.
Arguably though, it’s been beneficial in the way that they can come to treatment right now because they don’t have anything else to do.
2. Can you expand on how you’ve seen more patients come in citing COVID as a catalyst? What do you think this means?
I just notice that I’m typing in my paperwork a lot that one of their triggers or motivators was COVID-19. And I just wasn’t expecting that so that’s been surprising. It’s been pretty much with almost every client, they’ve mentioned the pandemic in some way.
“It’s been pretty much with almost every client, they’ve mentioned the pandemic in some way.”
I think [COVID] has highlighted the importance of self-care and having a regimen and how that positively impacts recovery — or the lack there of can negatively impact recovery. I think it’s really interesting that being forced to stay at home has thrown people off so much and I think that shows the importance of routine related to recovery.
So many people cite boredom or restlessness as a reason for using so making sure that they’re always doing something for their recovery every day — whether it’s a meeting, or meditation, or an exercise routine — I think structure is so important for recovery.
“Whether it’s a meeting, or meditation, or an exercise routine — I think structure is so important for recovery.”
3. Have you noticed any trends with patients since COVID began?
I would say right now a lot of the professional clients are coming in, so a lot of patients dealing with alcoholism. I think it’s the people who still have a job that stopped going into an office every day. Now being at home, I think depression and social isolation has increased and they’re drinking more.
4. Have there been changes to curriculum at all or the way you present information?
I think with residential treatment it’s a little bit different because the whole point is them being in our house, so you can’t change as much about the treatment as you would like in outpatient.
I know a lot of outpatient facilities are doing virtual Zoom groups or they’re having smaller group sizes. And I know with 12-step fellowships they’re having to turn people away from meetings because they can only have a certain number of people in there.
I think that’s also one of the challenges for us, the aftercare planning is a lot more difficult, we can’t just tell people to go to meetings like they used to because of these restrictions.
5. Do you think virtual meetings are as effective as in-person meetings?
From what I’ve heard from everyone is that no one prefers them, that’s just what I’ve heard from client, though.
6. Have patients’ motivations/behaviors changed at all since COVID began?
Because we’re getting more professional clients with careers that are already established, those clients typically have higher motivation to start with. Meaning, they’re not there because of probation, they’re there because they have a nice job and they want to keep it or they have a family that they need to feed and stay employed for. So, I would say, in that way, the motivation has been a little bit higher.
“You can appear to be functioning when you’re away from people all day.”
Also, I think that being trapped in your house with your family members only highlights what’s not going well. I think it’s easier to pretend or be in denial about if there’s a problem when you leave for work eight hours a day and you appear to be functioning and you can be away from the people that know you best. So, I think being at home in quarantine only brings those problems to light faster.
7. As COVID has progressed, what measures have to be taken during the treatment/recovery process to help ensure safety?
There’s been no outside visitors at all. Whether it’s a tour or family members, we’ve moved all the visitation to virtual, like Facetime visits. Obviously, the staff is wearing masks, we’re having temperature tests every day, we’re also COVID testing every patient before they even walk into the house.
8. How long have you been working in the addiction industry?
I’ve been working in the addiction industry as a therapist since 2011. Before that, I was working as a case manager and other professional roles for 2–3 years. So, over a decade.
9. What first drew you into the addiction industry?
I was working as a case manager with homeless youth at this drop-in center. So, these kids would just come in and take showers and we’d give them food and try and find them housing.
I would get homeless kids into an apartment and they would immediately go back to the street, they would break the rules of the house. There were all these other issues like addiction, and mental health, and cultural considerations.
I realized that the problem wasn’t just getting a homeless person a house. That was the moment when I was like, ‘Oh my god, there’s so many other things they need before they can live a less stressful and more fulfilling life.’
10. Can you describe how seeing patients through the recovery process feels? Do you see this as an accomplishment?
I do. I also feel challenged a lot. It’s a double-edged sword. The way that I view my role and the therapist role is more like a coach or a teacher so that all the successes [patients] have are due to the hard work they put in and then if there’s regression or failure it’s, you know, some part of their treatment is missing.
It’s a hard question to answer because we’re taught to have such good boundaries. If I took every success personally, I’d have to take every failure personally too.
11. Is there one success story that sticks out to you?
Yeah, there’s actually several. There are several clients that, in the beginning, they had such big behavioral issues — they were non-compliant, maybe they were cussing at us, yelling at us. By the end of treatment, they were going to aftercare, were more dedicated to their recovery, and had much more respect for us. There are numerous stories of that where I’m like, ‘Okay, treatment really works.’
I think that’s one of the biggest challenges in working in addiction is seeing people come back, or hearing about overdoses, or hearing about relapses and feeling as though somehow the system or our treatment center maybe failed them. So, when people finally get it, even if it is their 12th time in treatment, it’s that much more rewarding.
12. September is National Recovery Month — Do you think awareness campaigns like these can help those seeking treatment?
For sure, I think one of the biggest challenges for seeking recovery is the stigma. Nobody wants to admit they have an addiction, and most people think they don’t know someone with an addiction. I’d say that like 100% of the people in this country know someone with an addiction — they just don’t know it yet. I think destigmatizing it has been huge.
“I’d say that like 100% of the people in this country know someone with an addiction — they just don’t know it yet.”
This Q&A is part of a series The Hope House is doing to give people a better understanding of addiction treatment and help address the stigma that so many people face.
You learn more about the journey to recovery from a patient’s perspective from our admissions director, Patrick. Read his inspiring story here.
Also, be on the lookout for special article coming toward the end of the month detailing one man’s fight against addiction and how he was able to overcome and be a positive influence for thousands of others.
