Until the coronavirus pandemic, their meetings were quiet every day, discreet gatherings in the basements of churches, a guest room at the YMCA, the back of a cafe. But members of Alcoholics Anonymous and other groups of drug addicts found the doors closed quickly this spring to help prevent the spread of Covid-19.
What happened next is one of those creative cascades that the virus indirectly triggered. Rehabilitation went online with zeal almost overnight. Not just thousands of A.A. Meetings that take place on Zoom and other digital hangouts, but other key players in the rehabilitation industry have crept in and turned into a daily ritual that many attribute their lives to be saved.
“AA members I speak with are way beyond their initial fascination with the idea of viewing a screen of Hollywood seats,” said Dr. Lynn Hankes, 84, who has been in recovery for 43 years and with three doctors Florida retirement is decades of addiction treatment. “You thank Zoom for surviving.”
Although online rehab has increased as a stopgap measure, professionals say it is likely to be a staple of substance abuse treatment. The ability to find a meeting that you can log into 24/7 has welcome benefits for people who have no transportation, are sick, have parenting or work issues that make a face-to-face meeting difficult on a particular day and A support network can help them stay in touch with them more seamlessly. Online meetings can also be a good stepping stone for people just starting out in rehab.
“There are so many positives – people don’t have to travel. That saves time,” said Dr. Andrew Saxon, an addiction expert and professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine. “The potential for people who Not having easy access to treatment is a big bonus. “
Todd Holland lives in northern Utah and is wondering about the availability of Narcotics Anonymous virtual meetings around the clock. He recently checked out one in Pakistan that he heard had a good speaker but had problems with delays in the video and understanding the speaker’s accent.
Some participants say the online experience can feel surprisingly intimate.
“You get more of a sense of complete strangers, like a cat jumping on your lap or a child running around in the background,” said a 58-year-old A.A. Early recovery member in Portland, Oregon who refused to provide his name, citing the organization’s recommendations not to seek personal solicitation. In addition, there is no physical logistics for online participation. “You don’t go into a smelly basement and pass smokers and don’t have to drive.”
At the same time, he and others say that they long for the raw intensity of physical presence.
“I really miss hugging people,” he said. “If I can go back to the church on the corner for a meeting for the first time, I will, but I will still be holding meetings online.”
Mr Holland, who abused drugs for decades until Narcotics Anonymous helped him stay sober for eight years, said the online meetings may “lack the feeling of emotion and the way in which the spirits and principles are expressed will”.
It is too early to provide data on the effectiveness of online rehabilitation versus in-person sessions. There has been some recent research that has validated the use of the technology in related treatment areas. like PTSD and depression That suggests hope for the approach, said some experts in the field.
Even those who say personal therapy will remain superior said the development has proven to be of great benefit to many who otherwise would have faced one of the greatest threats to recovery: isolation.
The impact goes well beyond the pandemic. This is because the entire rehabilitation system has been grappling with practices that some consider both dogmatic and ineffective given the high relapse rates.
“It challenges our preconceived concerns about what is needed for treatment and recovery, as well as confirming the need to connect to a peer group and have immediate access,” said Samantha Pauley, national director for virtual services at the Hazelden Betty Ford Foundation. an addiction treatment organization and advocacy with clinics across the country.
In 2019, Hazelden Betty Ford first attempted online group therapy with patients in San Diego who were participating in intensive outpatient sessions (three to four hours per day, three to four hours per week). When the pandemic hit, the organization rolled out the concept in seven states: California, Washington, Minnesota, Florida, New York, Illinois, and Oregon – where Ms. Pauley works – and has since expanded to New Jersey, Missouri, Colorado, and Wisconsin.
Ms. Pauley said 4,300 people have attended such intensive therapy – which means they log into group or one-on-one sessions through a platform called Mend, which is similar to Zoom. Preliminary results, she said, show that treatment is just as effective as face-to-face meetings at reducing food cravings and other symptoms. Another 2,500 people have taken part in self-help groups for family members.
Without Covid, Ms. Pauley said, “creative exploration” of online meetings would still have happened, but much more slowly.
One of the hurdles to intensive online rehab is drug testing of patients who usually give saliva or urine samples under personal supervision. A handful of alternatives have emerged, including one where people spit into a test cup while being watched on-screen by a vendor who verifies the person’s identity. The sample is then handed in or sent to a clinic, although the risk of tricks always remains. In other cases, patients can visit a laboratory for a drug test.
In addition, some clinical signs of obsession cannot be easily diagnosed on a screen.
“You can’t see the sweat that could indicate a slight withdrawal from the person. There are limitations,” said Dr. Christopher Bundy, president of the Federation of State Physician Health Programs, a group of 48 state health programs for physicians who assist physicians He said that hundreds of doctors in these programs attend regular virtual professional monitoring meetings, where they meet with a handful of specialists to get peer support and assess their progress.
“Those kinds of things challenged our assumptions,” he said of the pandemic and the use of the internet for these therapies. “It feels like it’s not the same, but it’s close enough.”
Other drug rehab participants and leaders in the field say that while online was a good stopgap solution, they also hope to see face-to-face meetings returning soon.
“It’s been a mixed blessing,” said David Teater, who wears two hats: He has been in recovery since the 1980s and is the executive director of Ottagan Addictions Recovery, an inpatient and outpatient treatment center for low-income patients in western Michigan Therapy is typically paid for by Medicaid.
In this capacity, online tools were a godsend because they simply made it possible to continue the service. With $ 25,000 in grants, the center received new computers and other technology that enabled it to operate telemedicine and set up a “zoom room”. It includes a 55-inch monitor so that those who zoom in can see the advisor, as well as those who are comfortable enough to come in person and sit at a social distance with masks on.
“We think it works just as well, we really do,” said Teater.