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Until the coronavirus pandemic, their meetings took place quietly, every day, discreet gatherings in the basements of churches, a guest room at the YMCA, at the back of a cafe. But members of Alcoholics Anonymous and other recovering drug addiction groups found the doors quickly closed this spring, to prevent the spread of Covid-19.
What happened next is one of those creative stunts that the virus indirectly set off. Rehabilitation has moved online, almost overnight, zealously. Not only are thousands of AA meetings taking place on Zoom and other digital hangouts, other major players in the rehabilitation industry have stepped up, transforming a daily ritual many attribute to their rescue.
“The AA members I speak to go far beyond the initial fascination with the idea that they are looking at a screen of Hollywood squares,” said Dr. Lynn Hankes, 84, 43-year-old recovering and medical practitioner. retired in Florida. with three decades of experience in drug treatment. “They thank Zoom for their survival.”
Although online rehabilitation has increased as an emergency stopgap measure, people on the ground say it will likely become a permanent part of how addiction is treated. Being able to find a meeting to connect to 24/7 has welcome benefits for people who lack transportation, are sick, juggle parenting or work challenges that make an in-person meeting difficult an given day and can help them stay connected more seamlessly than a support network. Online meetings can also be a great stepping stone for people just starting out in rehab.
“There are so many positives – people don’t have to travel. It saves time, ”said Dr. Andrew Saxon, 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 wouldn’t have easy access to treatment to get it is a big bonus.”
Todd Holland lives in northern Utah and marvels at the availability of 24-hour Narcotics Anonymous virtual meetings. He recently checked out one in Pakistan which he said had a good speaker, but had some difficulty. hard to delay the video and understand the speaker’s accent.
Some participants say that the online experience can have a surprisingly intimate feel.
“You feel strangers more, like when a cat jumps onto their lap or a child can run around in the background,” said a 58-year-old AA member in early recovery from Portland, Ore., Who refused. to give their name, citing the organization’s recommendations not to seek personal advertising. Moreover, he added, there is no physical logistics to participate online. “You don’t go into a smelly basement and walk past smokers and you don’t have to drive.”
At the same time, he and others say they crave the raw intensity of physical presence.
“I really miss the hugs,” he said. “The first time I can go back to the local church for a meeting, I will, but I will still do online meetings.”
Mr Holland, who abused drugs for decades until Narcotics Anonymous helped him stay sober for eight years, said online meetings can “lack a sense of emotion and the way that minds and principles are expressed.
It is too early to obtain data on the effectiveness of rehabilitation online compared to in-person sessions. There has been recent research validating the use of the technology for related treatment areas, such as PTSD and depression, which suggests hope for the approach, some experts in the field have said.
Even those who say in-person therapy will remain superior have also said that development has proven to be a huge benefit for many people who otherwise would have faced one of the biggest threats to recovery: isolation.
The implications go far beyond the pandemic. This is because the entire rehabilitation system has been grappling for years with practices that some consider both dogmatic and insufficiently effective given the high rates of relapse.
“This challenges our preconceived concerns about what is needed for treatment and recovery, but also validates the need for connection with a peer group and the need for immediate access,” said Samantha Pauley, national director of virtual services of the Hazelden Betty Ford Foundation, an addiction treatment and advocacy organization, with clinics across the country.
In 2019, Hazelden Betty Ford first tried online group therapy with patients in San Diego participating in intensive outpatient sessions (three to four hours a day, three to four hours a 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 spread to New Jersey, Missouri, in Colorado and Wisconsin.
Ms Pauley said 4,300 people have been through such intensive therapy – which involves logging into group or individual sessions using a platform called Mend which is like Zoom. Preliminary results, she said, show the treatment is as effective as face-to-face meetings in reducing food cravings and other symptoms. 2,500 more people participated in support groups for family members.
Without Covid, said Ms Pauley, the “creative exploration” of online meetings would still have happened, but much slower.
One of the barriers to intensive online rehabilitation involves drug testing of patients, who normally give saliva or urine samples under in-person supervision. A handful of alternatives have emerged, including one in which people spit into a test cup while being observed onscreen by a provider who verifies the person’s identity. The sample is then deposited in a clinic or mailed, although the risk of deception still remains. In other cases, patients may visit a lab for a drug test.
In addition, some clinical signs of duress cannot be diagnosed as easily on a screen.
“You can’t see the sweating that might indicate the person is having a slight withdrawal. There are limits, ”said Dr. Christopher Bundy, president of the Federation of State Physician Health Programs, a group representing 48 state physician health programs that serve recovering physicians. He said hundreds of doctors participating in these programs regularly attend virtual professional monitoring meetings where they meet with a handful of specialists for peer support and to assess their progress.
“This sort of thing has 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 pretty close.
Other drug addiction participants and leaders in the field say that while the internet has been a good stopgap measure, they also hope that in-person meetings will return soon.
“It was a mixed blessing,” said David Teater, who wears two hats: he has been recovering himself since the 1980s, and he is the executive director of Ottagan Addictions Recovery, a residential and outpatient treatment center serving of low-income patients in western Michigan whose typical therapy is paid for by Medicaid.
In that capacity, he said the online tools were a godsend because they just kept the service going. With grants of $ 25,000, the center obtained new computers and other technologies that enabled it to do telemedicine and set up a “Zoom Room”. It includes a 55-inch screen so people who zoom in can see the advisor as well as people who feel comfortable enough to come in person and sit socially distanced while wearing masks.
“We think it works just as well, we really do,” Mr. Teater said.
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