When the comforts of the remedy are forgotten by coronavirus protocols, patients are forced to decide between recovery and safety.
Aneri Pattani / Spotlight PA
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When you wake up on June 14, Colleen Moskov may not forget what happened the day before. He had fainted as a result of some other episode of excessive alcohol consumption, a fact not unusual in the last six months. But that morning, Moskov had had enough.
He called Avenues Recovery Center near his home in Maryland, hoping to start fixing it right away. The status quo said it was full, however, there was an opening at one of its sites in Pennsylvania, near Scranton. The 28-year-old woman packed her bags and headed north.
Upon arrival, he was asked if he had been in contact with a user who had tested positive for COVID-19 or if he had a cough, and they took his temperature.
Over the next month, none of the members he met were dressed in a mask or appeared to be two metres away, he said. Customers who reled and spent days in Scranton’s largest domain, recently an outbreak of coronavirus cases, were allowed to return without any quarantine. Cleaning products were scarce and guest speakers were invited to assets almost daily.
“It’s like COVID-19 doesn’t exist there,” Moskov said.
And it’s not the only remedy facility that would forget about the fundamental protocols of coronavirus. Staff and citizens of a handful of services in Pennsylvania told Spotlight PA that they feared that the lack of protective measures could jeopardize their recovery and their lives.
Of the approximately 800 state remedy centers, 115 reported COVID-19 cases to the Department of Drug and Alcohol Programs, which authorizes them. Since March, the firm has won 170 court cases on services that have not implemented protective measures.
However, so far the state has issued subpoenas.
In many cases, addiction advocates and hope providers have stated that while establishments make a fair effort to put precautions into effect, they fight without an express recommendation from state and federal authorities. They also face demanding situations for staff and customers to routinely wear a mask and do not have access to the quick tests needed to prevent the virus from entering while new patients are allowed in.
In the end, patients have to fight two monsters at the same time, the coronavirus pandemic and the addiction epidemic, and many are forced to decide between the remedy and the risk of contracting the virus, or stay home and fight addiction alone.
Moskov said she was all at the Avenue Recovery Center in Lake Ariel, she had been marred by fear of contracting the virus, or worse, taking her home with her husband and daughter one year old at the end of treatment.
“I didn’t need to drink anymore and prevent on my own didn’t work,” Moskov said. “But the constant tension between some patients and COVID-19 has distracted my treatment.”
Courtesy of Colleen Moskov
Colleen Moskov involved that the lack of precautions against COVID-19 at Avenues Recovery Center in Lake Ariel, Pennsylvania, would lead her to contract the coronavirus or take her to her husband and daughter’s one-year-old home.
The Pennsylvania Department of Drugs and Alcohol, like many other state licensing agencies, has not issued express COVID-19 rules for remedy providers. Instead, it refers establishments to state and federal rules, adding Health Secretary Rachel Levine’s mask order.
But consumers told Spotlight PA that some services didn’t even adhere to those fundamental rules.
Interviews with four patients from Avenues to Lake Ariel, as well as a review of photographs taken at the facility, revealed a number of problems. A mask bag was at the front desk, consumers said, but it was largely intact. Some guest speakers took them, but staff and most patients never used them, even during the organization’s treatment sessions in which dozens of people sat side by side. The thermometer used to check the temperatures of incoming staff and consumers was not working properly, and a patient who felt feverish said they had told him not to worry, that they would have to be allergies. Social media posts show that at least two school staff members had COVID-19.
When Moskov and some patients raised considerations about the lack of precautions to the clinical director, he ignored them.
“He said, “Was he worried about COVID-19 when he was taking drugs off the street?” Moskov.
In a statement, Avenues Recovery Center said it was following all national and state recommendations, adding control staff and consumers before entering the facility, cleaning construction and requiring poor fitness personnel to remain in the home until it is legal through the fitness department.
“The avenues went beyond expectations to provide a high-quality remedy for addiction in the safest environment imaginable,” he said. “Our staff takes the duty of caring for the consumer very seriously, knowing that what we do is important.”
Erica Mortimer, Director of Quality Assurance, questioned the considerations raised through customers, stating, “It is unusual for actively dependent customers to divert attention from their own behavior by converting facts and manipulating conditions to serve their purpose.”
Several other people in remedy told Spotlight PA that they were reluctant to raise their considerations publicly or record court cases in anticipation of this type of response. They were involved in others not accepting them, that institutional staff and control could retaliate, and that judges or probation officers would misinterpret their fears as an attempt to avoid a court-imposed appeal.
“I wish I had chosen not to approve user and telehealth,” said a consumer who treats outpatients at a Gaudenzia facility in Norristown as a component of a court order for drug treatment. “But I don’t need to be punished in court for not doing what I’m asked to do.”
The consumer said the organization’s treatment affected another 20 people in a room, at most without a mask. The chairs were placed near each other and books, pens and other items were distributed, despite orders from Narcotics Anonymous discouraging this.
In a statement, Gaudenzia said that since mid-March, everyone and consumers should wear a mask in non-unusual spaces and that equipment was limited to 12 people. Management made two unannounced visits to verify compliance, and the facility had no instances of COVID-19, according to the release.
However, two other people close to the program stated that the protocols had not been implemented until the end of July, after Spotlight PA contacted Gaudenzia.
Instead of issuing subpoenas, the State Department of Drugs and Alcohol educates establishments and is helping them overcome barriers, Secretary Jennifer Smith said in an interview. The facilities are marked as in compliance whenever they make an effort.
“In my delight, it’s rare to meet a supplier who is simply belligerent and surely insists that he doesn’t need to stick to protocols,” Smith said. “Sometimes they need it, but in many cases there are genuine obstacles.”
In Pennsylvania, remedy providers highlighted difficulties in accessing non-public protective equipment, requiring insurance companies to reimburse telehealth and locating an area to isolate others who are positive to COVID from others. Many establishments are budgetless because they get as many customers as usual, but they also rent more staff to canopy workers who are in poor health or want to care for members of the family circle.
But the state can only offer limited help. You have no committed coronavirus investment for those amenities and a limited inventory of mask-to-percentage among fitness service providers, adding nursing homes. Instead, the Department of Drugs and Alcohol has a list of COVID-19 resources and has tried to connect amenities with suppliers to obtain protective equipment.
Suppliers say it’s too little. Across the country, addiction experts report a lack of help and direction for pandemic repair centers.
“There is not necessarily an express directive other than to act safely around others in the face of the threat of COVID,” said Paul Earley, president of the American Society of Addiction Medicine.
This is of particular concern, he added, because others with substance use disorders are most likely to get COVID-19 and are also more likely to transmit the virus to others.
“All states deserve to act now to help this population,” Earley said. “Whether it’s something as undeniable as leaving an N95 mask box, offering money to figure out how to help secure a home, our industry has a myriad of desires that serve not only the drug-addicted population, but also the general population.”
The corporation has created its own rules to fill the void. Advise providers to examine patients by phone and in person, practice social distance, quarantine newly admitted patients, and refer others to telehealth when possible.
Above all, it focuses on the use of masks.
“Wearing a mask is the most we do to prevent you from transmitting COVID,” Earley said.
Many remedy providers in Pennsylvania agree, but said it’s not easy to get customers to comply.
Vince Mercuri, executive director of The Open Door in Indiana, Pennsylvania, an outpatient drug and alcohol treatment center and an intellectual aptitude crisis line, said he had to prevent clients from being in the hallway and ask them to put on a mask. He uses his every time he leaves his workplace to inspire similar behavior.
In residential treatment, social estrangement and mask are even more difficult, said Michael Watterson, executive director of the ARC Manor Addiction Recovery Center in Kittanning.
“It’s your house and it’s overwhelming to keep a mask when you’re not in your own room,” he said.
Ideally, Watterson would like to check each patient for COVID-19 prior to admission. But as demand for controls across the country has skyrocketed, labs have expired and it can take days or even weeks to get results. It is impractical to keep a user quarantined for up to a third of their treatment, pending those results, Watterson said. Even isolating clients for a day or two was so painful that some objected to a doctor’s advice, he said.
Quick tests, which have effects in just 15 minutes, can solve the problem. But at this time, it is not widespread in Pennsylvania, a fear that arose in almost all patients, staff and control interviewed for this story. (The state recently announced a $1 million investment in a Lehigh Valley company that aims to expand immediate testing until the end of the year.)
Widespread verification with immediate effect is imperative to mitigate a COVID-19 outbreak at the Kirkbride Center in Philadelphia. After six patients developed coronavirus symptoms in early April, the facility called a local hospital to check everyone in this unit.
By early May, 46 patients in Kirkbride had tested positive. All were quarantined in the city, preventing the virus from spreading to many other patients, said Fred Baurer, Kirkbride’s medical director.
Since then, Kirkbride has instituted a universal mask policy, made patients aware of social estrangement, and separated new admissions from other patients. From mid-May to mid-June, Kirkbride had two positive cases and since then none have been recorded.
Across the border in West Virginia, Valley HealthCare System uses immediate testing to verify that all patients are COVID negative before entering their residential programs. The facility connects patients to nearby immediate detection sites and can also send them there, said Gerry Schmidt, director of formula operations and former president of NAADAC, a national agreement for addiction professionals.
As the pandemic persists, it is imperative that patients feel seeking treatment, Schmidt said, especially with the increase in overdose deaths across the country.
“It would be hard to immerse yourself in a remedy program where you don’t feel safe, no matter how serious your addiction is,” he said. But when establishments take the right precautions against COVID-19, it shows consumers “that we care about ourselves.”
“We care about them, we care about the general public, and we care about each other.”
PA Post is an independent, nonpartisan newsroom that covers politics and politics in Pennsylvania. For more information, PaPost.org.
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