Inpatients Face Balancing Act During Coronavirus Crisis

As a nation wades through the uncertainties of COVID-19's effect on daily life, patients who have been in inpatient substance use treatment during this time confront some particularly gut-wrenching decisions. Leaders at Spectrum Health Systems in Massachusetts have encountered some inpatients who want to leave treatment early, though often for reasons not directly related to their own care or sense of safety.

“For some, their kids are suddenly out of school and they need help with child care,” Lisa Blanchard, Spectrum's vice president of clinical services, tells Addiction Professional.

Other patients, conversely, might now prefer to stay longer in an intensive level of care, and that could be related to a more limited availability of outpatient services during this public health crisis.

Spectrum operates detox, residential and outpatient services in Massachusetts, with most of the outpatient care delivered at opioid treatment program (OTP) sites. As of this Tuesday, relaxed restrictions on methadone treatment delivery at the federal and state level had resulted in around 45% of Spectrum's more than 5,300 methadone patients being able to receive some form of take-home dosing of their medication, Blanchard says.

Supply of methadone has not posed a major concern at this point, Blanchard says, though she adds that Spectrum has had to place orders more frequently because of storage limitations at some of its smaller-volume OTP sites.

At Spectrum's New England Recovery Center inpatient campus in Westborough, Mass., admissions have continued uninterrupted in recent weeks. “We've been very much at capacity,” Blanchard says.

In order to maximize safety for patients and staff, Spectrum procured a trailer that is now serving as an on-site health screening location for newly entering patients. A few inpatient facilities in the state have had to reduce or stop admissions, Blanchard says, and Spectrum's goal is to continue admitting patients for as long as it can.

With much of everyday life in a holding pattern at the moment, and the threat of isolation for struggling individuals greater than ever, “Now is a great time to get treatment,” Catherine Collins, regional business development liaison at the New England Recovery Center, tells Addiction Professional.

For existing patients, however, the center is not physically equipped to isolate anyone exhibiting symptoms that may indicate the presence of COVID-19. Blanchard says that so far, four patients with respiratory symptoms have had to be sent out of the facility, though none were confirmed to have the virus and no staff members are known to have it either.

New ways of operating

All of the organization's counseling services are now being delivered telephonically. Blanchard says Spectrum's payers, including the state, have been helpful in giving the organization access to the proper payment codes for the reformatted services they are now providing.

“Our staff is still coming in, but they're going to their offices and using the phone,” Blanchard says. Administrators are trying to boost staff's spirits in various ways, including informing them of the availability of meditation apps to which health care workers have been given free access.

Spectrum also is trying to step up its regular contact with other community providers, such as shelters in the Worcester area, in an effort to connect people in need with treatment in the most efficient way possible. At this time of crisis, “We have to do more, with more communication,” Collins says.