Alex Dentsman ’00 and Kyara Panula Beck ’00 Work in Substance Use Disorder Treatment Field

By Alex Dentsman ’00 and Kyara Panula Beck ’00

 

In our field, the opposite of addiction is not recovery, as some may think. The opposite of addiction is connection. During a pandemic or any other time of national distress, connection in a consistent, stable form is threatened, and isolation tends to take over. Much of that is a prerogative in the form of self-preservation, like the social media accounts of families playing board games and staying safe inside their homes. However, for the populations with which we work, isolation can be a baseline, worsened by forced lockdowns, joblessness, homelessness, hopelessness and the cravings that go along with loss.

 

We work in a field specializing in co-occurring disorders—when someone has a substance use disorder coupled with one or more mental health diagnoses. Alex is the senior vice president and chief growth officer of a community-based residential and outpatient organization, and Kyara provides clinical counseling as a mental health clinical supervisor in a correctional facility for male offenders reentering society, as well as the newly reintegrated.

 

On any given day, our professional worlds have moments of intersection and divergence, but living through a pandemic unites us in many ways as we prioritize connection, stability and safety more than ever.

 

When COVID-19 became a headline, the correctional facility had already implemented mandatory temperature checks for all entering staff. Masks and gloves became part of everyone’s uniform. Handwashing stations and alcohol-free hand sanitizer seemed to magically appear in all corners, and we were instructed to minimize contact with each other and clients while employing a written correspondence protocol to supplement the six to eight hours of groups per day. Due to the arrangement of residential units, it quickly became imperative to reduce any health risk among the offenders, instating social distancing, moving staff offsite and halting family visits.

 

The vulnerable population I serve lives with co-occurring disorders such as anxiety, depression, bipolar I and II and schizophrenia spectrum and personality disorders in addition to irrational thought patterns that create and reinforce criminal addictive thinking. Their reintegration into society is itself a public health focus, thus therapeutic care remained a high priority in order to maintain self-awareness, accountability and realistic, critical thought in the face of uncertainties created by COVID-19.

 

Directives became comprehensive as the weeks went on, and working under Commissioner DeMatteis, respective bureaus and facility leadership, I was tasked with writing the first distance therapy procedure for Community Corrections. My focus was on the commitment to motivating clients toward prosocial connection and away from their history of emotional impulsivity, especially with this acutely increased fear. Hope was reinforced daily through new structure and stability as life in the community changed rapidly. Clients were able to group via telehealth methods while social distancing, had individual sessions and mental health visits through phone or video conference, and attended virtual AA/NA, Bible study, chapel and other self-help groups. Our community Aftercare population, the final level of care offered by the program, also benefited from phone conferences and the wide world of apps such as Sober Grid and their own group chats to encourage connection.

 

In Maryland, the Ashley Addiction Treatment staff also vowed to not close or limit services. If anything, the need for substance use disorder treatment has grown in recent months as people try to cope with anxiety, grief and various forms of displacement. Ashley instituted similar health and safety protocols and emphasized the mitigation strategies found in most workplaces such as universal masking, physical distancing, hand hygiene and self-monitoring for symptoms. The staff is screened daily for symptoms and have their temperature checked before entering the campus and the same policies and procedures which have been enacted in healthcare settings like hospitals have been implemented at Ashley. All new patients at their residential facility admit to a stabilization unit which includes COVID-19 testing and up to five days of close monitoring by Ashley’s medical staff. Our outpatient locations moved all their clinical services to telehealth and all alumni and family support services are now held virtually.

 

The staff at the respective facilities were encouraged to remain positive and find the silver linings throughout this process. Both clinical and operational applications have been expanded by this experience, and parts of our COVID-19 response have led to new implementations under which the clients and patients ultimately benefit. Many of our programming changes will remain intact even after the threat of this illness lessens. Amazingly, clients and patients at both sites have found meaning within the changes, commenting how the pandemic has pushed them toward motivation for change in a way they never expected.

 

People who work in the treatment field are well-equipped to respond to a pandemic like coronavirus because substance use disorders are just that—a pandemic, a disease which exists on a broad scale. We are flexible and patient and take missteps not as failures, but as new lessons learned. As different as these treatment settings may seem, the common thread has been our commitment to prioritize the health and safety of the staff and treatment populations in even the most uncertain of times.

 

Our mantra continues hope, as we tell our clients and patients every day: be safe, welcome change, find meaning, and stay connected.