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Stress induced by COVID-19 is driving opioid addiction risks. An expert weighs in on addressing one matter to resolve another.
Through nearly 3 decades as a healthcare leader, I have never experienced anything like joining Laguna Treatment Hospital as chief executive officer this past January. I stepped in to lead Orange County, California’s only licensed chemical dependency recovery hospital, one of just a handful in the state, in the midst of a double pandemic—the opioid crisis and COVID-19. More than 10 million Americans misused prescription opioids in the last year; over half a million people have died of COVID-19. My experience was tested by these intertwined crises, requiring adaptable, caring leadership that puts people first.
Pandemic stress has caused a spike in substance abuse and an increase in overdoses. As with healthcare providers the world over, COVID-19 has transformed the way we care for patients. Staff must observe strict protocols for protection, distancing, and patient admission to keep people and environment safe. These infection prevention measures are standard practice in a variety of healthcare settings but can have a profound impact on our vulnerable patients, who often come to us in a high state of anxiety.
The patients, seeking support for addiction, must be tested by nasal swab for COVID-19 and subsequently placed in isolation for between 24 and 48 hours—which can feel like an eternity for someone struggling with a substance abuse disorder. The facility, in accordance with local health restrictions, has prohibited family and friends from visiting since last March; loved ones provide a critical lifeline and source of support for patients recovering from addiction. Pandemic restrictions were keeping patients safe from one disease, even as they created obstacles to surviving another.
Every patient we see brings their own psychosocial, economic, mental health, even legal difficulties into treatment. We help them navigate the personal crises, such as a breakup or job loss, that may be entangled with their addiction. Adding to that the uncertainty, fear, and loss of a global pandemic has exacerbated the anxiety and stress staff and patients experience every day. That is why I make sure to start the workday with a meeting to discuss the status and needs of every patient, to deliver truly empathetic, customized care.
When each workday brings the unexpected, maintaining calm is vital. My primary responsibility is encouraging and supporting the team providing care to our patients. That means being present, being engaged, and getting involved—not hunkering down in an office. Some days I feel like I am the orchestra conductor. Not being clinical myself I do not play the instrument, but I know how and when it needs to be played. This is what I love about leadership.
That emphasis on mindfulness extends to the care we provide our patients, too. People struggling with addiction can become trapped in their own heads, consumed by their personal situation. Our approach, particularly with new evening activities programming like ping pong and charades, is to enable them, even if briefly, to focus on something beyond the problems that got them here. Enjoying laughter, companionship, play, sunshine, and a good meal can help ground us, reminding us of the basic joy of the human experience.
Finding joy is truly important when dealing with addiction, a disease laden with secrecy and shame. The fight to break down the stigma surrounding addiction is constant, whether it be with insurance carriers, demanding they provide our patients comprehensive care, or the shame carried by patients themselves. We work hard to change mindsets, so that patients understand that they are not some grim statistic, but rather a person with worth and dignity who is battling a disease like any other.
The need for more mental health resources in addiction treatment facilities is becoming ever more acute: Treatment centers are seeing a new, more deadly class of drugs emerge: Fentanyl is a powerful synthetic opioid 100 times more potent than morphine. Illegal use of this prescription drug is killing young people across the country.
There are promising new treatments: Cutting edge medications, such as Suboxone, Sublocade, and Vivitrol that allow those struggling with addiction to avoid relapse and lessen the pain of withdrawal. But even with increasingly advanced tools, we must shine a light on this tragic epidemic.
Helping those facing the searing personal struggles of addiction is tough, unpredictable work, and can take an emotional toll. Leaders must set boundaries to avoid burnout. Now, I understand how self-care—evening walks with my husband and dog, time with friends and family, plenty of sleep, and good nutrition—help me do my job better. Working in a high stress environment such as addiction treatment, you absolutely must practice what you preach regarding coping strategies. An agile healthcare leader, like an orchestra conductor helping each player’s notes soar, is tuned in, able to offer the guidance to help employees and patients thrive.
Barbara Kennedy, MHA, FACHE, is Chief Executive Officer, Laguna Treatment Hospital, American Addiction Centers.
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