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Tyler Yates’ typical setup has the look of a tailgate.
Twice a week, Yates and interns from GCSTOP, or Guilford County Solution to the Opioid Problem, would pull a white Dodge Durango into two separate permanent parking lot distribution sites.
They’d pop the trunk and set out folding chairs and a cooler full of water, Gatorade and other drinks for clients who stopped by to exchange their dirty syringes for clean ones as well as pick up naloxone, the lifesaving drug that can reverse an opioid overdose.
But these are not typical times. COVID-19, the disease caused by the new coronavirus, has turned GCSTOP’s parking lot visits into less elaborate affairs. Yates and a colleague now sit in the SUV. Their interns disappeared when UNC Greensboro closed its campus.
[The latest: North Carolina coronavirus daily updates]
Instead of allowing clients to linger, Yates said the organization is making bags of supplies in advance.
“We’re really trying to keep the distance and keep the visits to five to 10 minutes,” said Yates, GCSTOP’s syringe exchange program coordinator.
The pandemic has forced changes to how nearly everyone operates, including those who live with substance use disorder.
About 49,000 people are enrolled in treatment on any given day in the state, according to Addiction Professionals of North Carolina. The organization represents about 650 community-based service providers across the state, Executive Director Sarah Potter said.
According to a survey that APNC completed last month, 57% of addiction service providers have shuttered at least one program already since the start of the pandemic, with another 10% no longer accepting new clients. More than 80% have reported disruptions in service delivery, and at least 27% have had to or plan to lay off or furlough employees.
The cutbacks come at a hard time for those who are living with substance use or in recovery, Potter said.
Those considering entering a program might not be able to find one, or they may fear COVID-19 infection if they do enter treatment. Isolation and other side effects of the pandemic, including job loss or being stuck in an unstable or unsafe environment, might trigger a relapse.
“The opposite of addiction is connection,” Potter said.
While state data is not yet available, Potter and Melissia Larson, law enforcement programs manager for the N.C. Harm Reduction Coalition, said overdoses have increased since the pandemic began. Social distancing has changed the philosophy of not using alone for fear of overdose, Larson said.
“Now, in this time of social distancing; we’re all saying, ‘Hey, be 6 feet away from everyone,’” Larson said. “Unfortunately, people are in more private areas like hotels or bedrooms instead of maybe being out in the community or in a vehicle or wherever using drugs, and someone may discover them at that point.”
Josh Murray recently started working as a rapid responder for Raleigh-based Healing Transitions, traveling with emergency medical services to meet survivors following an overdose to offer connections to services and treatment. Murray said he has noticed an increase in repeat overdoses.
“I think it’s a lot of people are restless,” he said. “They’re sitting around a little bit more because there’s nowhere to go. They’re not out running and they’re just constantly using, and it’s just hitting them differently. They’re probably using more.”
Healing Transitions is no longer accepting new clients at its permanent facility, and a remote detox center that it set up after the pandemic began fills up quickly, Murray said.
When one man told Murray he was ready for help, all he could offer was a crisis center.
“I would normally refer him to a longer-term treatment facility, but that’s kind of been put on hold,” Murray said.
Raleigh-based SouthLight Healthcare has admitted 20 new clients to its medication-assisted treatment program since COVID-19 struck, said Brittany Jones, who directs the facility’s opiate treatment program.
While the program typically saw about 400 people daily, that’s now around 200 as SouthLight worked to allow a 70% increase in supply for take-home to decrease on-site interactions.
Counselors, who are now working from home, have also been asked to reach out to clients once weekly, Jones said. She said there have been no incidents of overdoses or misuse.
While COVID-19 has changed in-person interactions, it has also moved some online. Mike Yow, president and CEO of the private, nonprofit Fellowship Hall in Greensboro, said all outpatient services, including meetings with therapists, have moved online. Fellowship Hall is continuing to accept new clients after careful screenings and is operating with reduced staff.
“We’re doing a lot of Zoom AA (Alcoholics Anonymous) meetings because we would go out to real meetings here four or five nights a week, but those are all stopped now,” Yow said, referring to the popular online meeting platform.
Yow said he’s thankful for technologies like Zoom and FaceTime but he worries about substituting a virtual connection for an in-person one.
“They don’t allow hearts to connect, in my opinion,” he said.
The state declared syringe exchanges essential during the shutdown. GCSTOP has increased the amount of supplies it is giving out to limit interactions, Yates said. Before the pandemic, its parking lot operations would often see as many as 40 people per visit. That’s dropped to about 10-15 people. GCTSTOP continues to also set up weekly in a Greensboro church basement with a nurse.
While GCSTOP has supplies for now, “funding is always an issue with organizations like ours,” Yates said.
Yates, who is in recovery himself, tries to maintain contact with those he serves through phone calls and texts.
“People need naloxone,” he said. “They need clean supplies. Drug use is not going to stop because of COVID-19, and I say that from personal experience.
“I’ve never lived through a pandemic, but you know, even when I was sick, I was using. Even in times of chaos, I was using. It’s not gonna stop. We need to make sure that our folks have the stuff that they need to stay safe.”