Liam was discharged from the Royal Ottawa Mental Health Centre’s substance use and concurrent disorders program on March 26.
The 22-year-old, whose last name Global News is not using for privacy reasons, was four weeks into a six-week inpatient stay when the program announced it was closing because of the new coronavirus outbreak.
The early discharge was an unwelcome shock, says Liam, but one he’s been able to adjust to because he has a supportive family willing to give him a safe place to stay. He’s more worried about the other people alongside whom he was receiving treatment.
“There are a number of people who have extremely unstable housing situations … and virtually no external support,” Liam says.
“One of the biggest parts of recovery, both in active recovery and people who have 10-15 years sober, is community support, and right now (with COVID-19), we’re seeing a total lack of support.”
The pandemic, with its uncertainty, anxiety and demands for physical distancing, time spent mostly at home and no group — including Alcoholics Anonymous — gatherings, puts a unique burden on people with substance use disorders.
The idea that in the midst of the COVID-19 pandemic, people struggling have lost “an essential, life-saving inpatient program” significantly increases people’s risk of relapse, Elliot Hudson wrote in a letter to hospital leadership expressing his concerns with the closure.
Hudson, who has relapsed several times in the last few years and whose story Global News chronicled over 18 months, was admitted to the program in mid-February. He was discharged from the hospital on March 23.
“Isolation is a breeding ground for addictive behaviour and every single patient I spoke to before composing this email is terrified that this sudden interruption to their treatment could lead to relapse,” Hudson wrote.
“(It is) particularly concerning that most other supports in the community are closed at this time.
“This is a life-and-death situation for many.”
The concurrent disorders unit (CDU) was closed because, by design, it allows patients to go back and forth between the hospital and Ottawa at large, said the hospital’s spokesperson Karen Monaghan.
“This format presents an increased risk for the spread of COVID-19,” she said. “The decision has been made to serve these clients in other ways.”
Monaghan noted that each of the nine people who were in inpatient care at the time of the closure was discharged after putting together a personalized plan for community rehabilitation.
Liam appreciates that. He does nothing but sing the praises of the program’s staff, who’ve helped him live sober.
“It takes people who are really at a low point in their lives and gives them a safe place to access those (recovery) tools,” Liam says.
“The flip side is that the people in that situation are also the most vulnerable, and it’s a big shift from immediate withdrawal to long-term abstinence and that transition is difficult for anyone at the best of times.”
But doing it without the support of people who share your traumas and addictions and without health-care professionals? Even more difficult, he says.
Monaghan says the hospital’s inpatient assessment and stabilization unit remains open because its clients don’t come and go from the hospital, as does the rapid access to addiction medicine clinic and other outpatient services.
But that doesn’t come close to what the CDU provided, Liam says.
“Virtual care doesn’t fill the emotional, spiritual and health void of sitting in someone’s presence and learning from them and being in a safe environment… we’re really at a loss.”
This is an issue for more than just “nine addicts,” Hudson wrote in his email.
“This is about keeping access open to a life-saving service. Addiction does not take a break.”
Indeed, an estimated six million Canadians will meet the criteria for substance use disorder in their lifetime. And as Canadians settle in for potentially months of physical distancing and isolation, people struggling with addiction — for whom community is an integral part of recovery — are bracing.
Housing and finances — both already feeling the effects of the COVID-19 outbreak — can contribute to and exacerbate addiction, which is, as Dr. Raj Bhatla, chief of staff and psychiatrist-in-chief at the Royal, told Global News, “a relapsing illness” — and that’s before the pandemic.
So, even though there’s telemedicine and Liam knows providers are doing their best in difficult times, he says there’s still the worry. He worries about people feeling that much more isolated and the ways in which that might threaten someone’s hard-fought early sobriety.
After all, he says: “Gyms are closed, psychiatrists are closed, NA meetings are closed, but your dealer is still open.”
The Royal’s substance use and concurrent disorders program offers telemedicine for people who are struggling and need help. They can be reached at 613-772-6521, ext. 6508.
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