PORTSMOUTH — Stressed out about being stuck at home, not able to connect with friends or family as much as you’d like, or perhaps because you lost a job or had your hours reduced due to Covid-19?

Imagine dealing also with a substance use disorder on top of all that anxiety.

In the midst of the coronavirus, the opioid crisis has moved to the back burner as a news story — despite an increase in the number of overdose deaths from last year. According to the R.I. Department of Health, there have been 166 overdose deaths in the first five months of this year, compared to 124 in that same timeframe in 2019. 

While there are no numbers of overdose deaths since June yet available, treatment providers say the problem has gotten even worse locally since the pandemic arrived in the United States.

“The impact of Covid is stresses — huge stresses,” said Portsmouth resident Christine Nolan, founder and board chairwoman of Trinity Village, a recovery community with facilities in Portsmouth, Middletown and Newport. 

“It’s just elevated a lot of depression, a lot of anxiety and a lot of substance use. The whole change of lifestyle with Covid, as far as some of the quarantine issues, social distancing, social learning, and all of those different adjustments in people’s lives that came on fairly quickly, definitely had an impact on the stresses. So, we’ve seen an increase in need of resources and outreach to help people understand what’s accessible to them and how tor embrace that help.”

Trinity Village focuses, she said, not only on clients’ emotional and mental health, but also their employment status, which has impacted many during the pandemic.

“With the loss of jobs, or the temporarily relief of their position, it’s hit them financially,” Ms. Nolan said. “They’re home-based now and there’s a huge adjustment to that and raising children in that home-based environment. Not having that social interaction, there’s great mental health issues.”

‘Perfect storm’

James McKenna, a partner and board member of Trinity Village, agreed with Ms. Nolan that the pandemic has only exacerbated problems with substance use.

“This is like the perfect storm. You have loss of employment, you have them buying drugs from new sources because people aren’t interacting. The overdose rate has gone up,” he said, adding that federal stimulus checks are often being used to purchase illegal drugs.

And, due to the isolation and loneliness many people are experiencing due to essentially being shut in since March, “we’ve seen mental health issues increase, and we’ve seen suicide attempts increase,” Mr. McKenna said.

Covid has not only made day-to-day life more challenging for people with addiction, at many recovery service facilities it’s created logjams, he said.

“Because of COVID, they can’t always take you in immediately,” Mr. McKenna said. “It’s tough to tell somebody, ‘Well, tough it out through the night, or go to the ER if you have to and maybe we can get you in tomorrow.’ That didn’t happen before.”

He said Trinity Village “is rising to the challenge,” however, partly by finding another local mental health partners if it can’t offer immediate services to someone.

“We would send people at one time to detox and rehab in other states, but with COVID, people couldn’t get across state lines to do so. It’s posed a challenge, but we’re doing very well,” Mr. McKenna said.

It’s important that clients receive in-person care at a facility set up for social distancing, rather than resorting to online treatment, he added. “You don’t have that human interaction; you can set your screen off,” he said. “When you’re home, you can do a million other things. When you’re in (a recovery community), you’re getting the group dynamic — people helping people, and we’re the facilitators.”

Ms. Nolan said access to recovery services has changed due to Covid protocols and mandates. 

“We have to keep everybody safe, but in this element of mental health and substance use, there’s immediate need for care,” she said. “We were one of the facilities that stayed open and is accessible to the community. We’ve expanded services by collaborations with partners such as Newport Hospital and other treatment facilities so we can manage what the community needs and everyone has access to some level of service.”

BRIDGE device

According to Ms. Nolan, Trinity Village is the first recovery service provider to bring to Rhode Island the cutting-edge technology known as the BRIDGE device that battles the symptoms of withdrawal. 

“It’s a percutaneous nerve stimulator that helps with opioid withdrawal management,” she said. “So if someone comes into our facility or accesses our services that’s symptomatic of opioid withdraw and does not require an in-patient level of care, they can come and meet with our professional team to make an assessment.”

The device, which has been cleared by the FDA, fits behind the ear and sends gentle electrical impulses to areas of the brain and branches of nerves leading to the spinal cord. 

“It’s an ambulatory effect of treatment, but they can be symptomatic-free of opioid withdrawal within 45 minutes. And if they are still symptomatic, you can wear the device for up to five days and then come back to our clinic where our nurse practitioner will assess them," she said of the BRIDGE device, which is in the final year of clinical trials.

Mr. McKenna said Trinity Village is hoping to receive more funding for the implementation of the device, which he said is a game-changer. “Instead of putting them on methadone for the rest of their life, this makes them drug-free,” he said.

Greater need for treatment

The facilities may be fairly new, but the people behind Trinity Village are not new to recovery services. And, Mr. McKenna, who was a vice president at the former drug and alcohol rehabilitation center Edgehill Newport, said the need for treatment has never waned.

“There were 166 beds on the drive in Newport, and the place was full,” he said. “We had three inpatient facilities in Rhode Island, and they were always full — and they’re gone. We don’t have all the resources we used to have, and that’s sad. But we’re bringing a lot of the good things that I learned down there in Edgehill, and Christine is learning new things and implementing them in the program.”

“We’re here for the community,” added Ms. Nolan. “We have had an overwhelming sense of support from the town, from the (substance abuse) coalitions, from other outlets and agencies.”

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