Updated 10 a.m.
The meeting started like any video conference: People in their bedrooms, kitchens and garages fiddled with their microphones to mute themselves, and adjusted the angle of their screens to make sure their faces were front and center.
A facilitator greeted more than 200 people from across the country. Some folded laundry, others did the dishes, others cuddled their dogs on their couches. The facilitator asked for a moment of silence and then announced the day’s topic: control.
This was one of five daily meetings for people in recovery, offered via Zoom video chat through the Manayunk-based nonprofit Unity Recovery. Robert Ashford directs the center, which before the coronavirus outbreak, he said, he would have described as a YMCA for recovery services. Open 12 hours a day, seven days a week, Unity offered everything from Alcoholic Anonymous meetings to recovery yoga and family therapy sessions. But over the weekend, as he shut down in-person sessions in response to the virus, Ashford knew he had to replace them with something.
“People who go to meetings every day in the community, they have nowhere to go,” he said. “We tried to replicate what we were doing face-to-face.”
In the course of a few hours, Ashford worked with Zoom and another partner, Seattle-based digital app WEconnect Health, to expand the capacity of his online meeting rooms. Until then, virtual meetings had accounted for only about 5% or 10% of Unity’s services. The first day they were up and running, they served 216 people across four meetings. On Monday, Unity added another session to meet demand and served more than 1,100. It partnered with a Portland-based recovery group, Alano Club, to offer sessions at convenient times for those on the West Coast.
In Tuesday afternoon’s meeting about control, participants took turns sharing by raising the virtual hand button. Some used the traditional 12-step convention of introducing themselves with their names, identifying as an alcoholic or an addict, and noting the last time they went to meetings. For many, the last meeting they attended was the virtual one just a few hours earlier, or the day before.
“You keep seeing similar faces every time you come on Zoom, it’s just like being in your home group,” said one man in New York.
A small business owner in Newark, New Jersey, said this was the next best thing to the hug she so desperately needed. One woman said she was proud to be attempting her mom’s corned beef and cabbage recipe for the first time. It was simmering in the crock pot for St. Patrick’s Day. A young man in Philly confessed he’d only just now started taking the pandemic seriously. Another participant said he had contracted the coronavirus and was calling from home, where he was self-isolating, playing video games, and recovering.
“I’m nervous, I’ve been waiting to be called on for a few days,” said a young woman with blonde hair, sitting at her kitchen table, who said she’d just been laid off due to her business’s closure because of the coronavirus.
“I’m just like, ‘what am I going to do?’ The uncertainty can be so scary.”
But, she said, she had a lot of practice developing coping mechanisms and focusing inward through therapy and her work in recovery. She’s slowing down and trying to grasp what she can control, and what she can’t.
“It doesn’t really matter what the outside conditions are — this is an inside job,” she said.
Later, a participant thanked her for using that term, “inside job.”
“That really helped me — I don’t remember your name, but you had blonde hair,” she said.
In her little corner of the screen, the young woman with the blonde hair smiled from her kitchen and waved.
Recovery services scale back
As businesses shut down across the region and the country to mitigate the spread of the virus, many recovery services are among them. That’s concerning to a lot of providers, who worry that a lack of access to treatment could lead to life-threatening withdrawal symptoms or overdose deaths.
The syringe exchange program Prevention Point is cutting back its services. While it will still offer daily syringe exchange and critical medications — such as PrEP and treatment for hepatitis C — it will stop its drop-in, meal, case management, and primary care services.
In advance of Pennsylvania’s state-run liquor stores closing across the commonwealth Tuesday night, state Department of Drug and Alcohol Programs Secretary Jennifer Smith issued a statement urging providers to brace themselves for an increase in demand for treatment as a result.
“For individuals with substance use disorder, including those with alcohol use disorder, services to manage withdrawal symptoms are important,” she wrote, and encouraged providers who are near-capacity to partner with nearby facilities. But Brooke Feldman, who works at an outpatient recovery center in South Philadelphia, said she doesn’t think that’s realistic — especially as treatment centers are wary of admitting new people, to protect the safety of their current patients and staff.
“I don’t think there’s the resources to meet the demands, and then you end up with people presenting at the emergency rooms with alcohol withdrawal symptoms,” said Feldman. “That’s the last thing we want.”
Some accommodations are being made.
Medication-assisted treatment services are considered essential, and clinics offering buprenorphine and methadone are still open. Federal restrictions allowing for take-home doses of methadone have been loosened, so that states with emergency declarations in place may authorize patients to receive 28 days’ worth of doses, 14 days for those patients who are less stable.
The Drug Enforcement Agency and SAMHSA waived the requirement for initial in-person visits to prescribe buprenorphine, so it can be prescribed remotely.
For those in active addiction, Philadelphia police announced Tuesday that they would not prosecute low-level drug offenses, which would keep people from rotating in and out of the city’s jails.
“This is nothing new for us”
When he heard his recovery meetings would be canceled, Bill Kinkle’s first thought was a practical one: How would he satisfy his board’s requirements? A former registered nurse who lost his license as a result of his struggle with addiction, Kinkle has to attend three meetings a week as part of a program to earn his credentials back. When he learned about Unity’s meetings, he was relieved. In fact, in some ways, he likes the online meetings better.
“I don’t like the touchy-feely hugging, group prayer, I’m not a big fan of all that,” said Kinkle, who is based in Philadelphia. “So it was actually kind of nice to hide behind a computer screen.”
Kinkle said virtual meetings are critical because so much of recovery is dependent on developing a routine.
“When you’re in early recovery, you go to treatment or whatever, but you come out and you’re like, `Crap, I have all this time on my hands, and I used to fill it with either using substances or trying to figure out how to get money to get substances. And now I need to relearn all of that.’ And meetings fill that void really, really well for people.”
Many participants expressed the view that, despite being in completely uncharted territory, something about handling life one day at a time was familiar terrain. Their time spent in recovery, and in groups like these, gave them a jump-start on knowing what it takes to battle the feelings of isolation, and get through a situation where the circumstances may be out of their control.
“This is nothing new for us,” one woman said. “We never know what to expect — if I knew what to expect as a person in recovery, I probably wouldn’t be here.”
This article has been updated to offer details about West Coast sessions.