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Long before the pandemic, this country was trying to fight another public health emergency - addiction. Doctors are now warning that the coronavirus could escalate deaths for drug and alcohol users unless recovery and treatment programs change. Here's Martha Bebinger from WBUR in Boston.
MARTHA BEBINGER, BYLINE: At 8 o'clock on a cold morning, a 32-year-old who lives outside Boston called us while in line outside a clinic where she goes daily for her addiction treatment medicine.
EMMA: This is Emma (ph). At my methadone clinic right now and I'm just waiting in line right now to get my dose.
BEBINGER: Methadone helps Emma use less heroin, but she has not stopped altogether. So we've agreed not to include her last name.
EMMA: Not much has really changed since the coronavirus except we don't have groups now at all. We used to all - everybody always has a weekly group, and they don't do that anymore.
BEBINGER: Emma misses the camaraderie of her support group. She has the dial-up conference call info for both drug and alcohol support groups and says she might try one. Emma goes to AA meetings, which have largely moved online. Her main beef right now is that her methadone clinic still requires some patients, sick and healthy, to ignore the stay-home guidance and come wait in line every day. Emma says she hasn't seen anyone get screened for the coronavirus.
EMMA: I do think there's something they could do to help prevent the spread of coronavirus. Like, they could give us take-homes. I really do think that would be good.
BEBINGER: Take-homes, as in methadone doses patients can take at home, are a privilege granted those who stop using illegal drugs. Last week, a federal agency loosened the rules so that patients can stay on the medication even if they have to shelter in place or quarantine or come down with COVID-19. Clinics are beginning to comply. But staying home to slow the spread of the coronavirus is not ideal for people in recovery either, says Dr. Marvin Seppala, chief medical officer at the Hazelden Betty Ford Foundation.
MARVIN SEPPALA: We consider addiction a disease of isolation in the first place. So now we're isolating all these people and expecting them to, you know, pick up the phone, get online, that sort of thing. Well, it may not work out as well.
BEBINGER: Seppala says there's a lot of work underway to help people in recovery adjust quickly to appointments and counseling via telehealth, virtual meetings, social networks and apps - because all of these changes are stressful.
SEPPALA: There's also the psychology of fear associated with this virus that can really drive people to an elevated level of anxiety. Anxiety certainly can result in relapse.
BEBINGER: Patients with a history of drug and alcohol use are at greater physical risk for the coronavirus as well. They often have weak immune systems and higher rates of infections, such as hep C and HIV. Dr. Peter Friedmann, president of the Massachusetts Society of Addiction Medicine, adds this.
PETER FRIEDMANN: They have very high rates of nicotine addiction and smoking, high rates of chronic lung disease.
BEBINGER: There's a lot of concern, too, about whether treatment programs are prepared to test for the coronavirus and isolate sick patients. Some are just not admitting new patients right now. It may be difficult for all medical staff to tell the difference between COVID-19 and the flu-like symptoms of withdrawal without widespread testing. And there's a concern that calling for more physical isolation will mean more people using drugs alone, where an overdose is more likely to be fatal.
For NPR News, I'm Martha Bebinger in Boston.
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