During coronavirus pandemic, Johns Hopkins addiction treatment facilities continue to provide the best care they can, whether virtual or face-to-face.

Helping people fight the battle against addiction is hard enough without a global pandemic and nearly universal stay-at-home orders.

But medical and mental health professionals at Johns Hopkins continue to provide care, counseling and services to patients working to beat substance use disorder.

As people adhere to physical distancing guidelines to prevent the spread of coronavirus, most outpatient programs at Johns Hopkins-affiliated facilities have switched to online communication for patient visits.

Dan Buccino, L.C.S.W.-C., B.C.D., assistant professor of psychiatry and behavioral sciences and clinical manager of the Johns Hopkins Broadway Center for Addiction, says he’s been impressed by how resilient and resourceful many of the center’s patients have been in recent weeks.

“So many have endured and survived so much in their lives already,” he says. “I think they see this as just another challenge to overcome.”

Buccino adds that the Broadway Center staff has worked hard to stay connected to the center’s patients during the pandemic.

“They’ve been quite resourceful in trying to stay engaged with patients,” he says. Like many people, some of the Broadway Center staff members came into the pandemic with limited proficiency in online video technology.

“Most of our patients, and some of our staff, struggle with ‘the digital divide,’” Buccino says. “But it’s a testament to the commitment on both sides that they’ve gotten themselves tech-prepared to be able to participate in telehealth.”

‘You are my second family’

Michael Fingerhood, M.D., associate professor of medicine and medical director of the Comprehensive Care Practice at Johns Hopkins Bayview Medical Center, says that isolation is the exact opposite of what he would recommend to his patients in normal times.

“But these are not normal times,” he says. “I’m doing telemedicine visits from my office. Patients understand. The video offers a connection that’s at least better than a telephone call.”

Fingerhood agrees with Buccino that patients fighting addiction, especially those with low incomes, encounter many trying situations.

“We all feel stressed,” says Fingerhood. “But for patients with addiction, coping with life is an active and stressful state every day, regardless of COVID-19.”

Visits are not all virtual, however. At Suburban Hospital’s Addiction Treatment Center Rockville, director Beth Kane-Davidson says patients still come in for face-to-face visits and group therapy.

“We all stay well apart and we’re all wearing masks,” she says.

In April, a patient sent an orchid arrangement to the center with a card that read, in part, “You are my second family. Thank you for being open and keeping me healthy!”

At the outset of stay-at-home orders in Maryland, the Addiction Treatment Center’s staff assembled a 31-page “pandemic toolkit,” a photocopied collection of resources to fight the urge to break sobriety. The toolkit features hotline numbers, lists of online Alcoholics Anonymous and Narcotics Anonymous meetings and an “active coping calendar” — the entry for April 16 reads, “Rediscover your favorite music that really lifts your spirits.”

An especially tough challenge

Addiction psychiatrist Sarah Andrews, M.D., who manages the inpatient substance abuse units in the Department of Psychiatry at The Johns Hopkins Hospital, says that some of the strict regulations around distributing methadone to patients fighting addiction to opioids have been relaxed during the pandemic.

Treatment centers typically dispense the drug, which suppresses the urge to use heroin and other opioids, one dose at a time. But to encourage physical distancing during the COVID-19 pandemic, federal regulators have loosened restrictions so that patients with a methadone prescription may now take home multiple doses for future use.

Andrews explains that, while the hospital continues to treat some patients on the inpatient unit, others are hesitant to come to the hospital for detoxification and acute management of their substance abuse during the pandemic.

She adds that it has been harder than usual to find aftercare facilities that are able to accept patients to help them continue their recovery after being discharged from the hospital.

“This is a challenging time for all of us,” Andrews says. “But [our patients] face an especially tough challenge. We’re trying to get them what they need.”

Fingerhood says clinicians need to pay particular attention to their own well being during the pandemic.

“Our own mental health is getting tested by this virus,” he says. “Stay informed, but don’t overdose on the news. Creating hope is a crucial component of helping our patients in recovery.

“We need to stay hopeful for our patients — and for ourselves.”