Last week we began talking about the changes that were happening around alcohol use disorder treatment, starting during the Covid-19 pandemic, which is still ongoing. One especially important point that is made in the study we used for research last week is that ongoing longitudinal studies are necessary to understand both Covid-19 and Alcohol Use Disorder (AUD) during the pandemic. The authors of the study explain that longitudinal studies are those which account for long periods of time, in order to understand how a particular community being studied is reacting to a set of circumstances over time. The authors give the example of 9/11, they state that:
“Post-9/11 research showed that alcohol use increased as a result of post-traumatic stress symptoms and that the intensity of exposure predicted a greater likelihood of binge drinking.”
Longitudinal Studies of Trauma
The same issues must be studied longitudinally related to Covid-19 and alcoholism. The best drug and alcohol rehabs in Florida and around the world will use that data to better understand the way people with alcohol use disorder respond to traumas like the Covid-19 pandemic and the accompanying feelings of helplessness and loneliness that many people have reported. The authors also believe that those 9/11 studies are similar enough to the pandemic to give us information on what must come next. According to the study, “Health registries such as the World Trade Center Registry and similar longitudinal analyses will help us better understand and respond to the complex relationship between pandemic-related trauma, AUD, and other psychological comorbidities.” Comorbidities are simply health challenges or diseases that are present at the same time as, in this case, Substance Use Disorder, and can make treatment and long-term healing more difficult in some cases. Great drug and alcohol treatment centers, such as Florida Springs Wellness and Recovery Center in Panama City, Florida, deal with substance use disorders with comorbidities every day. Those comorbidities often include physical pain from an injury, depression, anxiety disorders, ADHD, diabetes, or other long term health challenges and diseases.
Covid-19 Policy Analysis
From the study authors, “The vast majority of states have allowed alcohol takeout and delivery, and at least 40 states deemed liquor stores essential businesses during shelter-in-place orders. However, relaxed sales policies that may serve to protect restaurants and bars contribute to major long-term costs from alcohol harm. The relaxation of licensing restrictions is allowing establishments such as restaurants and bars, which are not usually authorized to sell alcohol to go, to sell alcohol for at-home consumption.”
In the past I have not always been on board with the idea that stricter laws and guidelines around substances help the effort of treating people for substance use disorders. However, it is fair to acknowledge that a pandemic that negatively affects those with preexisting substance use disorders may not be the time to make stronger alcohol more readily available to those people during the Covid-19 pandemic. I am personally even more interested in some of the ways that drug and alcohol abuse treatment centers across the country managed to be completely blindsided by the ongoing Covid-19 pandemic. Here is another quote from the study,
“it should be noted that federal- and, in some cases, state-level operations policies were already in place before COVID-19 to guide behavioral health services during large-scale crises. In 2013, SAMHSA published Disaster Planning Handbook for Behavioral Health Treatment Programs, which has specific guidance for organizations to modify services in times of a flu pandemic. The publication deals with planning for tele-behavioral care (telehealth), hygiene, staffing, communication, and vulnerable patients, as well as steps for implementing emergency plans. An evaluation of substance use disorder treatment services related to 9/11-related trauma reported the need for agencies and administrators to develop, communicate, and practice emergency operations, emphatically stating, “States, counties, cities, and programs must have a disaster plan!””
If we were to go back and look at the things we published on this blog during the heart of the Covid-19 pandemic, you would see major failures of certain portions of the substance use disorder treatment infrastructure to ready themselves for a changing ecosystem in some obvious ways. This includes not using telehealth, which is mentioned by the authors, and not having the ability to give medication assisted treatment patients supplies of “take-home” medications, forcing people to congregate at increasingly crowded and dangerous treatment facilities. At the best drug and alcohol rehab in Florida, Florida Springs, we were lucky enough to have telehealth in place, but many organizations were not ready with telehealth options. We also saw many facilities being slow or unable to enact changes when federal authorities rightly changed rules and guidelines to better fit a Covid-19 affected landscape.
The authors point out that disaster plans had been ready in many places as early as 20 years ago or more. Most facilities had some disaster planning in place after 9/11. It is important to note that disaster plans are not effective if they are not readily available to all staff, practiced, and understood. During the early days of the Covid-19 pandemic it was necessary for every SUD treatment facility in the country to seriously inspect all day to day policies for places where Covid-19 would interrupt the course of treatment, but evidence suggests we did not do well in that respect, and we must do better in the future.
By T.A. Cannon (Contact me at TACannonWriting@gmail.com)
ATTONITO, J.; VILLALBA, K.; FONTAL, S. Priorities for Alcohol Use Disorder Treatment and Prevention During COVID-19’s Second Wave. American journal of public health, [s. l.], v. 111, n. 3, p. 359–362, 2021. DOI 10.2105/AJPH.2020.306070. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=33566664&authtype=geo&geocustid=s8475741&site=ehost-live&scope=site. Acesso em: 9 abr. 2021.