You can’t escape the numbers surrounding COVID-19. The number of new cases, fatalities, rate of transmission … for the state, the country — even the world.

But, as the world has adjusted to health emergency that is a global pandemic, realize this: Other health emergencies have not subsided. In fact, substance abuse issues — which rarely are mentioned these days — are on the rise.

There has been an 18% increase in drug overdose deaths since governors began enacting stay-at-home orders, and spikes seen in 60% of counties nationwide.

The issues will be the subject of a free virtual town hall from 2-3 Tuesday afternoon, when leaders in behavioral health and addiction treatment services from across the state will discuss how substance use disorder treatment has been impacted due to COVID-19.

The event, titled “Substance Use Disorder Treatment in N.J. During COVID-19 and Beyond,” will be moderated by reporter Lilo Stainton of NJ Spotlight and NJTV News. It is being presented by R&J Strategic Communications.

ROI-NJ caught up with one of the panelists — Bob Budsock, the CEO of Newark-based Integrity House — to get his thoughts on the issue.

The Q&A has been edited for space and clarity.

ROI-NJ: Talk about the impact COVID-19 has had on substance abuse treatment?

Bob Budsock: We are showing a big increase in the number of overdose deaths in New Jersey. I’m also getting reports from clients and former clients about more use in the community. I think what’s happened is that the shelter in place, the social distancing requirements, the fear and the uncertainty that was associated with the pandemic, has led to an increase in alcohol use, drug use and also the associated mental health issues.

ROI: How does that impact treatment?

BB: Recovery happens in the community. Individuals come to Integrity House and other facilities for their addiction treatment. Once they complete their addiction treatment, they have continuing care. And the expectation is that the recovery plans are going to include recovery in the community. The pandemic has completely disrupted that.

The AA meetings and the NA have moved to the Zoom format, but you lose the opportunity for the human connection. That’s not all. The folks that are in the recovery community will meet before or after a meeting for a cup of coffee. They’ll go bowling together. They’ll go to the movies together. They are looking for positive things to do with their time, a social activity that helps keep them engaged with positive people and keeps them away from that pull back to drugs or alcohol.

ROI: How will COVID change treatment moving forward?

BB: There are a lot of ways. Part of the new normal is going to be wearing masks. Just think about therapy sessions. You will miss all the facial expressions.

At Integrity House, we do a lot of residential treatment and treatment in the congregate care settings. The future is a little uncertain in the years ahead. We know we’ve had to reduce our bed density from 420 beds to 348 beds.

On the flip side, we’ve also eliminated some barriers to care. We have individuals receiving services in their living room or at their kitchen table. So, we don’t have to worry about transportation as a barrier.

ROI: A lot of the issues you’re facing do not have easy answers. What could the state do to help?

BB: The state recently created a $25 million relief fund for providers to help defer some of the expenses related to facility cleaning, (personal protective equipment) and some of the extra pay that we’ve had to provide to staff. So, the state has stepped up with that particular relief.

But, when you look at long term, the state is going to have to recognize that there needs to be some infrastructure changes. One part would be related to outpatient care, making sure that we have the technology infrastructure for programs to provide that care through video counseling.

When it comes to the residential, I think our facilities are going to have to look different. They are going to have to be built with virus protection in mind, in terms of the client flow — where clients sleep and where they go the groups.

ROI: You’ve been in this business for more than three decades. Have you ever seen anything like this?

BB: It’s hard to compare it to anything else I’ve seen. I was in this business in the 1980s, when we had the AIDS epidemic. There was fear, there was uncertainty and there was death, but not at the rates that we have seen recently with COVID. It’s just hit us really hard. And really quickly.

When COVID hit, everyone was experiencing fear and uncertainty. You had the COVID pandemic, you still had the opiate epidemic, and, I would say, back in April, we had an epidemic of fear. It was almost paralyzing. Many of my colleagues slowed down admissions to treatment, or stopped admissions to treatment, because of the fear and the uncertainty regarding COVID-19.

ROI: Last question: What’s the biggest challenge?

BB: Overcoming that fear. Everyone experienced fear and uncertainty back in April. Some treatment providers were really unsure of how to proceed. And individuals that needed to enter treatment had a fear of coming because everyone was being told to shelter in place.

If somebody was ambivalent about whether or not to enter a program to start facing their issues, there was some wiggle room, and they were deciding to defer that decision to go into treatment — whether it be a real fear, or just using it as an excuse not to go into a program. We need to reach them.

The panelists for the event:
Dr. Kaitlan Baston, program director, Southern N.J. Medication-Assisted Treatment Center of Excellence; division head, addiction medicine, and medical director, government relations, Cooper University Health Care; assistant professor of medicine, Cooper Medical School of Rowan University;
Robert Budsock, CEO and president, Integrity House;
Assemblywoman Joann Downey (D-Ocean Twp.), chair of the Assembly Human Services Committee and parliamentarian of the Assembly;
Connie Greene, vice president, RWJBarnabas Health Institute for Prevention and Recovery;
Dr. Jerry Joseph, VP of addiction medicine for CarePlus NJ Inc.;
Dr. Erin Zerbo, director of the Northern N.J. MAT Center of Excellence; assistant professor of psychiatry, Rutgers New Jersey Medical School.

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