There are 21 girls living in Daybreak Youth Services inpatient facility, and they’re learning to get their hands dirty. Normally, they would have the opportunity to do activities in the community through Daybreak’s life enrichment program, but with the stay-home order they can’t exit the facility.
Through donations from the community the girls are starting their own garden, and they’ve painted vibrant wall murals throughout of the facility.
“They’ve just been painting nature and beauty all over the walls,” said Sarah Spier, Daybreak Youth Services external relations director. “We’re just doing a lot of creative projects to really keep them engaged, and then they’re also able to process their fear and emotions. It gives them a space where they can feel safe, but they can process what’s going on around them, because it’s heavy stuff.”
The staff at Daybreak are trying to offer these new outlets to the girls because sobriety is difficult during the best of circumstances, but even more so in a pandemic.
“Youth are smart, they pick up on everything and so there’s a lot of anxiety when they’re first coming into the treatment program, and it definitely is an added layer for anybody in treatment right now,” Spier said. “So we’re building a Daybreak garden, and it’s focused on getting back in contact with the earth and learning how to utilize food. It’s been really inspiring for our girls.”
Daybreak has a holistic treatment approach, and so in addition to addiction treatment the girls also receive mental health services to help them process trauma. Girls stay at the facility for an average of 45 to 90 days, some for much longer. Each girl’s recovery is individualized, something Spier understands personally as she is in her 10th year of sobriety after a long journey with various treatments. Because many of the residents come from unstable living situations, Spier has heard many girls express that they don’t want to leave.
Like many treatment facilities, Daybreak is offering telehealth for outpatient services, which are coed. Spier said some of the patients are doing better with telehealth.
“Some of them feel more comfortable sharing and talking in group settings with their peers through the screen, which kind of makes sense if you think about it with the younger generation and social media technology,” Spier said.
With a stay-home order in place, substance abuse treatment services are still widely available, though many have transitioned to telehealth. In fact, new patient visits can now be conducted through telehealth, and the Washington State Health Care Authority said this is an opportune time to start treatment. The options in the treatment world can be difficult to navigate, and the agency suggests starting with the Washington state recovery helpline (1-866-789-1511).
“The main thing that we can see definitively is that the level of individuals who needed help has not diminished during COVID-19,” said Jessica Blose, Washington State Health Care Authority opioid treatment specialist. “The main thing we want families to know is that you do not have to go through this alone, that there is help out there.”
Blose said medically assisted treatment – such as methadone, naltrexone and suboxone – should be considered the first-line approach to treatment because it can decrease the risk of overdose death up to 50%. In 2020, 37 people in Spokane County have died from overdoses, according to preliminary data from the Department of Health. Within city limits, four people have been revived this year using NARCAN, a naloxone nasal spray, according to Sgt. Terry Preuninger, Spokane Police spokesman.
The rise in telehealth treatment can create a barrier for someone who doesn’t have easy access to a telephone or reliable Wi-Fi, Blose said, and to address this the agency has been providing health care providers with phones to distribute to patients.
Dr. Lora Jasman, who specializes in internal medicine and addiction medicine at Rockwood Clinic, said staff there have been able to give patients phones for this purpose. Jasman said the stressors of the pandemic are affecting patients.
“When people have had long-term substance use problems, then it’s almost like their brain has learned to deal with stress through drugs, and so about any stressor will cause the individual to want to use drugs more,” Jasman said. “(The pandemic) is a stressor that is affecting everyone, but in some ways it’s affecting the individuals who have substance-use disorders even more.”
Jasman also recommends medication-assisted treatment to her patients first, and while she also suggests counseling, she does not want that to be a barrier to people receiving treatment. She and other treatment providers also have been struggling with how to prescribe these medications for their patients. For patients dealing with housing insecurity, she has to negotiate minimizing trips to the pharmacy with the possibility that their medication could be stolen from them.
“If we get them a two-week supply, they might not be able to hang on to it because there’s so many other people that want it,” Jasman said. “Yet if we give them a really small supply, then they’re going to the pharmacy frequently, which then puts them in more exposure risk.”
With the stressors of the pandemic this is not an uncommon time to relapse, Jasman said, and there are patients whom they have lost track of, in some cases because the patient’s phone is no longer working. With most people working from home, it’s hard to figure out where patients went.
A woman from Narcotics Anonymous who wished to remain anonymous said with meetings going to Zoom, attendance has dropped 25% to 50%, depending on the meeting, and she has heard of many people relapsing. A big part of the NA experience is the community: getting coffee after meetings, hugging one another – actions that don’t translate well over Zoom.
“I hate to say if we would have had meetings they wouldn’t be doing this, but we probably wouldn’t have seen the numbers,” the woman said.
Misty Challinor, Spokane Regional Health District treatment services division director, said that if someone is wanting services, the help is out there. Challinor stressed that whether someone is trying to get help through abstinence-based programs or medically assisted treatment, it’s always an effort worth celebrating.
“Any help is going to be effective,” Challinor said. “No one modality works for every patient, so it’s always good to have an array of different types of therapies to provide.”
Challinor said it is fortunate that Spokane has not seen a spike in overdose deaths during the pandemic. The treatment programs have maintained consistency in admissions, but she said a barrier is that rather than being able to walk in and receive help, there is often a sign on the door that directs people.
“A lot of times when someone wants help, getting them help right then at the time that they’re seeking it is the best opportunity, and unfortunately with a lot of places limiting their in-person contact it really minimizes the potential of someone being able to have that in-person interaction to actively seek out help,” Challinor said.
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