Instead of in-person check-ins, Arlene Brown says, counselors connect with their clients over the phone.
“Now more than ever, it’s important to have more communication with that patient,” she said.
While in the past, Brown may have each week connected with a patient once, she now talks to them two or three times.
In San Francisco, Dr. Barry Zevin agrees. He’s the medical director of street medicine at the San Francisco Department of Public Health.
“People are really struggling with the basic harm reduction messages that we have been giving … for many years,” Zevin said. “Our very key message has consistently been: ‘Don’t use alone.’ Now we are doing everything in our power to say to people, ‘Stay alone.’ And it’s really hard to have both of those things work.”
Despite the isolation born from the pandemic, some clinics and their patients have managed to create a new kind of normal.
That’s the case for Ronald, a patient at the Opiate Treatment Outpatient Program at San Francisco General Hospital. We’re not using Ronald’s last name to protect his privacy.
When he first showed up to the clinic 16 years ago, Ronald was addicted to heroin and alcohol. He lived on the street and was often sick.
Ronald speaks about the clinic with admiration. “They saved my life. I’m productive and happy now,” he said.
Sober, and living in a San Francisco apartment, he has a job providing in-home support for a client with disabilities.
Even if Ronald doesn’t want to change, the pandemic means his treatment has to. There are the small changes when Ronald picks up his medications on Tuesdays from the clinic: He wears a face mask, and he socially distances. But the big change is that his and every other patient’s regular counseling now happens mostly by phone.
To make this work, clinic staff have distributed nearly 500 flip phones with unlimited talk and text, a critical donation from an anonymous supporter. Many of the program’s patients are homeless.
The clinic now dispenses daily doses of methadone or buprenorphine from a mobile van in a parking lot outside the hospital. In order to do this, the clinic had to get permission from the hospital, state, federal government and the U.S. Drug Enforcement Administration.