Substance use disorders (SUD) have had a significant and costly impact on the health, well-being, and economy of West Virginia. The West Virginia Department of Health and Human Resources (DHHR) reported there were 888 overdose deaths in 2018. The substance use epidemic in West Virginia has negatively affected individuals and families, presented new challenges to health care and behavioral health systems, and significantly impacted the economic vitality of the state. Although a great number of advances have been made in SUD treatment, far too few individuals who could benefit from treatment receive it. The Substance Abuse and Mental Health Services Administration (SAMHSA) 2017 Behavioral Health Barometer estimated that 5.8% of West Virginians age twelve and older, approximately 91,000 individuals, have a substance use disorder. During that year, only 18,115 people received treatment for substance use disorders, a drastic increase from 9,990 treated in 2013.
Recovery Residences provide safe, stable, supportive, and drug and alcohol-free housing for people with substance use disorders. There are many thousands across the United States that vary in size, scope, target populations, and services provided. Recovery residences provide mutual supportive environments for people with SUD to work on their sobriety, global health, and citizenship. Recent research has shown that participation in recovery residences decreases in-treatment and post-treatment relapse rates and significantly increases recovery outcomes, using such recovery measures as sustained abstinence rates, improvements in global health and social functioning, at up to two-years of follow-up.
The West Virginia Alliance of Recovery Residences (WVARR) is seeking funding to create a COVID-19 relief fund for recovery residences in West Virginia. The outbreak of COVID-19 has presented a wealth of challenges across the globe; the nation is facing months of dislocation, uncertainty, stress, and potential isolation as we come to terms with our new day-to-day realities. The impacts of COVID-19 have been devastating for people with substance use disorders. Johann Harri once said, “The opposite of addiction is not sobriety. The opposite of addiction is connection.” Meanwhile, amidst the COVID-19 outbreak, the CDC recommends “social isolation” and recovery support services and support groups like Alcoholics Anonymous have either ceased or shifted to virtual platforms.
The week of April 9th, 2020, Wyoming County officials reported 14 overdose calls in 36 hours. The report attributed all 14 cases to the pharmaceutical fentanyl, a synthetic opioid pain reliever used to treat severe pain, such as end-of-life-stage cancer. The CDC noted that fentanyl is 50 to 100 times more potent than morphine. Thankfully, all Wyoming County first responders are equipped with Naloxone, a medication that can reverse the effects of opioid overdoses if administered in time. One first responder recalled administering three doses of Naloxone to one overdose victim to revive him.
Based on the statewide fatal overdose reports issued by the DHHR, there were approximately 74 overdose deaths per month from all 55 West Virginia Counties in 2018. Charleston’s Solution Oriented Addiction Response (SOAR), a grassroots community group that has distributed hundreds of Naloxone kits across the state, reported 52 Naloxone saves in Kanawha County alone between April 15th and May 6th. That means 52 potentially fatal overdoses were prevented just from the Naloxone they dispensed in the county. These numbers are startling.
At a time when service need has increased, recovery residence operators have been forced to determine how to continue accepting admissions while still ensuring the safety of residents already living in their houses, many of which are particularly high-risk individuals. Public health officials recommended quarantining newly admitted residents for 14 days upon arrival. Some residences were able to designate quarantine spaces in their houses, while others inevitably halted or placed significant restrictions on admissions. Both options resulted in loss of revenue.
Many recovery residences across the state have experienced significant financial hardship. Some have reported that they are at-risk for closing their operations. With less than 50% receiving state funding, West Virginia recovery residences largely depend on resident program fees to sustain the day-to-day operations of their programs. Many residents have lost employment, and others are forced to continue working in high-risk situations, like food service or retail. In a recent survey, 60% of recovery residence operators reported that between 65% and 100% of their residents had lost employment due to COVID-19. As a safety precaution, many residences have limited admissions to individuals coming from supervised settings, including corrections and treatment facilities. Many individuals coming from these settings are considered non-eligible for state or federal unemployment benefits due to limited or nonexistent employment history within the required time frame.
Limited access to COVID-19 testing, limited access to personal protective equipment (PPE), limited access to food supplies, and limited access to and increased costs associated with purchasing recommended cleaning supplies, and loss of private donor and grant funding have placed an added burden on recovery housing operations. Very few local, state, or federal resources are available to offset the financial impact of COVID-19 on our state’s recovery residences. A relief fund could serve to alleviate some of the immediate financial challenges and ensure that recovery residences can continue to provide vital recovery support services to West Virginians with substance use disorders. WV Recovery Residences will have the opportunity to apply for funding via minigrants to offset financial hardships related to COVID-19. WVARR staff will review the relief-fund applications and award mini-grants to operators based on funding availability, need and potential impact.