Co-Occurring Disorders and Your Child
If your child has been diagnosed with co-occurring disorders, it can be helpful to stay vigilant, especially during this time of social distancing.
While we hear daily reports on business closures and the importance of social distancing, many treatment programs are still open and accepting patients. If your child is currently out of school or work, or is in unexpected withdrawal (especially due to alcohol or benzodiazepines which can be life-threatening), it may be an ideal time to encourage them to attend a program. If they agree, prepare to ask some important questions of potential treatment providers.
How are you pre-screening potential patients? Does your process include questions about recent travel, having flu-like symptoms or contact with others who have the virus?
Many places do a phone intake. If there is a waiting room, be sure social distancing policies are in place.
How are you preventing the spread of COVID-19? What procedures are in place for sanitizing facilities?
Hopefully, staff has been trained and there is frequent cleaning of surfaces such as doorknobs, desks, kitchen tables, stairwell handles, elevator buttons, etc. Everyone should wash hands with soap and water often, and facilities need to make hand sanitizer widely available. (Note: Hand sanitizers contain alcohol so many facilities haven’t allowed it in the past. Under these circumstances, it should be made available).
What measures are being taken to remind staff and patients about ways to prevent the spread of germs, including avoiding holding hands and hugging during 12-step meetings or other fellowship?
Training, signage and reminders of these safety precautions should be in place. Use of telehealth (long-distance patient and clinician care) for one-on-one and group counseling and online meetings may be used instead of in-person meetings. Some places are reducing the number of people in group counseling, or moving to more individual counseling, so that social distancing can happen.
How is the program managing evaluations and on-going monitoring of patients who are on prescription medications? Is this done using telehealth (over the phone or videoconferencing) or in person?
Knowing the availability of the provider for usual care and emergencies is important, as well as where medications can be obtained. For instance, some programs offering methadone treatment are using lockboxes for medication pick up while others are allowing take-home doses.
What are your visitation policies? Are any visitors allowed on campus? If so, for what reasons?
This can include medical personnel such as a visiting psychiatrist, 12-step guest speakers, clergy, family members, etc. Many places are limiting visitors unless they are absolutely required for treatment.
What steps are being taken to regularly sanitize housing and transportation (if the treatment program your child needs includes housing that is separate from the program itself)?
Halfway houses, supervised apartments and motels are often used for housing in conjunction with Intensive Outpatient Programs (IOPs) and Partial Hospitalization Programs (PHPs). Be sure to ask what’s being done if transportation to treatment is provided.
Are patients taken off campus?
Many residential treatment programs take patients out to fellowship meetings or to activities like the beach or bowling. Assuming these outings have been curtailed because of the virus, what are they doing instead?
What will happen if my child, a staff member or someone else gets sick, or if there is an outbreak of COVID-19 on the property?
Be sure to ask about staff’s medical credentials and training. Many people with substance use disorders may be at greater risk of getting COVID-19 due to other underlying problems. Some facilities are checking for symptoms and fevers by taking temperatures daily. People who have symptoms should be isolated, tested and given the necessary level of care either at the residential facility or in a hospital. In some programs, tablets are provided to anyone in isolation so that they continue working on their treatment despite being symptomatic. Staff members should be asked to stay at home if they have any symptoms.
Who does the residential facility refer to for COVID-19 testing or if critical care is needed?
You may wish to have your child transported to a place of your choosing if you are not comfortable with the program’s selection or if there are insurance concerns.