Throughout life, the course of evolution has always been an inevitable one. When faced with change, humanity is forced to adapt and survive.

At our core, we’re all trying to survive, really. Some days we’re either treading water, gasping for air or blissfully floating along. Life can be habitually beautiful or it can be unpredictably scary. And when it’s the latter, adaptation is a must.

Case in point: COVID-19. This virus has added a raucous ripple in the already choppy waters we’re all just trying to navigate. Its health concerns and ancillary side effects, like stress, depression and economic downturn are threatening our very existence. And it has been especially difficult for those with substance abuse disorders (SUD). Social isolation is a breeding ground for relapse.

This pandemic has monopolized the country’s attention, but that doesn’t mean the opioid problem has gone away. Rather, it’s been silently growing behind COVID’s ominous shadow.

In New Jersey, for example, the number of drug-related deaths were slightly higher this year compared to 2019. According to data collected by NJ Cares, an opioid response effort overseen by the Attorney General’s office, the state lost 164 more residents by the end of April than it did the same time last year.

So it’s no surprise that health care, treatments and risk reduction programs are now evolving to combat these challenging times.

While some community–based treatment programs have shut down operations when non-essential businesses were forced to close and stay-at-home mandates were issued, many others have remained opened and have implemented new infection-control protocols. 

According to a recent article published by New Jersey Spotlight, safety concerns, and limitations on staff and personal protection equipment (PPE) caused some of the state’s needle-exchange programs to suspend operations for several weeks at the beginning of the outbreak.

But many are operating again – albeit fewer days than in the past – and clients are provided gloves, masks and hand sanitizer, and clean needles are being passed through a van window instead of face-to-face. Narcan kits, which contains the overdose antidote, naloxone, are also being provided. Without these controversial harm reduction initiatives, there could be a rise in blood borne pathogens, experts say.

At clinics, patients are now being screened for COVID-19 symptoms and directed through facilities in a way that minimizes infection and possible exposure. They are reconfiguring how the waiting rooms are used and are scaling back group sessions to create more space.

Federal and state regulators have also created waivers to allow some treatment to be conducted via telehealth rather than in person, and has permitted medication home delivery to be distributed to stable patients. These patients are allowed to receive up to a month’s worth of prescriptions for medication-assisted treatment, or MAT, which is the use of highly controlled pharmaceuticals without counseling and behavioral therapies to treat SUDs and prevent opioid overdose. According to several reports, New York City has begun delivering methadone to individuals with SUDs, who are in quarantine.

Even New Jersey’s Department of Human Services has extended telehealth for Medicaid members, distributed additional naloxone, and enabled certain MAT home-delivery options.

Many support services have migrated online, including some Alcoholics Anonymous meetings. And Horizon Blue Cross Blue Shield of New Jersey, the state’s largest health insurance company, is working with health care providers to expand access to mental health and SUD assistance through telemedicine.

Without a doubt, the beginning of 2020 has brought with it its share of adversity. But changes are being made, support services are evolving, and as creatures of resiliency, we are adapting to this new normal.