Pennsylvania Secretary of Drug and Alcohol Programs Jen Smith Reminds Public That Substance Use Disorder Treatment Centers are Open and New Patients are Being Admitted Amid COVID-19

Pennsylvania Secretary of Drug and Alcohol Programs Jen Smith Provides Substance Use Disorder Treatment Update Amid COVID-19

• People Suffering from Substance Use Disorder (“SUD”) Have a Small “Window of Opportunity” and Need Services Now

• Thanked Pennsylvania Drug and Alcohol Treatment Professionals for Providing Services During COVID-19 Pandemic

• Explained that New Patients Are Being Admitted for Treatment by SUD providers

April 1, 2020/ Harrisburg, PA / In a media briefing, Secretary of Drug and Alcohol Programs Jen Smith discussed the importance of continuing to treat individuals with substance use disorder amidst the COVID-19 pandemic and provided guidance for treatment programs.

Sec. Smith began by thanking professionals in the drug and alcohol field for their work and emphasized that they continue to provide critical services to individuals during this challenging time. “It’s quite an interesting dynamic dealing with two public health crises at the same time: the opioid crisis and COVID-19,” she stated.

Sec. Smith said new patients are “absolutely” being accepted at this time. “Our providers have recognized that folks who need our services need them now,” she said. She stated the “window of opportunity” is small and providers are putting their own strategies in place using the Centers for Disease Control and Prevention (CDC) and Department of Health (DOH) guidelines regarding individuals arriving at facilities.

Sec. Smith said the department also issued guidance on telehealth. “Substance use disorder counselors can now provide telehealth using two-way interactive audio such as video conferencing or teleconferencing,” she stated. “Drug and alcohol services are deemed essential [and] telehealth gives extra flexibility in how those services are delivered and helps reduce risk to patients and exposure of staff members.”

Sec. Smith then discussed the closure of Pennsylvania’s liquor stores. She said the closure has potential to impact thousands of Pennsylvanians who currently live with alcohol use disorder and could force individuals into withdrawal, which can be life-threatening. “My staff and I are in constant communication with providers in the field and sister agencies in the commonwealth to help determine how to best support the changing needs of individuals and ensure we are trying to reduce the need for them to enter emergency departments for alcohol withdrawal syndrome.”

Sec. Smith emphasized that resources are available for individuals with substance use disorder. She encouraged individuals to contact the hotline — staffed 24/7 to answer phone calls. “By having individuals enter the drug and alcohol treatment system through that hotline, we can make sure they can get directly connected to that treatment provider or other resources they really need,” she stated. “We are actively monitoring the hotline data specifically related to alcohol use disorder.”

Sec Smith said last week alcohol-related calls to the hotline decreased by about 20 calls and that detox referrals also decreased. “Currently we have not heard of capacity issues related to detox nurses for individuals with alcohol use disorder,” she said. “We have providers on standby and are working closely with managed care organizations. Our field is standing at the ready for these individuals.”

Sec. Smith explained that because of the governor’s disaster emergency declaration, the Department of Drug and Alcohol Programs (DDAP) issued guidance around opioid treatment, specifically with regard to the amount of prescription medication a physician can prescribe for an individual to take home. She said physicians may prescribe medication individuals can take home for a maximum of 28 days. “The [federal government] made a change to their regulations which allowed us to then bend some of our regulations to make that happen,” she stated. Sec. Smith said patients “need to be at a point in their treatment and protocol where they are able to take home 28 days worth of medication.”  She said the department allows providers and their clinicians to make that determination. 

Sec. Smith responded to questions from the media.

Can you discuss the new guidelines for take-home prescriptions?

Sec. Smith said prior to the new guidance, individuals could only receive up to 14 days worth of methadone. She said the federal government increased the timeline from 14 days to 28 days. She said, “Essentially, instead of individuals reporting every two weeks, they could be reporting every four weeks.” She added that this change is a way to help keep individuals away from providers where the potential to spread COVID-19 exists.

Has there been an increase or decrease in calls to the hotline for opioids?

Sec. Smith said calls to the hotline have been relatively consistent since the start of COVID-19. She said, in general, the increasing calls to the hotline the last several months related to stimulants, cocaine and methamphetamine. She said calls related to opioids have been declining for some time while calls regarding heroin remained steady. She added that when COVID-19 cases start to decline and the United States starts to recover from the crisis, individuals will still have substance abuse disorder to cope with and the trend of substance use disorder is now shifting from opioids to methamphetamine.

Are there any efforts by the department to prevent recovery houses from closing?

Sec. Smith explained that recovery houses are not currently licensed by the state, but that changes beginning July 1, 2020. “At this point we have no regulatory authority over those entities. However, a lot of our funding is driven at the local level by Single County Authorities (SCA).” She said “Those entities contract with various treatment providers who are under or uninsured to receive treatment and the Single County Authorities pay for that treatment through contracted providers.” She added that SCAs also contract with recovery houses. She said there is an opportunity for some of the block grant dollars which go through DDAP to SCAs to fund housing for individuals. “It’s not something the state is dictating or controlling, but at the local level it is happening,” she said.

With the economic fallout from COVID-19, do you expect an increase in substance abuse?

Sec. Smith noted that she does not have a “crystal ball” but opined that there will likely be an increase in substance use disorder cases. “Under the circumstances we are living in, it is extremely likely we will see more individuals turning to substances to deal with anxiety and depression,” she stated. “Speaking personally, working from home the last three weeks with four children in the home is very stressful and very isolating,” she said “For individuals who are prone or have existing mental health conditions you are looking for ways to make it easier on yourself and substances are sometimes the answer to that question,” she added. I think it is likely we will see an uptick.”

Do all individuals receive a 28 day supply of methadone?

Sec. Smith explained that it will be a clinician-based decision and will be determined by where that individual is in their recovery process and treatment plan.

Are you expecting to see an increase in calls to the hotline for alcohol use disorder if the closure of the state stores continues?

Sec. Smith indicated that the department expected to see an increase to the hotline already. “We did not see that increase, but it is possible we will see it in the next couple of weeks,” she stated. “Our field is equipped to handle this,” she said. “We are ready and waiting to get folks into the treatment and other resources they need to help mitigate this, she added. “We are going to try our best to keep individuals out of emergency rooms when possible and make sure they are getting into our treatment programs or detox if it is alcohol related.” She encouraged individuals who are alcohol dependent and no longer have access to alcohol to not wait until the withdrawal symptoms are present to seek assistance. “Please call the hotline and find out what your options are,” she said.

Has the timeline for the July 1 regulations for recovery houses changed?

Sec. Smith said, as of now, the regulations will be implemented July 1. “That is still our hope. We don’t control every step in the process, but those regulations have left our office and are circulating through the final approval process,” she said. “It will depend upon those other entities and if they are operational and how quickly they are prioritizing our work,” she stated. “We are making sure we are capable of implementing those regulations once we get the finalized version.”