Friday, August 20, 2021 | Seaside Signal | SeasideSignal.com • A5
Opioid addiction clinics adjust to pandemic
“If you’re a person who has been struggling
with the idea of whether or not you want to be
sober, COVID was a lousy time to get sober,”
Noice said. “And so I worry a lot about how
many people out there could have benefited
from our help — maybe didn’t know that we
were still available — and I really hope we can
help more.”
By ERICK BENGEL
The Astorian
In the last week of January 2020, the Sea-
side Recovery Center, a clinic that uses meth-
adone and other medication to treat people
with opioid addiction, opened in the city’s
south end.
Less than two months later, the clinic had
to rethink how to care for patients, as did Clat-
sop Behavioral Healthcare’s clinic in Warren-
ton’s Premarq Center.
Quietly operating in nondescript buildings
where their services aren’t outwardly adver-
tised, both clinics provide medication-assisted
treatment for opioid abuse. The medication
— methadone and Suboxone in Seaside; just
Suboxone in Warrenton — does not replace
the euphoric experience of opioids like her-
oin, but works to suppress cravings and
withdrawal.
Medication-assisted treatment is rooted in
the idea that addiction is best seen as a chronic
illness rather than a moral failing, said Alison
Noice, the executive director of CODA, the
Portland-based treatment provider that runs
the Seaside facility.
Amid the coronavirus pandemic, the clin-
ics had to rapidly adjust to a world where a
setting based on closeness of care could itself
become a health risk.
The Seaside clinic dispenses methadone, a
heavily regulated pain reliever. Federal rules
are strict about how the drug can be given to
patients, down to how often patients need to
check in and make direct contact with a nurse.
Historically, patients in the early stages of
treatment have needed to visit the clinic six
times a week, often for months, if not years,
before being allowed to leave the clinic with
methadone, Noice said.
These rules held for decades, even as meth-
adone clinics became more sophisticated in
their care and their services more robust.
“Some — I think rightly — over time have
come to feel like those rules were very, very
restrictive, if not almost punitive,” Noice said.
“But it’s been very difficult to get the federal
regulations to change in any way.”
Then came COVID-19 and the need for
more flexibility.
More freedom
Federal and state authorities and the U.S.
Drug Enforcement Administration came
together — “which, honestly, I’ve never seen
them do this way before,” Noice said — and
agreed on two things: Patients would, for the
most part, have to stay out of clinics, and the
pandemic could not be allowed to interrupt
their medications.
So the feds began to grant clinics like Sea-
side Recovery Center the freedom to deter-
‘Zoom fatigue’
Hailey Hoffman/The Astorian
John Bisson, a registered nurse, sits behind the glass at his station where patients receive
methadone and other medications at the Seaside Recovery Center.
mine whether patients
still underwent urine anal-
AMID THE
yses, met with counselors
could be trusted to take
— if only briefly — and
medicine home with them
CORONAVIRUS
scheduled longer therapy
— to not sell, abuse or
PANDEMIC, THE
sessions to take place later
otherwise mishandle it —
by phone or video.
and how often that person
CLINICS
HAD
“But we didn’t build a
should have to visit the
TO RAPIDLY
community the way that
clinic. A patient who had
you normally see a com-
been dropping by daily
ADJUST TO A
munity develop in a clinic
could now do so weekly.
like that,” Noice said.
“We actually got to
WORLD WHERE A
The pandemic has so
make those decisions
SETTING BASED
defined the experience
based on what we knew
of Seaside’s staff and
about the patient, and not
ON CLOSENESS
patients that it is hard to
necessarily just based on
tell whether unforeseen
what these very old rules
OF CARE COULD
challenges — for instance,
told us we had to do,”
ITSELF BECOME A the patient population has
Noice said.
not increased as fast as
One upshot is that Sea-
HEALTH RISK.
side patients missed out
CODA had expected —
on a key part of their treat-
are due to COVID or the
ment: group counseling. The clinic tried to newness of the clinic.
hold electronic sessions, but individual phone
Noice said the Seaside Recovery Center
calls between counselors and patients proved did not see an unusually high rate of relapse
more successful.
or ongoing opiate use among patients. What
Addiction treatment relies on peer groups; CODA has seen across their clinics, including
recovery involves building a network that Seaside’s, is that once people get into treat-
supports a person’s sobriety, Noice said. ment, they generally stay and do well. “We
For about a month and a half, the few Sea- just didn’t see people initiating treatment at
side patients met in the group therapy room, the rate that we anticipated we would,” she
but a strong cohort — the desired number is said.
between 8 and 12, Noice said — couldn’t get
The clinic can serve between 300 and 350
established before in-person meetings were people. At the moment, they have about 120
discontinued.
patients, about 110 of whom are actively com-
The clinic’s doors remained open, medica- ing, and 60% of those pass through the clinic
tion went to everyone who needed it, new peo- daily, according to Staci Donley, the senior
ple signed up and care never ceased. Patients clinical manager.
When Clatsop Behavioral Healthcare’s
medication-assisted treatment took its group
counseling virtual, attendance remained at
nearly its normal level, hovering between
eight and 12 patients — at least at first, accord-
ing to Rick Martinez, the lead clinician. Most
patients were used to participating in group
sessions twice a week.
“Zoom was very productive in the begin-
ning,” Martinez said. “Clients just wanted
some kind of contact.”
As the pandemic dragged on, however,
“Zoom fatigue” began to set in and fewer
patients began showing up at sessions.
“Not having that (in-person) interaction
and peer support was really difficult for them,”
Martinez said.
The program, which works with prescrib-
ing doctors at Columbia Memorial Hospital
in Astoria and Oregon Health & Science Uni-
versity’s Primary Care Clinic in Scappoose,
has about 60 patients on the roster, about 45
of whom work with Martinez. Clatsop Behav-
ioral Healthcare, Clatsop County’s mental
health and substance abuse contractor, has
served about 200 patients since the program
opened in 2018, according to Dave Hsiao, an
agency program manager.
Suboxone contains buprenorphine and nal-
oxone, which, like methadone, are approved
by the U.S. Food and Drug Administration to
treat opioid abuse. The medicine is intended to
reduce cravings and withdrawal from opioids.
Martinez was doing assessments by phone,
trying to bring in new patients that way, but
that also started to slow down. “Folks didn’t
appear to be seeking treatment like they were
when we were open,” he said, adding that his
caseload has recently increased.
Some patients who had managed to stay
sober for a while before COVID started using
again during the pandemic, Martinez said.
When vaccinations got underway and Ore-
gon started opening up, patients began meet-
ing for group therapy again. “People were very
happy to be back — be back in the office and be
back in the groups,” Martinez said. The nearby
Shilo Inn donated a large conference room for
their sessions to help them spread out.
Now, as the delta variant circulates and
virus cases climb, Martinez is watching atten-
dance drop again. At least two of his patients
recently contracted COVID, though not, he
said, from the group therapy.
1981-2021
For 40 years Providence Seaside Hospital
has been honored to be your partner
in health.
As we celebrate this milestone, we’re proud to
continue our Mission of caring for all people,
especially the underserved. We invest in the health of
our North Coast communities and partner to support
the needs of our neighbors because we care. Whether
responding to the COVID-19 pandemic, partnering to
protect people in crisis or providing transportation to
medical appointments, Providence Seaside is always
here for you.
In 2020, we continued our tradition of compassion
and dedication to our communities with Providence
Seaside Hospital investing more than $16.2 million
to improve community health. These targeted
investments include $820,000 in community health
services and $2.7 million in free and low-cost care.
As we celebrate our 40th anniversary, we thank you
for choosing Providence. Mostly, we thank you for
being our friends and neighbors. We invite you to
learn more about how we give back to the North
Coast by visiting Providence.org/cares.