An epidemic within a pandemic

PATERSON  Becoming clean and sober is a complex journey for a person battling addiction, but imagine the road to recovery compounded by a global health crisis. This is the experience of the clients of Straight and Narrow (SN) faced with the opioid epidemic while in the middle of the COVID-19 pandemic.

This agency of Catholic Charities continues to help many men and women during this critical time with its medical departments working around the clock for both outpatients and inpatients. Currently more than 300 men and women are in drug and alcohol treatment in the programs of the rehabilitation center. Young children with their mothers, who are in recovery, continue to reside at the residential centers.

“God bless the leadership, medical staff, and nurses at Straight and Narrow who have worked diligently and bravely on the frontlines of COVID-19. When I think of our staff at Straight and Narrow, the first word that comes to mind is resilient,” said Scott Milliken, Catholic Charities CEO. “In August we endured the biggest one-day catastrophe in the history of our organization, when we experienced a five-alarm fire. Now, our staff and service recipients persevere through this terrible pandemic. We know that with the support of the faithful in our Diocese, we will emerge stronger than ever before.”

At the Msgr. Wall Social Service Center (MWC) in Paramus, men and women addicted to opioids have been able to receive the vital treatment they need during this time due to the strong commitment of the agency to help those recovering from addiction. This treatment helps ease the physical discomfort for them.

The center, which has been in operation since 1971, is an outpatient medication-assisted treatment and detoxification program. As part of its compendium of treatment services, MWC provides specialized services to women who are pregnant, HIV positive individuals, and individuals that are involved in the criminal justice system.

On March 23, at the onset of the COVID-19 pandemic and the N.J. state lockdown, the center took the steps to ensure that there is continuity of the care and methadone dosing for all its clients. The clinic has remained open six days a week and closed on Sundays.

Alfredo Nadera, a registered nurse and director of nursing for SN’s outpatient and Medication-Assisted Treatment (MAT) services, said, “Based on their phase counseling level, length of enrollment in the program, medical reasons and presumptive exposure, and positive COVID test results, Monsignor Wall clients were provided with additional take-home bottles — staggered every other day dosing and two- and four-week supplies of take-home bottle doses. Those that are unstable due to constant use of illicit substances continue to attend daily.”

There are only eight clients allowed at a time inside the center, with two at the dispensing window and six in line, six feet apart. Clients are given appointment times for dosing to control long wait lines. Every two hours and the end of each business day, nursing dispensing areas and surfaces are sanitized and disinfected. Signs and verbal reminders are given to clients regarding social distancing and hand washing. All clients and staff are required to wear a mask or no entry is allowed. The staff continues to take weekly urine drug screenings on all clients and took necessary actions such as rescissions of their multiple take-home bottles and increased telehealth sessions by the counselors for clients that are testing positive for illicit substances.

“For the staff, we began daily check-ins for COVID-related symptoms and body temperature to monitor exposures and possible infections,” Nadera said. “Clients that report possible exposures or COVID symptoms are referred to their primary doctors, COVID hotlines and on-site testing areas.”

For the men and women in residential treatment, the medical unit is where most of SN’s inpatient client medical needs are provided. Inpatient Residential treatment for Women at Straight and Narrow offers three residential treatment (ASAM Level III.5) programs for women: Alpha I, Alpha II and Alpha III. At the inpatient residential drug treatment for men, the center offers two separate programs out of Paterson — Short-term Level III.7 and Long-term Level III.5. The detox program is a medically monitored inpatient withdrawal management Level III.7, which is an organized service delivered by medical and nursing professionals that provides 24-hour medically supervised evaluation to clients whose withdrawal signs and symptoms are sufficiently severe to require 24-hour medical monitoring.

Falguni Choksi, acting director of nursing for SN, said, “The medical team works together to meet the enormous medical needs of both the residential and detox clients. Our service to the clients includes a doctor assessment and treatment, nursing admission, assessment and treatment, psychiatric evaluation and treatment, seven days per week, 24-hour nursing evaluation and treatment are provided, HIV screening and counseling, dietitian assessment for residential admissions, scheduling of all off site appointments needed including all follow-up visits and treatments.

‘Similar to the outpatient center, several changes were implemented due to the pandemic. The medical department was open and functioning 24 hours to care for our clients,” said Choksi. “All clients and staff were informed and educated on the coronavirus pandemic and precautionary measures; social distancing and masks were provided. Wearing masks was mandated for all clients and staff. Temperature checks were conducted on a daily basis for all incoming staff. All existing clients’ temperatures were also checked twice a day. Clients who presented with COVID symptoms were sent to St. Joseph’s University Medical Center in Paterson for further evaluation and testing.”

According to Choksi, “We deferred admissions for two weeks until a plan was put in place and then admitted only clients negative for COVID. Rooms were reassigned for isolation of clients who tested positive for COVID and continuous monitoring provided by our nursing professionals. Deeper cleaning services on the medical unit were conducted. Medical nurses were provided with additional PPE to care for COVID positive clients being monitored.”

National Nurses Week was observed last week and “the nurses were recognized for the tremendous work and diligent care they have been providing for the clients and staff in the community,” said Angela Nikolovski, executive director of Straight and Narrow. “I would like to acknowledge and thank all of our dedicated staff for their continued commitment to our clients during this health pandemic,’ she said. “Thank you again for all that you do on a daily basis. Please know not only during this time, but also all of the time, how much you are appreciated.”