LARGE NUMBERS OF people struggling with drug addiction were abandoned and ‘left to kill themselves slowly’ during the Covid lockdown, support service workers have told The Journal.
For five months from March to September 2020, the government designated substance abuse support groups, such as Narcotics Anonymous, as non-essential services and ordered them to close, leaving thousands of struggling addicts without a lifeline.
A survey of 157 drug and alcohol support services conducted by the government earlier this year revealed the extent of the distress caused. The survey found that 84% of the support groups saw an increase in drug use among their clients, with 87% of the groups reporting an increase in the number of clients relapsing and 57% reporting an increase in overdoses from their clients.
“The ball was dropped by the government and people were left to kill themselves slowly for the first year of the pandemic,” said Shane Fallon, a facilitator at a Cork-based substance abuse support group called SMART Recovery Ireland.
The organisation switched to online meetings when public health measures required it, during the pandemic.
“Thankfully, the services are back now, but that doesn’t help the unfortunate people that aren’t with us because of the decisions that were made in 2020. It’s too late for many people,” Fallon said.
Fallon himself once struggled with substance abuse and was able to recover two years ago thanks to the work of SMART Recovery Ireland. Fallon said trying to help struggling addicts through video calls has been a nightmare.
“If I was still using in Covid times, I believe I could easily be dead, simple as. The support wasn’t there – it would be so much harder to quit,” he said.
Fallon personally knew two people who were not able to access in-person support services and who took their own lives during the period.
Darren O’Brien, the Chairperson of Smart Recovery Ireland, said that the pandemic had been a difficult time “as it has been for all organisations”.
“I would like to reiterate that at no time did Smart Recovery Ireland feel abandoned,” he said in an email.
“We have been supported thoroughout by the relevant bodies and organisations that support Smart Recovery. While it would be great to have face to face meetings, Smart Recovery Ireland, like all other organisations must follow the guidelines as set down.”
Derek Byrne, a former manager of a drug rehabilitation centre in Ballyfermot, said the initial lockdown had exacerbated many people’s substance issues.
“The closure of these services was, for someone with substance misuse problems, their worst possible scenario,” he said. “Somebody might have felt that they had a justification to drink or do drugs again. Closing these places made people struggling to stay sober feel like they had an excuse like, ‘oh, my group is closed, so I don’t need to be as disciplined.’
The issue was especially apparent in Dublin.
“We were aware of people being very cut off, and this led to changes in their drug habits. Even people that had been doing well often took to alcohol which then brought them back into doing hard drugs,” said Hugh Greaves, coordinator of the Ballymun Drugs and Alcohol Taskforce, which organises support meetings and works closely with the area’s drug addiction community.
“I’d absolutely say that people have slipped through the cracks because of how challenging things became, and that’s across Dublin, that’s the wide experience of services I know. People who had been doing very well, they could be going six months without being seen [by the support services] and might have started doing crack cocaine, because when they were seen again, they’d be massively underweight and just look very uncared for.”
Limited capacity
Even when services re-opened in the autumn of 2020, support groups still had a massive challenge on their hands. Government restrictions resulted in a dramatic limiting of capacity; usually no more than eight people in an average meeting room.
“We still only have one face-to-face meeting a week in Cork,” Fallon said. He was critical of the Covid guidelines for support groups which have been updated to only allow a maximum of 20 people at a time.
“I’ve been at meetings in hotels with nearly 100 people. Even if we had a [room the size of a] basketball hall, the most I could possibly have [at a support meeting] is 20. The guidelines for us haven’t been updated. No matter how big the indoor setting is, our maximum is 20.”
Now that Covid restrictions are beginning to tighten again, Fallon said the window has passed to increase capacity at his meetings. His service has had to turn away people in desperate need of help, sending them back to deal with their potentially life-threatening issues alone.
The result, Fallon said, was a frightening sight. He described going outside at night and seeing “absolutely no one on the streets in the evening except for drug users, people who were slowly killing themselves.”
Thomas Gould, Sinn Féin TD for Cork North Central and spokesperson on addiction, recovery and wellbeing, has been lobbying the government since March 2020 to prioritise keeping support groups open, an effort, he says, that was met with “dismissal”.
What made it worse, Gould said, was that he knew the government’s indifference was costing lives.
“We’ve had reports from groups about people who’ve been off drugs but became addicted again and overdosed or taken their lives. I think it was a failure of the government to realise how important those meetings were.”
When contacted by The Journal about restricting substance abuse support services during the Covid lockdown, the HSE said, “We need to continue to implement strict infection prevention and control measures across our services in order to deliver care in the safest way possible. Due to the Covid-19 pandemic, in order to maintain social distancing and adhere to public health advice, we are aware that the capacity of residential services has been affected.”
In marked contrast to the response of the Irish Government, substance abuse support groups in the UK were never required to close. However, Sky News reported that up to 20% of the country’s groups closed on their own volition due to Covid concerns.
Rehab Centres
Addiction recovery generally involves more than one type of treatment. People who struggle with a drug addiction usually have a mental as well as a physical addiction, according to the HSE’s National Drug Rehabilitation Framework.
Support meetings and services, like SMART Recovery Ireland and the Ballymun Drugs and Alcohol Task Force, focus on the mental or cognitive side of addiction by helping patients find the motivation and willpower to overcome their abuse.
While these services felt abandoned during the Covid lockdown, the rehab centres in Ireland, which focus on treating the physical side of addiction, also struggled, but for a different reason. They were forced to reduce capacity during the lockdown period.
In December 2019, Ireland had a total of 888 drug rehabilitation beds spread across the country, according to an HSE report obtained by The Journal. When the pandemic struck, the government began converting some of these rehab centres into Covid wards, slicing the total bed count to 680 by June 2020, a 23% fall.
One of the hardest-hit centres was the Cuan Mhuire rehab centre in Athy, Kildare. As one of the nation’s largest rehab facilities, it saw its bed numbers cut from 165 in December 2019 to 113 by June 2020, when the government converted one of its sections into a Covid ward.
Workers in Cuan Mhuire described a grim story of what life was like at the centre when the pandemic first struck.
“We had to change almost everything to be quite honest – we locked down, completely shut down in March 2020,” said Kieran Ryan, an addiction counsellor at Cuan Mhuire. “We ceased taking in people for treatment at that point. We held onto most of the residents we already had, but we couldn’t keep everybody, and we stopped access for families. The only people that were allowed in or out were the staff that were on duty at any time.”
Cuan Mhuire, a government-funded rehab centre, focuses on short term care, and operates on the model of bringing in patients usually for no longer than a week.
Ryan said that as someone who has given his life to helping people through their addiction, seeing so many desperate people being refused the help they needed was heartbreaking.
“There was definitely an increase in people seeking treatment for obvious reasons. There’s no doubt about it, the addiction services did suffer because of the pandemic,” he said. “I think most if not all centres closed down. It’s just common sense to be honest. If the centres are not taking people, they’re not going to get the help that they need.”
The Keltoi Rehabilitation Unit in Phoenix Park saw all 12 of its rehabilitation beds removed when the HSE converted the entire centre into a Covid ward during the beginning of the pandemic.
This meant removing 12 people who were currently receiving care. Keltoi even warned the HSE of the danger that its patients would suffer “suicidal ideation and death” if the centre shut down, according to an investigation from the Irish Daily Mail in June. The centre remains closed today.
Gould said that even if the government could justify closing the centre at the time, he sees no reason why it hasn’t re-opened.
“There were some dramatic cuts to beds due to social distancing. I can accept that, it has to be done. But there was nothing done to move those beds to another facility or a place where those beds could be made back up. They never replaced them. To me, that’s a shocking indictment of how the system treats people in recovery.”
In the UK, people with addictions faced even harsher challenges. The NHS converted over half of the country’s drug rehabilitation centres into Covid wards during the height of the pandemic, according to The Times.
The Sinn Fein TD Gould emphasised how vital it is for the government to listen to what workers in rehab centres and support groups are saying about their situation.
“You can’t really explain what the people working on the ground see,” he said. “The throe of addiction is an abyss. If you haven’t been involved with these services, it’s impossible to explain. You don’t wake up one morning and decide to stop doing drugs, it’s not that simple.”
Knock-on effect
The Coolmine Rehab Centre in Limerick saw consequences of the changes too.
“I know of a particular person that had been doing exceptionally well, was going to programmes every day, and because they lost their bed, they relapsed unfortunately and are back using substances,” said Lynn Collopy, a worker at Coolmine.
For Collopy, she hopes the past 22 months have illustrated just how vital the support systems are for people struggling with substance abuse.
“Now that I’m in the Coolmine setting I can see how important it is, for not only the person who is currently using substances, but their family members,” she said. “The knock-on effect that addiction has on family, or even children – services are needed to be provided for both.”
Derek Byrne, the former manager of a Ballyfermot drug rehab centre and a lecturer in addiction studies at Maynooth University, said he feels the pandemic has just perpetuated how people, and the government, treat people with addictions.
“There are people dying all the time and we don’t get the numbers. People are using Covid as an excuse but it happens all the time,” he said. “I think Covid highlights the inhumanity of the situation in relation to how we treat people in addiction, but it’s nothing new to us who work in the field. The proper care and support weren’t there before Covid, and it certainly wasn’t there during Covid.”
While many rehabilitation centres have re-opened and increased their capacity in the past few months, the total number of beds nationwide is still 111 less than it was in December 2019, registering a 12.5% drop. It means that one-eighth of rehabilitation beds in Ireland have not returned since the pandemic began.
The Department of Health announced a €2 million fund in late December for community-based drug and alcohol services, will be provided between now and March.
However, the outlook for support groups remains uncertain. SMART’s Fallon says the new Omicron variant and subsequent tightening restrictions have not left group organisers optimistic that they will be able to increase meeting capacity anytime soon.
Coolmine’s Collopy says that Irish society needs a broader view of people with addiction issues.
“I think with addiction, the stigma is still there slightly. Some of the best people I’ve met were people who are currently using drugs. It can happen to anybody, I’m a firm believer in that. It can cross anybody, it just doesn’t stop at one.”
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