Why Hurricanes are a Huge Test for Addiction Treatment

When the skies fall and floodwaters rise, what happens to people in recovery?

Image courtesy of Flickr.

A third of Florida residents were told to evacuate before Hurricane Irma hit the state. Tens of thousands of homes have been impacted by Harvey-induced floods in Texas. Natural disasters like these can turn anybody’s life upside down. But if you’re recovering from problematic substance use, things get even harder.

In the mental health literature, storms like the kind hitting the Gulf Coast are called “Big Events”—complex emergencies that, like political or economic crises, can cause widespread destabilization in a region. They’re a huge source of stress for anyone involved, and while they often bring out the best in people, they can also lead to mass cases of PTSD for the surviving communities. Even if you have expert coping skills, these events can be overwhelming. If you used to use a substance to cope with difficult emotions—the hallmark of problematic use disorders—a natural disaster can increase the chance of relapse or overdose. And historically, supporting people in treatment hasn’t been the kind of thing that disaster planners and urban designers account for when readying for historic weather events, even though hospitals shut down and clinics close before the storms hit.

But, as Carla K. Johnson and Nomaan Merchant report for the Associated Press, preparations had been made for Harvey and Irma. In Texas, Louisiana and Florida, some patients were able to take days’ worth of methadone (which helps people get off heroin or other opioids) with them or received it in shelters. More than 400 doses of Narcan, which stops opioid overdoses, were distributed in Florida, and 500 have been distributed across the Texas coast as cleanup continues.

“There’s people that are going to be without jobs and without homes because of this hurricane,” Mark Kinzly, co founder of Texas Overdose Naxolone Initiative, told the AP. “They’re going to be less stable in their overall lives to begin with. That can be dangerous.”

This kind of preparedness is the fruit of hard-won wisdom. Public health researchers who studied Hurricane Katrina in New Orleans and Superstorm Sandy in New York dug into the volatility that those storms brought into the lives of active drug users. Following Sandy, a team from the Institute for Infectious Disease Research interviewed 300 people who injected drugs in Manhattan’s Lower East Side. A full 70 percent of people who were on methadone and other opioid maintenance therapies at the time didn’t get the doses they needed, and more than 40 percent of HIV positive participants missed HIV treatment doses. On a more hopeful note though, more than a quarter of respondents rescued others from floods or accidents or volunteered with aid groups.

But around the Gulf Coast, agencies and treatments centers are getting ahead of the storms. To Dr. Hansel Tookes, who runs a needle exchange in Miami, the point is to help users not only help themselves, but to help other users, too. “We want to make sure all of our [patients] have Narcan so they can save lives and be first responders in the storm,” he said to the AP. It goes to show that while Katrina and Sandy were both tragic, they helped prepare us for the extreme weather we’re facing today in a multitude of ways. 

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