Dispatches from quarantine: Denver’s Detox clinics are a forgotten niche in the COVID frontlines
"It's been strange to see all this, from our world."
The front lines in the fight against COVID-19 are broader than anyone might imagine.
Throughout the onset of this pandemic, nurses, doctors, EMT’s, grocery store workers, and many in the alcohol and cannabis industries have all been working tirelessly, exposing themselves and putting their own safety at risk to keep us fed, to keep us high and happy, and of course, above all, to keep us healthy.
But there are forgotten corners of the frontline, too — niches of that battlefront that often get overlooked.
One such forgotten corner, are our detox clinics. Both the clients and the workers at these centers are being exposed to strangers constantly; they are coming and going from hospitals, and interacting with one another in close proximity (face-to-face more often than not). Many of the clients are homeless, and have nowhere else to go; all of the clients are either intoxicated or in the process of detoxifying; and few, if any, have been tested for COVID-19 — staff included.
“Being in a pandemic like this, and not having any medical staff here, but being kind of treated as a medical facility has been really hard.”
That’s Elaina. She works as an assistant program director at a detox clinic in the Denver area. She works on the floor and off the floor doing… well, kind of everything — from overseeing the peer program, to helping with clinical training, electronic computer training, onboarding, coverage out on the floor — the works.
And things in her clinic have been somewhat tense since the pandemic came to Denver.
“I think that the staff who are on the floor every day have felt overwhelmed,” she says. Many of her coworkers have been questioning their own safety, and the measures their executives have enforced. They’re struggling with how they’re being told to respond to the virus on the ground, while their administrators work comfortably from home.
“The staff anxiety is about at a 10. Everyone's patience is running thin and a lot people are just getting triggered a lot easier.”
Elaina explains that, their census has been lowered, so there are fewer clients in each room, to better enforce social distancing. People are being encouraged to take one day off a week (though, they’re also offered hazard pay if they don’t).
“Anybody who's on a unit has to wear a mask at all times, we have gloves as optional and then we have hand sanitizer everywhere in the office,” she says, adding, “But we can't leave that out on the floor because the clients will drink it.”
One of the biggest changes, though, which Elaina points out, is that the police can no longer arrest clients breaking the law, because they can’t take anyone to jail. Their reluctance to intervene or get involved at the clinic is higher than ever.
“Straight up, I saw two cops do nose-goes in our doorway to see who was going to be the one who had to step inside and go talk to one of our clients,” Elaina
tells me. They’ve had people pull fire-alarms (a felony offense), people getting aggressive with staff, damage property and even make threats against the detox staff — and the police have done next-to-nothing to help.
Elaina describes how one client checked in intoxicated, fell asleep, woke up and decided he wanted to leave. But, detox doesn’t really work like that, they told him — once you’re in, you stay until you’re sober and stable.
The man, disgruntled by this news, waited until one of the clinic’s shift coordinators was walking past his room, then leapt out and grabbed her, shouting, “Now you’ve got COVID!”
They called the police. And the police showed up, though, they didn’t do much of anything beyond that. They said it wasn’t something they couldn’t take action on and simply told the man to leave.
“The police didn't take it seriously,” Elaina says. “If all they're going to do is stand in the doorway and tell the person to get out, like, we can do that. We don't need to call you for that.”
Things haven’t just been intense for the addiction techs, the drivers and directors like Elaina, either. Around 25% of the people who come through their facility are homeless and have nowhere to go.
“Some of them are really, really scared. It's really sad,” Elaina says.
She sat with one client who was in a state of sheer panic, she tells me. He had a debilitating alcohol problem and knew that it was putting him at risk. He was terrified of going to a shelter: mortified by the idea of being crammed into such close quarters with so many strangers; afraid of being offered a bottle or cigarette, that he couldn’t refuse.
“The way his voice sounded, he was truly scared for his life. And he felt like he had nowhere to turn,” Elaina says. “Which is something that we can only offer so much for. How are we supposed to offer this person hope when he has zero resources, zero money, zero ability to find himself somewhere better to go, everything is shut down, and he can't stay with us forever?”
It’s a grim situation. One that many homeless people across Denver and the US at large are finding themselves in. And sadly, some hospitals are using detox facilities like the one Elaina works at as a dumping ground for such individuals. In order to free up bed-space, some hospitals are passing off homeless or drug-addicted patients, who might have been directly exposed to COVID. And they aren’t always being honest when they do so.
“Some of the hospitals have been lying to us about client symptoms,” Elaina says. They’ve received clients from hospitals who they’ve had to discharge immediately because they are coughing, have a fever or flu-like symptoms. And then, that person is out on the street — with nowhere to go, and potentially carrying the disease with them.
There’s nothing they can do about that, either. Without putting themselves and all the clients in their facility at risk, they simply cannot afford to take in anyone who could infect everyone.
Elaina has maintained hope through all this, though. Despite the bleak situation and the stress she and all her peers are dealing with; despite the spotlight on the fight against COVID being focused elsewhere, she still feels encouraged by her coworkers and her community.
“There's been a lot of love and support from our own internal team,” she says. And some community members have made them cough masks, dropped off food, and thanked them with bouquets of flowers. “A lot of people have stepped up and really offered great support for us during this time. So, it's not all bad.”
For people working in detox clinics like Elaina, this pandemic has brought with it a whole host of new challenges. They’re dealing with risks they never could have anticipated, and handling situations without the help they normally get from police and hospitals.
But they keep on showing up every day — and they do so because they know how badly they’re needed. Detox may be a forgotten corner of the COVID frontline, but it’s one that’s serving one of the most at-risk populations in America — it’s one that is serving a huge and very necessary purpose.