In 1980, Greenwich Hospital established its Alcohol Recovery Center to help people fighting an addiction to drinking. Over the years, this endeavor was renamed Addiction Recovery Center and its focus was expanded to assist individuals trying to move away from opioid abuse.
According to Joseph Flynn, a psychiatrist and the center’s medical director, the greatest change that this facility has witnessed in the past 40 years is how addiction is viewed by both doctors and the wider society.
“One thing that has changed — and there’s a long way to go in this — is that it’s looked upon less as a character flaw or a moral weakness and accepted much more as a disease,” he said.
“There was a lot of stigma attached to it, but I think with a lot of high-profile people being very public about their struggles with addiction and alcohol, it’s helping normalize it.
“I don’t think anyone chooses this — there are multiple factors that could be genetic predispositions, combined with life experiences, that all combine to manifest this disease. But inherently, that’s the angle that we come at it from now. Whereas in the past, I think it was viewed a little differently.”
Joshua Hrabosky, who is also a psychiatrist and the program director for outpatient behavioral health, added that the “idea of relapse has evolved over the last 40 years. Relapse is a reality and a very likely thing to happen. How we’ve approached it, how we treat struggles with addiction — which encapsulates relapse — evolved, so we come at it with a much more compassionate, understanding approach and help patients try to experience and develop self-compassion for themselves, as well.”
While the center has traditionally focused on outpatient care, the Covid-19 pandemic has forced the majority of its operations to shift entirely to off-site treatment via digital platforms.
“We transitioned pretty quickly to using phone and video telehealth,” Hrabosky said. “I think that the fact that psychiatry and behavioral health can be done very successfully in formats like Zoom enabled an easier transition. Because our program is a group-based program, it took a little more time to transition and get everybody Zoom-organized, but our patients have responded very well to it.
“There are some, understandably, who missed that human-to-human contact that occurs in a group room,” Hrabosky added. “But they also value the benefit of not having to go out into situations where they might feel uncomfortable due to Covid. Being able to receive the support in such a time of isolation has been very successful.”
During the pandemic, the center has seen an increased volume of inquiries from individuals who’ve fallen into alcohol addiction. One might imagine that the initial lockdown protocols contributed to the problem when liquor stores were deemed an essential business and were allowed to remain open. Flynn admitted that he thought this decision was “ridiculous,” but he quickly changed his mind.
“If someone is drinking heavily and they don’t have access to alcohol and go into acute withdrawal, that’s a potentially life-threatening situation,” he explained. “And no one was coming to the emergency room, other than for Covid. On a secondary analysis, it was actually a pretty good thing — for some people, it might have kept them alive.”
The center currently works with roughly 100 individuals who range in age from their early 20s to earlier 80s. Despite some significant age differences, the center’s group session often generates cross-generational bonding experiences.
“It makes for a much richer experience,” Hrabosky said. “When there are a lot of younger folks with the older folks, sometimes the older folks can take them under their wing a little bit. It becomes a much more educational process.”
Looking ahead, the center is planning to increase its focus on individual psychotherapy and family therapy.
“Our focus is building on that to a much greater degree,” Hrabosky said. “By supporting the patients on an individual basis, they will be able to meet with an individual therapist to work on issues commonly associated with substance use, such as depression, anxiety and past trauma. That’s going to be a big focus in 2021.”