The COVID-19 pandemic has challenged nearly every part of the health care system, and addiction treatment providers have been among the most affected. Unlike some areas of behavioral health care that can quickly pivot to telehealth, substance use disorder (SUD) treatment often depends heavily on in-person connections, medication access, and community-based support. For people in recovery, isolation can be dangerous, and providers are under pressure to balance safety with continuity of care.
This balance has required creativity, resilience, and cooperation across the industry. Providers are adapting rapidly, implementing new safety protocols, and leaning on one another for solutions that protect patients while still addressing the life-threatening nature of addiction.
The Risks of Isolation in Recovery
For individuals living with SUD, social connection is more than a comfort—it’s a protective factor. A spokesperson for American Addiction Centers (AAC) explained the stakes clearly: isolation lowers dopamine levels, the very neurotransmitter that people in recovery often struggled to regulate while using substances. Without connection and support, relapse risk can increase dramatically.
This makes the pandemic especially dangerous. While social distancing protects physical health, it can endanger recovery progress. Providers, therefore, face the unique challenge of fostering connection in safe, innovative ways.
Adapting Care at the National Level
AAC, the only publicly traded addiction treatment provider in the U.S., has taken swift action to keep operations running across its 11 inpatient facilities, 24 outpatient centers, and four sober-living residences. Measures include halting visitation, instituting strict screening protocols, limiting facility access, and increasing cleaning intensity.
Despite these precautions, AAC emphasizes that its doors remain open. “We must also be mindful of the 131 people who die every day in the U.S. from an opioid overdose,” an AAC spokesperson noted. “We have a duty to provide lifesaving care.”
Similar stories are playing out across the country. Providers are tightening infection control practices while refusing to let the pandemic derail their mission.
Leaning on Collaboration
In such uncertain times, collaboration has become one of the most valuable tools. Bob Ferguson, a board member of the National Association of Addiction Treatment Providers (NAATP) and CEO of Alpha180 in Austin, Texas, emphasized the importance of reaching out. When his team encounters an obstacle, their first instinct is to call other providers and ask, “What are you doing about this?”
Ferguson, who also founded Jaywalker Lodge in Colorado, has seen firsthand how community collaboration fuels innovation. Providers across the country are sharing strategies, successes, and lessons learned in real time, helping each other adapt quickly to ever-changing conditions.
Keeping Spirits High in Residential Care
Residential providers like Alpha180 and Jaywalker Lodge are not only increasing cleaning and emergency preparedness but also working to maintain morale. Recognizing that “shelter in place” can feel stifling, Ferguson’s team is making lifestyle adjustments to keep clients engaged.
From adding PlayStations and Pelotons to expanding Netflix subscriptions and converting group rooms into recreational spaces, providers are embracing creative solutions. Outdoor activities remain a staple, offering fresh air and structure to daily routines. These changes may seem small, but they make a meaningful difference in helping patients feel supported rather than trapped.
Outpatient Challenges and Telehealth Expansion
While inpatient facilities have more control over environment and safety, outpatient centers face steeper challenges. Patients may be hesitant to come in, or they may miss appointments altogether. Recovery Centers of America (RCA), which operates seven inpatient and 10 outpatient facilities, has already seen no-show rates rise at its outpatient centers.
To adapt, RCA is rapidly developing telehealth capabilities. This aligns with new federal regulations that expand flexibility for virtual care. For example, the Drug Enforcement Administration (DEA) now permits clinicians to prescribe certain medications following virtual visits, even without prior in-person contact.
The Substance Abuse and Mental Health Services Administration (SAMHSA) has also relaxed rules, allowing patients to take home larger supplies of medication-assisted treatment (MAT) drugs. Stable patients can now receive up to 28 days of medication, reducing the need for frequent in-person visits while still maintaining continuity of care.
Federal Flexibilities and State Uncertainty
In addition to changes around MAT access, the federal government has eased restrictions related to HIPAA and 42 CFR Part 2, giving providers more freedom to share necessary information and use everyday technology for telehealth. These moves have been broadly welcomed by providers, but they don’t solve everything.
Sarah Johnson, chief medical officer at Landmark Recovery, praised the federal changes but pointed out a major concern: state-level regulations often lag behind federal updates. Providers can feel uncertain about what rules truly apply, creating confusion and risk. “It would be really helpful if state governments and medical boards could align with federal standards and make that clear to their providers,” Johnson explained.
Admissions, Discharges, and Patient Engagement
At Landmark Recovery, which operates residential facilities across Indiana, Kentucky, and Oklahoma, admissions have held steady, but early in the pandemic, stricter visitation policies led to a spike in discharges. Some patients were uncomfortable with the restrictions, and providers had to work harder to reassure families and maintain engagement.
This highlights the delicate balance providers must strike. Safety measures are necessary, but they must be paired with strong communication to avoid undermining treatment progress. Providers are learning that proactive, transparent communication with patients and families is key to sustaining trust.
Finding Opportunities in Crisis
Despite the immense challenges, many addiction treatment providers are finding silver linings. The expansion of telehealth, though born out of necessity, could have long-term benefits. Greater flexibility in prescribing and medication management may become a permanent feature, increasing access for patients who live far from clinics or have mobility issues.
Providers are also discovering new ways to foster connection. Virtual group meetings, creative recreational activities, and stronger industry collaboration may outlast the pandemic, ultimately strengthening the field.
Looking Ahead
Addiction treatment providers know that the stakes are high. The opioid epidemic has not paused for COVID-19; in fact, stress, isolation, and economic hardship may increase the risk of substance use and relapse. That makes the work of providers more critical than ever.
By adapting quickly, sharing knowledge, and advocating for clearer regulations, providers are not only weathering the storm but also shaping the future of SUD care. The pandemic has tested their resilience, but it has also highlighted their dedication to saving lives, no matter the circumstances.
As AAC reminded the industry: while the coronavirus presents new dangers, addiction remains a deadly crisis. Providers cannot—and will not—close their doors. Instead, they are stepping up, innovating, and proving that even in the most difficult times, recovery is possible.
