Last year, when the COVID-19 lockdowns began, Marvin Vereen had been in recovery from a heroin addiction for nearly three years. Over that time, he’d entered addiction treatment, attended recovery group meetings, and found housing and stability in a North Philadelphia recovery housing program.

Then, the pandemic hit — and the support system Vereen had built up over the years changed dramatically. He couldn’t attend support group meetings, or see his family in person, fearful of getting or spreading the virus. Recovery by phone, he feared, wouldn’t be the same.

For many people in recovery, public-health measures such as social distancing and isolation flew directly in the face of what they’d found crucial: connection, not isolation; community, not seclusion.

Sure enough, fatal overdose rates soared during the pandemic to levels never before seen.

» READ MORE: 2020 marked Philly's second highest drug death toll on record

But Vereen and others managed to stay in recovery, relying on advocates and treatment workers who pieced together a safety net, and on techniques they’d learned before COVID-19 struck.

“It was a whole lot of change — once the pandemic came, we didn’t have no meetings. And if it was a meeting, we would have a meeting over the phone. That’s not like being there. But I just learned to talk to people — and I’m not a people person,” said Vereen, 51. “I had to learn to trust people, and that allowed me to trust myself.”

The treatment clinic he attends, across the street from Ife Wellness Center, where Vereen has lived for 16 months, was a rare in-person lifeline. “I have a wonderful counselor over at the clinic that’s always in my corner. If I needed to talk, she would be there,” he said.

Ronald Romano, 42, entered recovery during the pandemic, going through inpatient treatment and then moving into recovery housing. After nearly seven years on the street with a heroin addiction, he finally listened to a woman who offered him a chance at treatment along with the sandwiches she gave him at his regular panhandling spot at Broad and Vine Streets.

“During the pandemic, they wouldn’t let us leave the house, you couldn’t go see your family — you couldn’t do anything, really,” he said. “I’m on methadone, and they took me to my clinic and back. Couldn’t go to [Narcotics Anonymous] meetings — that’s a good support system.”

Still, he said, life on the street had become even more unbearable than those challenges. “All those problems you face being homeless — not knowing where your next meal is going to be, whether you’ll be sick or well. There’s worse things in life than being isolated.”

Romano now lives at Safe Haven, a housing program run, like Ife Wellness Center, by SELF Inc., the city’s largest emergency housing provider. With 14 months of recovery under his belt, he prides himself on the way his mother’s face lights up when he visits her now. He’s hoping to soon become a peer specialist, helping others in addiction navigate treatment.

He knows the need too well. He lost two friends to overdoses during the pandemic.

Support for the supporters

Kenya Edwards, the program director at Safe Haven, said it has been a rough year for clients and employees. Some treatment centers shut down or dramatically reduced intakes. Case managers who usually showed up to work with clients dropped off. The staff had to find ways to improvise life skills group meetings and other support systems for people who could be together because they lived in the same recovery house.

“Part of recovery, for some people, is building a routine,” said Michael Hinson, SELF Inc.’s CEO. “When you don’t have that routine, you begin to question what you should do. And not only did they not have the routine, they also didn’t have the support system. It really put people in a tailspin.”

For many of SELF’s participants, who don’t have much income, private insurance and even stable housing, options for treatment and case management were scarce during the pandemic. Stress and uncertainty were high, and no one saw that more clearly than the people trying to help others maintain recovery.

Nicole O’Donnell, a peer specialist at Penn Presbyterian Medical Center who is in long-term recovery, lost three clients.

“We started a ‘peer support for peer supporters’ meeting,” over Zoom, O’Donnell said. “We were all losing people. We had to … try to help people not die. How are we going to handle this, reach our people, and stay in recovery ourselves? Processing with our peers is literally what got us through.”

‘There’s nothing you have to handle alone’

O’Donnell and her colleagues at Penn launched a virtual clinic to get people into care without having to enter a hospital, since many clients were afraid, in the early days of the pandemic, to visit an ER. They also worked to get relapsed patients back on medication.

The mobile overdose prevention program run by Prevention Point, the public-health service that serves people in addiction around the city, recruited patients off the street. “There were a number of patients who had fallen out of care at one point or another during the pandemic, and were interested in getting back into it,” said Maggie Lowenstein, a Penn physician who also works with the mobile program. “They were just walking down the street and saw what we were up to.”

At Caron Treatment Centers, which runs an outpatient facility in Plymouth Meeting and an inpatient center in Wernersville, the program specifically for people who relapsed was “just about full during the pandemic,” said Kate Appleman, Caron’s senior clinical director of men’s treatment and clinic support. “We are really ensuring that we are supporting people and getting the right level of care, both in treatment and post-treatment, so they have enough connection,” she said.

Even for Caron’s patients who do have stable homes and incomes, the pandemic-imposed isolation might have been harmful. So the team recommended sober living environments for some people instead. And they checked in on prior clients they thought might relapse.

“Our alumni department did three times the amount of outreach as they normally did,” she said. “If you were here in the past five years, you got a phone call and a connection. And some people came back in.”

Jacqueline M., a former Caron patient who did not want her full name used to preserve her privacy, is five years into recovery from an addiction to alcohol and pills. She said her experiences — including an overdose that nearly killed her — and the peace she’d found in sobriety had kept her strong during the pandemic.

During lockdown, she attended 12-step meetings on Zoom, tried to spend time outdoors, and did her best to stay connected with friends. Now, with lockdowns easing, she’s attending recovery meetings in person again, and watching herself for the urge to withdraw from others.

“Isolation is where my addiction wants me to be,” she said. “So when things are bad — with the pandemic — and when things are good, what I do is the exact same. Go to meetings. Stay connected. There’s nothing you have to handle alone.”