‘They’re so vulnerable and fragile’

Karen Cotler, DNP, FNP-BC, FAANP, clinical assistant professor at UIC College of Nursing

Karen Cotler

Most Fridays, clinical assistant professor Karen Cotler, DNP, FNP-BC, FAANP, can be found at the West Side location of the UIC-run Community Outreach Intervention Project (COIP), providing primary care at the busy needle-exchange site.

But like so many other places, the COIP clinic has had to adjust operations to prevent the spread of COVID-19, encouraging over-the-phone ‘visits’ with providers instead of in-person ones. In the office’s small quarters, there would be no way for patients to practice social distancing.

But Cotler says she worries about these patients in particular: As drug users, they are susceptible to overdose and other health issues, such as serious wounds at injection sites.

“What’s happening with COIP population is frightening,” Cotler says. “So many are socially isolated, and when they’re alone, they’re more likely to overdose.”

Cotler says she and the other clinicians who work at the COIP clinic called their entire roster of patients, but given the instability inherent in the population, some phones were disconnected and others were wrong numbers. Cotler says she felt glad to be able to get some patients a month-long prescription of Suboxone, rather than the usual seven day prescription, “so they don’t OD while this is going on.”

One small success was when she helped one patient, blind in one eye who lives alone, find a nearby elementary school where he could get some food.

“They’re so vulnerable and fragile,” she says. “We hope for the best and expect the worst.”