How the COVID-19 Pandemic Lowers the Likelihood of Addiction Recovery
The global Covid-19 pandemic has proved difficult for people in all situations but perhaps one of the worst affected groups are those who are battling drug addiction or alcohol addiction. Times have been uncertain and access to various facilities and treatments limited. This has translated into an unfortunate situation for many people struggling with alcohol and substance misuse, heightened by the anxiety and uncertainty of lockdown.
For many people who struggle with addiction, the difference between success and failure can be a support group or a doctor’s appointment, yet these services, which are often taken for granted are no longer widely available. But what does this mean for the mental health, safety, and success of those trying to overcome addiction?
Increasing Use and Misuse During The Pandemic
For the most part, when we think about addiction, we think about drugs and alcohol but it is important to remember that addiction can take many forms such as shopping, sex, and gambling to name a few.
For many people, engaging in these addictive behaviours is a way of coping with the stresses and strains of everyday life, and with lockdown proving to be one of the most stressful situations of our lifetime, it is little wonder that people are turning back to these behaviours. [1]
With many people in complete isolation during the lockdown, the support and human contact that they are used to is removed and this has directly translated into a more profound misuse of substances as a way of relieving their anxiety and upset. What’s more, many people are beginning to develop an addiction to alcohol as a result of drinking out of boredom.
Where drugs are concerned, many people were stockpiling or accessing less pure forms of their chosen substance which could ultimately lead to overdose or death. Whilst patients would normally access support from their GPs, this privilege has been as good as removed with surgeries now taking only virtual appointments for the most part.
The Pandemic & Risks oF Turning to Harder Drugs
The common social drugs such as cocaine and cannabis may be used less during lockdown, however, those who struggle with addiction to drugs may begin to use more powerful and harder drugs as a way of coping. Experts have predicted that those whose drug use is relatively light may increase their use throughout the pandemic which could result in more deaths from overdose and more cases of drug dependency. [2]
One of the key elements is that whilst some people will use the lockdown as a way of finally winning the battle over their addiction, others may turn to harder drugs once their supply of less hard ones runs dry, simply as a way of eliminating any emotional pain or distress they are experiencing.
Risk of Relapse During Lockdown & The Pandemic
With reports of a decrease in inpatients at rehab facilities in recent months, it is clear that relapse may be a serious problem related to the pandemic. Many people who have been treated for addiction and are in recovery may be under the false impression that, unless they require treatment for Covid-19, they will have to go it alone, whilst this is not true, it is certainly having an impact.
The good news is that addiction treatment centres remain open to both new patients and those who are facing a potential relapse and these facilities are working hard to adhere to the new safety rules surrounding the pandemic. There is also a range of virtual support services to further aid those who may be susceptible to relapse. [3]
Limited Access to Clinics During The Pandemic
Society is functioning in a way that it never has before and access to support groups and clinics has become very limited, and in some cases non-existent, with things such as 12-step programs now been done virtually.
For many people struggling with addiction, their doctor’s surgery was the first port of call when trying to access support but most GPs are now operating on the telephone and virtual calls and access to these is limited. This is having a direct impact on those seeking help for addiction.
However, many drug and alcohol organisations are making it clear to people that they can self-refer and access support – but are people hearing this message? With referrals in the both the public and private health sectors taking a massive decrease, it is unlikely.
The Pandemic & Patients Undergoing Therapy
One of the key aspects of recovering from addiction is the support of family, friends, and professional counsellors but the lockdown has forced people back into the isolation they were once subject to in the throes of addiction.
Where therapy is concerned, to achieve success, this must be consistent and there is great concern that the lack of therapy may have an impact on the success rates of those who have been in recovery.
Furthermore, the fear of coronavirus and with social distancing in place, it can be difficult for patients to find the drive to attend any therapy sessions that may be taking place – virtual or otherwise. This can swiftly cause them to revert back to their previous, destructive behaviours. People may not return to their previous chosen substance, but may move on to something different, especially if they have been taking medications to suppress the effects on substances. [4]
Additionally, with services now stretched to their maximum in the healthcare sector, it is more difficult to obtain appointments and medications as freely as we used to meaning that those battling addiction may not receive the consistent care they require.
Online Meetings: Heroic or a Hindrance?
Many people are now working from home and if the same space is being used for work meetings as it is for fellowship with other recovering addicts, this can blur the lines and be problematic for some people.
What’s more, there simply isn’t the same connection online that we would get in real-life and a lot of the time, there are issues with Wi-Fi, people leaving the group or blank screens that turn what was once a personal experience into something very robotic and disjointed.
Moreover, there has been a surge of ‘bombers’ who will enter into group chats with the sole purpose of causing a disruption which can be detrimental to the focus of the group.
The Absence of Contact In The Face of The Pandemic
Human contact is so important for all of us but perhaps even more so for those who are recovering from addiction and this contact is taken away with online meetings simply not providing enough support. When using an online conferencing service such as Zoom, things can often go quiet which takes away from the entire experience and leavers members of the group feeling as though they are talking to themselves.
Whilst addiction is a disease that causes people to isolate, it is not until that option is taken away that folk really start to appreciate that human contact and with no option for this it can lead to feeling depressed and further isolated.
As the world places its attention on the Coronavirus pandemic, there is another pandemic that is going unnoticed – opioid use, and it is worsening as Covid-19 takes the spotlight more and more. With much more limited access to support, those dealing with addiction are being left to almost fend for themselves and this is having a direct impact on their health. Frequently leading to worsening drug use.
One of the key components of opioid addiction treatment is collecting medications, in person, from the medical centre. But this is no longer as simple as it once was. Not to mention that it makes social distancing increasingly challenging. In turn, this could increase the number of COVID infections resulting in a greater strain on the health services.
Furthermore, with limited travel, the usual influx of drugs into the country is significantly lowered which could mean that people are more likely to cut the drugs with dangerous chemicals, leading to serious health complications for those who take them. With the stress of lockdown proving to be a factor in many relapses, this could also lead to an increase in the number of overdose cases and deaths. [5]
Prescription Drug Shortages in the US
Due to the outbreak of Covid-19 beginning in China, many manufacturers of medicines in the country have been forced to close down. It is thought that as much as 90% of prescription drug ingredients come from China, so it comes as no surprise that the US may face running low on supplies.
Of course, many of those dealing with addiction rely on medications for their recovery and if this shortage becomes a problem, this could result in people relapsing or escalating their substance use.
The Dangers of Home Detox During The Pandemic
Detoxing from drugs or alcohol at home can be dangerous at the best of times, but during the pandemic, there are additional problems. Detox can cause very unpleasant withdrawal symptoms that often require medical care to manage. During the pandemic, if you were to experience any complications whilst detoxing, medical help may be more difficult to access.
If patients are unable to access care so readily, this could lead to many failed attempts at getting clean which could ultimately cause emotional distress and mental health complications such as depression. In turn, these problems may lead to further substance use creating a vicious circle that patients cannot get out of.
How to Correctly Self-Medicate If You’re Addicted to Alcohol
It is important to realise how serious a condition alcohol withdrawal can be and so for those who struggle with alcohol addiction, stopping drinking suddenly is never a good idea. But there are some effective ways of being successful with a home detox and the following steps will demonstrate this: [6]
- Keep a drinking diary which should include how many drinks you have had, when you had them, and how many units they consist of
- Make an attempt at spacing out your drinks across the day rather than drinking them altogether. Do this for at least one week
- Once you feel that you have your drinking stabilised, you can gradually begin to cut down. This should be done by removing no more than 10% of your daily intake every four days
It is also important to keep your mind active and engage in activities that will take your focus away from drinking alcohol such as going for a walk, doing some reading, or meditating. Your physical health is also important so be sure to stay hydrated and eat a balanced diet.
Pandemic Travel Ban & The Rise of Adulterated and Toxic Substances
As a result of bans on travel across the globe, there is a significant shortage of pure substances for those who are addicted and this is directly translating into wider use of adulterated and toxic substances that potentially stand to cause serious harm. Furthermore, due to a fluctuation in prices, many people battling addiction are stockpiling drugs, or worse, engaging in illegal activity to get a hold of them.
If people who are addicted to substances are unable to access their preferred substances, this can lead to changes in mood and personality which ultimately leads to aggression and dysfunction in social relationships. In order to solve these problems, some people are taking to creating their own alcoholic beverages using alcohol that is not designed to human consumption or mixing substances and alcohol putting them at risk of serious health complications.
Isolation In Lockdown May Mean A Spike in Overdose Deaths
One of the major causes of addiction is anxiety with many people using substances to quell this feeling and during the lockdown, anxiety levels have been through the roof for a lot of people. This can lead to an increase in how much of a drug is being taken by any one person. The most dangerous and concerning part of this though is that because users are now taking drugs alone, there will not be anyone else present to call for help should an overdose occur.
That being said, even if help is summoned, it is likely that it will not arrive as promptly as we are used to, in which case, it could be too late. If patients are taken to hospital, the overwhelming demand for COVID patients means that they may not receive the life-saving treatment that they need as quickly, leading to further complications or even death. [7]
Most disturbingly, however, is that there have been worldwide reports of police refusing to administer naltrexone, as they may usually do for fear of the person regaining consciousness and coughing potentially infected droplets onto them.
Continuity of Care for Those Struggling with Addiction During the Pandemic
One of the most important things that will ensure care is given to those struggling with addiction during the pandemic is to be certain that rehab facilities and other support services have the resources they so desperately need but also that the staff is correctly protected and that procedures are followed. Additionally, careful planning is imperative if services are to remain consistent.
Since drug services are considered essential, they will continue to operate throughout the pandemic. However, it is important that each of these services has a contingency plan should there be a shortage of medication or staff. It is also vital that these services are prepared for sick days and have an appropriate cover where necessary as well as introducing ways of delivering care whether this is in temporary buildings or at the patient’s home. [8]
Furthermore, it is important for services to address whether face-to-face support is necessary or if services can be provided remotely. This is of particular importance when looking at the homeless community, in which, there are many people struggling with addiction.
Whatever outcome governing bodies and public health organisations decide, there is no doubt that substance abuse and addiction is as much as an evergreen issue than the coronavirus pandemic.
References
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282772/
[2] https://www.theguardian.com/society/2020/may/03/coronavirus-crisis-could-increase-users-drug-habits-report
[3] https://www.bbc.co.uk/news/uk-northern-ireland-52811931
[4] https://www.drugabuse.gov/about-nida/noras-blog/2020/04/covid-19-potential-implications-individuals-substance-use-disorders
[5] https://www.wdp.org.uk/coronavirus-opioid-substitution-therapy-ost-support
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085800/
[7] https://www.npr.org/sections/coronavirus-live-updates/2020/08/13/901627189/u-s-sees-deadly-drug-overdose-spike-during-pandemic
[8] https://www.gov.uk/government/publications/covid-19-guidance-for-commissioners-and-providers-of-services-for-people-who-use-drugs-or-alcohol/covid-19-guidance-for-commissioners-and-providers-of-services-for-people-who-use-drugs-or-alcohol
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