A Disease Wrapped in a Pandemic

Our nation has been at a high state of alert for the last several months. The immediate threat of the virus is not the only challenge we face. Currently, financial and emotional impacts are being felt and may continue to be pressed for time. As we struggle through the damage that has resulted from COVID-19, it can be easy not to pay attention to other problems. One topic that the public may not be paying attention to is substance misuse. That problem is not being ignored by individuals and families recovering from substance misuse or those still struggling with it.

What makes it difficult is support systems are compromised. In-person support meetings are virtually nonexistent now, and individual therapists may not be available. Privacy and technology obstacles can hamper access to online resources. Coping techniques used to address urges associated with substance use are unavailable. Or they are limited due to stay at home (which most states are enforcing).

During times of stress, we usually seek to increase drug and alcohol use. After Hurricane Katrina hit New Orleans, hospitalization rates for alcohol disorders increased (35%), and consumption of alcohol (and problems related to alcohol) increased as well (source). When terrorists attacked New York (911), residents had an increase in substance use (source). There are examples to illustrate this point. In times of stress, individuals turn to substance use for a way to cope (source).

In our current crisis, there has been a significant increase in alcohol sales (Nielsen figures). The reasons for this could vary. Individuals stockpiling alcohol and boredom are also other reasons we see this rise. Some suburbs are even relaxing their standards, allowing the purchase of alcohol. They are enabling curbside pickup of purchases.

The relationship between stress (what we are all experiencing now) and substance misuse is substantial. It is a risk factor for substance misuse. It affects or ability to reason as well. It can lead to poor decision making and impulse control issues. Both are detrimental to those in recovery and trying to maintain abstinence. Add boredom and disruption in our schedules, and this lends itself to further risk.

It is essential to recognize that individuals who have been abusing substances, generally, are not in good health. Chronic use takes its toll on the body. Vaping and other types of substance use create respiratory problems with regular users. That would make them more vulnerable to getting COVID-19/. Infrequent visits to the doctor could also present additional risk factors for COVID-19.

Familiar sources for illicit drugs may not be available. Drug users could create the desire to seek out their drugs through unfamiliar means. They are putting themselves at higher risk for overdose. Also, for those on maintenance programs such as Methadone, Buprenorphine, and Suboxone, typically require for in-person check-ups and administration of the drugs. Medical offices closing and lack of transportation create issues with them receiving their medication. Substance users will then turn to other sources.

Additional factors to consider that impact on recovery or increase of use would include:

  • Irregular sleep patterns
  • Lack of structure
  • Isolation
  • Poor eating habits
  • Difficulties in concentration

It is essential to understand that addressing a substance misuse issue is stressful enough. During a crisis such as one we are experiencing; it makes it even more challenging. That does not make it hopeless. There are important considerations to keep in mind.

First, substance abuse disorders are consuming, overpowering, and destructive. Most people are aware of this. It is not breaking news. It is important not to underestimate how difficult it is for addicts/alcoholics/abusers. Even after years of abstinence, individuals can return to their use. Despite the impact it had on them, and most likely will have again. Those in recovery must work hard at maintaining their sobriety, even years into their recovery program. They are always one drink, or one hit away from returning to the destructiveness world of their addiction. Routines help maintain sobriety. Relationships help avoid temptation. Rational Thoughts(sober) are worked on daily, in some cases, with great effort. Our current crisis throws this all out of balance—individuals at a higher risk for relapse or ongoing use escalating to harmful levels.

Establishing routines in recovery is important. Impulsivity, boredom, under-stimulation are factors that will lead to relapse. For those in recovery, urges can be intense. The longer they continue, the more intense they become. The less engaged we are, the stronger the part of our brain (reward center) will try to convince you to satisfy itself (using alcohol and drugs). Here are some suggestions:

  • Set goals, both short term and long-term ones. These goals should be realistic, as well as challenging.
  • Create a schedule for yourself. Committing it to write increases the likelihood of completing them. It also holds yourself more accountable.
  • Incorporate brain breaks. Not mindless tasks or breaks that take a lot of emotional energy/ But stimulating breaks. These could include taking a virtual tour of a museum or a puzzle. Brain breaks can vary according to individual needs.
  • Understand times of day you find more challenging. Engaging in activities during these times will make it easier. Just thinking about these times will give you an advantage in minimizing urges.
  • Scientists and the government feel social distancing is the safest choice for everyone. Understandably, the decision to maintain safe distances is important. However, the social part of the definition is misleading.

Relationships are essential for everyone. Human beings need social connectivity. It is hard to exist without feeling connected to someone. Those in recovery must work particularly hard at maintaining their social networks. Particularly true for those who are a part of sobriety-based support groups. In-person meetings are nonexistent during the quarantine. There are online groups, but for some, they are not the same. Some areas to keep in mind would include:

  • Utilize online support group resources. For some individuals, they may not be the same as in person. Online support groups will still offer a connection to a sober community. Benefits derived from support groups can be received virtually. If you are not finding what you need from one group, try another group. You can even start an online recovery group. Many of the platforms offer this, and the additional costs in getting it set up would be worth it. Especially if you consider the costs if you relapse (emotional and financial).
  • Relationships do not have to center exclusively around other recovering individuals. Reach out to other support systems. Support such as family, friends, or nonrecovery groups as well (book clubs, for example).
  • Avoid previous relationships that would jeopardize your recovery.
  • There are Facebook groups you can explore for areas of interest. Reach out to religious institutions or other places you could virtually volunteer. There can be opportunities organizations are looking for support.

Addressing addictive thoughts is a common struggle with those in recovery. Because the drinking/using experience is intensely connected to our brain’s reward system, thoughts urging a return to use present themselves. These thoughts could be quite convincing. “One drink won’t hurt me,” Or “just this one time,” and similar ideas present themselves often, especially in early recovery. Rational thought base to guide users through these thoughts. That is why meetings can help some individuals as they keep themselves grounded through hearing from individuals who struggle with the same ideas. It allows them to keep their using thoughts at bay. Inactivity can create more intense using views. Aside from meetings, other helpful strategies could include:

  • Keep a journal. Getting the thoughts out on paper can help see them as addictive thoughts.
  • Daily meditations can benefit those in recovery.
  • Try listening to audiotapes on recovery.
  • Write a gratitude list. It will help you focus on the benefits of sobriety. Reading books on substance misuse will also help. Many authors have come up with creative and productive tools to maintain sobriety.
  • Seek out a substance abuse counselor to assist and ground you in your struggles.

Taking an aggressive and proactive approach overall will benefit those in recovery. A good diet, healthy eating, and exercise are all critical actions that support recovery. Keeping stress at a minimum helps as well. That may seem like a simple thought, but during these times, it may not be so easy. Talking to other family members and planning ways to reduce stress will certainly help.

Making your way through this Pandemic can be challenging. In Greek Mythology, it refers to a King named Sisyphus. He believed himself smarter than Zeus. Zeus, being offended, punished Sisyphus. He was tasked with pushing a boulder up a steep hill. Once he got to the top of the hill, he would return to the bottom. Only to have to push it up to the top again. At times, these suggestions can feel like Sisyphus did. However, challenging you to find it, remembering what events pointed you in the direction of abstinence, is vital. The longer you allow the struggles to continue, the more difficult it will be to turn your situation around.