As if the opioid crisis wasn’t enough, COVID-19 has unleashed its virulent strain to complicate global health challenges further. World leaders are now battling co-occurring pandemics. Governments, following recommendations from the World Health Organization and the Centers for Disease Control and Prevention (CDC), are implementing the primary containment measure of social distancing in varying degrees of severity.
The US and Canadian governments are discussing temporary closure of their common borders, but are balking at the trade and supply ramifications. Canadian Prime Minister Justin Trudeau said he would close the country’s borders to anyone that is not a citizen, an American, or a permanent resident—and even they have to self-isolate for 14 days on arrival. He and his wife (who has been infected with the virus) are themselves self-quarantining.
What does this mean for people struggling with addiction? Will their ongoing battle be worse, or will the imposed self-exile be a blessing in disguise? How will they have continued access to detoxification, medication, and treatment facilities? Will quarantines and lockdowns impact community support?
Mandatory social distancing may be inconvenient and economically draining for the majority, but it has more serious implications for the addicted. First, human DNA is hardwired from birth for close social contact. Second, isolation is the enemy of addicts—whether they have substance abuse disorders or behavioural compulsions—because an important part of recovery is social support. When recuperating addicts are isolated, they become vulnerable to relapse. For some, isolation is the cause of their addiction. For others, addiction is the cause of their isolation.
The National Institute on Drug Abuse claims that substance abusers infected with the COVID-19 virus are more likely to have severe effects due to their compromised immune systems. Abusers of tobacco, e-cigarette aerosols, cannabis, crack cocaine, opioids, or methamphetamines are more at risk because these substances have detrimental effects on respiratory and pulmonary health. Even if addicts are spared from being infected, the pandemic’s economic and psychosocial implications worsen the effects of addiction. Sufferers begin consuming substances or act out compulsions to deal with social and emotional isolation.
The CDC recommendation of cancelling gatherings of 10 or more has resulted in the temporary discontinuation of 12-Step meetings and suchlike, which provide recovering addicts a safe place to share their experiences. With the imposition of social distancing, they are forced to deal with addiction in isolation. Going more than a week without the fellowship of others in recovery can have adverse impacts on well-being. What about a month?
Before North Americans gripe about month-long exiles, though, we might consider that the world’s worst-affected sectors have been quarantined since last year! Perspective, folks. Another consolation: even Hollywood celebrities (Tom Hanks, Rita Wilson) and royalty (Monaco’s Prince Albert) are not COVID-19-immune, nor exempt from self-isolation.
• Under the guidance of the Substance Abuse and Mental Health Services Administration, opioid treatment programs (OTPs) now provide patients with take-home medication during the pandemic, reducing the need for frequent clinic visits. (In the US, methadone is dispensed only at highly regulated OTPs, which require daily clinic visits. In Canada, pharmacies also dispense methadone.)
• Outpatient clinics and urgent care centres use virtual visits and Telehealth to assess symptomatic patients. Insurance companies are expanding coverage for them.
• Virtual addiction recovery meetings are now available via phone or video conferencing. Families Against Narcotics continue outreach by holding Facebook Live meetings, operating a ‘hope line’, and deploying peer recovery coaches.
• Graduates of addiction treatment programs have secret social media groups and chat forums. Other support outlets allowing recovering addicts to connect online or by phone provide daily affirmations, verses, advice, and information about local groups.
• Psychiatrist Dr. Laurie Ballew recommends the following for ongoing support and relapse prevention:
✓ Narcotics Anonymous: https://www.na.org/meetingsearch/text-results.php country=Web&state&city&zip&street&within=5&day=0&lang&orderby=distance
✓ Alcoholics Anonymous: https://www.onlinegroupaa.org/
✓ Addiction recovery classes and meetings: https://www.smartrecovery.org/
✓ Alcohol and addiction recovery audio tapes: https://www.recoveryaudio.org/
Ballew advises those who can’t video conference to have a point of contact like a group leader or sponsor.
Addicts on self-quarantine can turn a negative situation into something positive. They can use it as an opportunity for self-discipline and reflection. Without the stress of the daily commute, jobs, and social obligations, one can indulge in leisure activities that not only benefit the soul, but also serve as distractions from addiction. These include declaring self-affirmations, watching motivational videos, exercising, and practising mindfulness and meditation.
Connection with others is essential for tackling loneliness and isolation. It’s important, however, to boost one’s self-esteem and be comfortable with solitude. Social distancing provides this opportunity. Take advantage of it.
Shields, Leah. “Online addiction recovery meetings you can join during COVID-19 pandemic”. WPSD News. March 2020.
“COVID-19: Potential Implications for Individuals with Substance Use Disorders”. NIDA. https://www.drugabuse.gov/about-nida/noras-blog/2020/03/covid-19-potential-implicationsindividuals-substance-use-disorders. March 2020.
Levander and Wakeman. “Covid-19 will worsen the opioid overdose crisis if we don’t prepare now”. STAT. March 17, 2020. https://www.samhsa.gov/sites/default/files/otp-guidance-20200316.pdf