What are the risks of COVID-19 for recovering addicts and alcoholics?

Dealing with addiction is difficult no matter the circumstances. However, facing addiction and maintaining sobriety in times of crisis and catastrophe can be especially daunting. The pandemic produced by a newly discovered Coronavirus known as COVID-19 has created a global health crisis, with new infections being detected at an increasingly fast rate in many areas of the U.S. and across the world. Widespread uncertainty and shared anxieties can be especially stressful for those dealing with substance abuse disorders, who in many cases may also suffer from co-morbid conditions such as depression. The following guide offers information on the ways in which your sobriety may be challenged during Coronavirus, addiction recovery tips that will help you stay sane and remain sober, and relevant recovery resources. Consider the ways in which the Covid-19 might impact your recovery:

1. Increased risk of infection and complications for those with substance use disorders

Although for many, this infectious virus may produce moderate respiratory symptoms that do not require specialized care, for others, it can be deadly. Those especially vulnerable to the effects of the virus include the elderly as well as individuals with underlying conditions such as  cardiovascular disease, HIV, diabetes, chronic respiratory disease, compromised immune systems and cancer. Individuals with substance use disorders may be included among those at greater risk, as chronic heavy drinking and illicit drug use can affect the adaptive immune system in a number of ways. 

According to an article published in FEMS Immunology & Medical Microbiology journal, several studies reviewed indicated a relationship between the use of alcohol and illegal drugs–such as opiates, cocaine and marijuana–and increased susceptibility to infections. For instance, smoking marijuana or other drugs may irritate the lungs, increasing the likelihood of serious lung infections, while morphine and other opioids can suppress the immune system, making it harder to fight off viruses.  

2. Limited access to medical resources

Other indirect health risks may occur as a result of COVID-19. If you take regular medication for mental or physical health issues, refilling your prescription while under quarantine or social distancing may become more challenging, which can have important effects on your wellbeing and, consequently, your sobriety. For instance, if an individual taking medication for depression is unable to refill his or her medication in a timely manner and symptoms of depression return, the likelihood of remaining sober could also be impacted. Moreover, regular medical appointments may be cancelled as a preventive measure, making it difficult to see your physician, mental health or treatment professionals for regularly scheduled appointments.

3. Forced withdrawal without medical support

Additionally, those not yet in recovery may find themselves unable to obtain their drug of choice, and as a result, be forced into withdrawal. While stopping the use of drugs and alcohol is positive, for those who have had a substance abuse disorder for a long period of time, immediately quitting cold turkey can be quite dangerous. The Mayo Clinic recommends slowly tapering off the use of opioids under medical supervision to stop use safely. Given current circumstances, this may be difficult for many. 

4.  Coronavirus and addiction recovery support networks

Most drug and alcohol rehabilitation programs rely on group-based activities during and following treatment, in addition to medical and therapeutic appointments. According to a 2017 study, 12-Step programs and other mutual help group attendance, post-treatment drug monitoring, and the completion of treatment programs were found to be related to remaining sober in the 6 month period following residential treatment. 

However, in current times, continuing such activities may pose a public health risk. As many do their best to limit the spread of Coronavirus, addiction recovery groups find themselves affected. For addicts and alcoholics in recovery, following a post-treatment plan may be especially difficult. If you are part of a 12-step program or another peer support group, the fellowship and structure of regularly attending meetings may play an important role in your recovery process. As social gatherings are either not permitted or greatly discouraged, in-person Alcoholics Anonymous and Narcotics Anonymous meetings are likely not taking place. Non-emergency therapy and medical appointments may have been suspended as well. The lack of access to a support system combined with the loneliness produced by social distancing measures may lead those struggling with substance use disorders to feel isolated and cut off. This is only further compounded by the overall environmental stress surrounding COVID-19. 

5. Stress can increase the likelihood of a relapse

Given the great amount of uncertainty, the swathes of less-than-comforting information being published across media platforms, and the social distancing taking place as a preventative measure, it is not surprising that many are feeling especially overwhelmed and anxious. Unfortunately, for addicts and alcoholics, these stressors can affect their sobriety. Dealing with the precariousness of the Coronavirus, addiction, and other related financial and emotional stressors is not an easy task.

During treatment, one learns new and healthy ways to cope with stress that don’t involve the use of drugs or alcohol. However, coping may be more difficult than usual, as the stress produced by COVID-19 is further intensified by the lack of access to one’s normal recovery support system, making a relapse all the more likely. Research indicates that environmental factors, such as chronic and acute stress, can increase one’s likelihood of substance use and relapse. Especially vulnerable groups during this time may include those with anxiety disorders as studies have found a significant relationship between anxiety disorders and alcohol and drug use disorders. This could be especially troubling, as during a relapse one may be more likely to overdose because their body is no longer accustomed to the same dosage of a drug in its system, which can be deadly. 

Advice on how to handle Coronavirus and addiction

While there are many difficulties facing us as we learn more about COVID-19 and as countries and communities seek to “flatten the curve” of the virus’ spread, there are steps that can be taken to limit the stress caused by the uncertainty, reduce the impacts on your physical and mental health, and protect yourself from a relapse. Here are 6 things you can do right now that will allow you to maintain social distancing protocols during the Coronavirus and addiction recovery support networks. 

Try and keep a regular routine as much as possible

Avoid anxiety, loneliness and the urge to relapse by getting a support system in place that works under current circumstances. See what activities can be done from home or via video and phone calls. Try keeping your daily routine in place as much as possible, taking care of your basic needs and practicing healthy coping strategies. Also, keep in regular contact with those involved in your recovery. This will allow some semblance of normalcy, which will be comforting. If you can’t translate your usual routine to your current circumstances, come up with a new one that provides you with daily structure, which is quite important for recovering addicts. 

If you find yourself with little to do while staying in the house consider taking on a small, low-pressure project or hobby. Find something that is achievable, not stressful, and can be done inside your home. Engaging in new healthy activities can be therapeutic and provide some mental distraction from stressors and triggers. Additionally, you can share your hobby or activity with friends and family via phone and video calls or photos. 

Seek emotional support through technology

Following social distancing protocol might leave you physically separated from friends, family, and other members of your support network. However, this doesn’t mean you must be isolated from loved ones and others supporting your recovery process.  Despite the difficulties create by the Coronavirus, addiction support networks should not be compromised.

Technology has made it easier than ever to access support and resources. Using video calling and meetings apps such as Skype and Zoom is a great way to reach out for help and avoid feelings of aloneness. You may consider making a deliberate effort to regularly speak with members of your support network or even schedule a group meeting where you can talk to several people at one time. Suggest holding your peer support group meetings via videoconference if this contingency isn’t already in place. Odds are you are not the only one feeling stressed, isolated, and alone right now. If you haven’t already made the effort to reach out to your circle, do so now and ask for help when you need it. 

If you don’t have anyone to reach out to, there are a number of options online. The National Alliance on Mental Illness (NAMI) has compiled a list of online support groups such as Support Group Central and Emotions Anonymous which you may consider joining.

Find out what telemedicine and remote options are available in your area 

COVID-19 has affected millions of Americans with medical and mental health conditions, making it difficult, and sometimes dangerous, to seek in-person professional help. As a result, health care providers as well as local and national governments are seeking to ease the burden, making telemedicine and remote options for care more widely available. There are a number of resources and services available that can be helpful to you during this time. 

Medical appointments

If you are seeing any medical, mental health or treatment professionals as part of your recovery, it is likely that most non-emergency, in-person appointments will be cancelled. As a large portion of the medical system is dealing with the Coronavirus, addiction treatment and mental health services may be available remotely. Find out if your care provider is willing to offer appointments online or via phone. Otherwise, ask if they can refer you to resources. Appointments by phone may be option, as medicare has loosened its restrictions regarding tele-health and the CDC has provided facilitating guidelines on the topic in effort to reduce the current burden on the medical system and avoid physical contact when possible. Additionally, the Drug Enforcement Administration (DEA) announced it would grant an exception requested by the Substance Abuse and Mental Health Services Administration (SAMHSA) to allow for telemedicine to be used in place of an initial visit between a patient and doctor trying to treat a substance use disorder. Therefore, if you are just seeking treatment now or are concerned about having to deal with withdrawal without medical supervision, there may be options available for you. Also, reach out to drug and alcohol treatment centers to find out what contingencies they have in place. 

Filling your prescriptions

If you have any prescribed medications that you take regularly for mental health or other issues and are concerned about running out, take precautions by checking if there are any regulation changes regarding prescription refills in your state. The American Pharmacists Association is urging insurers to remove administrative barriers on pharmacists and patients to provide access to early medication refills, ensuring that patients can continue to take their prescriptions for chronic diseases. It is important to follow your care plan, check if early refills or home delivery is available in your state, plan ahead, and always take your medication per your doctor’s instructions.

Mental health and support groups

Additionally, there are a number of other ways to seek professional support online. If you don’t know where to turn, try reaching out to your local NAMI for information on programs and resources available in your area. The comprehensive online COVID-19 Guide provided by NAMI also offers information on a number of mental health, financial, shelter and emotional support resources. 

Shut off your devices when necessary

Being informed is easier than ever today. However, with the barrage of information available on Covid-19, things can quickly become overwhelming, leading some to experience anxiety, depression. Although it is necessary to stay updated in terms of any important developments regarding COVID-19, you also have to allow yourself a break. 

Limit your scrolling time

For those who suffer from extreme anxiety and depression, too much information can leave you feeling overwhelmed and helpless. Educate yourself about the protective measures to take to avoid spreading infection and what to do in the case that you are infected. Empower yourself with accurate and relevant information, but remember that obsessing will not help keep you any safer. Keep track of your emotions and know when you need a break. Turn your TV off or put down your smartphone if you are feeling anxious. 

Setting a daily time limit for the number of hours you spend looking at social media and consuming information on Coronavirus may be helpful. You might even decide to set out particular hours during the day or use a timer so that you don’t lose track of time. If you find certain websites or programs make you feel more anxious than others, avoid them and look for less sensationalist and editorialized versions of information. 

Validate your information sources

Remember, not all information being shared is accurate or factual. In times of uncertainty it is important to look to reputable sources and avoid sharing misinformation. With the rise of social media platforms, information, accurate or not, spreads quickly. If you do receive information or instructions regarding the Coronavirus via social media or elsewhere, make sure it can be corroborated by a valid source before passing it on or following the instructions. This will be beneficial to both your physical wellbeing, mental state, and to those around you.

Additionally, consider subscribing to email updates to receive information on COVID-19 from your local, national and global health authorities as well as from a few trusted news sources. This way, you can receive updates by email while limiting the amount of time you spend seeking out information. Make sure you do so directly on the organizations’ webpage. 

Follow  instructions provided by global, national and local health authorities

As following prevention and control measures becomes increasingly important to our own wellbeing as well as that of our loved ones and community, it is critical to properly comply with protocols set out by international and local health and safety authorities, such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention. General recommendations for prevention include:

• Wash hands frequently and thoroughly with an alcohol-based hand gel or antibacterial soap and water.
• Maintain social distancing. Put physical distance between yourself and other people if COVID-19 is spreading in your community, if you have any symptoms of the virus, have interacted with someone who may have the virus or just as a general preventative measure. Keep at least 2 meters (6 feet) distance between yourself and anyone who is coughing or sneezing.
• Avoid contact with those who are sick, may have the virus and those who are more vulnerable to the virus.
• Practice respiratory hygiene by covering your mouth and nose with a bent elbow or tissue when you cough or sneeze, disposing of the used tissue immediately, and washing your hands.
• Avoid face touching and wash your hands before and after if you do touch your face.
• Stay home if you feel unwell. If you do have a fever, cough and difficulty breathing, seek medical help by calling for instructions in advance of going to a medical facility.
• Frequently clean and disinfect regularly touched surfaces and objects. 
• Follow social distancing protocols
• Follow specific guidelines for those who have traveled recently, are caring for someone who is sick, or if you might have the virus.
• Remain informed and follow advice from healthcare providers, and national and local public health authorities.