#66 substance use and the corona pandemic

People involved in substance use find themselves facing some unexpected dangers during the corona virus pandemic.  The first is their increased physical vulnerability to disease. People involved in substance use often have health conditions exacerbated by poor nutrition, COPD, cirrhosis, cardiovascular disease, HIV, Hep C and compromised immune systems which make them more vulnerable to severe illness and especially CoVid.  Some people in recovery reside in communal living situations which increase their risk for exposure to the Coronavirus.  
Nationally, the quarantine has seen a 50 to 70% increase in alcohol sales.  Whether people are hoarding alcohol or actually using it to self-medicate remains to be seen.  Mental health and substance use treatment providers express concern about the isolation during a pandemic and the ease of hiding a relapse or an increase in use.
According to Mike Thibideau, with Indiana Workplace Recovery, during the CoVid quarantine the Indiana Addiction hotlines went from 20 calls per week to 20 calls per day.  The 211 resource helpline, which typically has 1000 mental health calls per day, is currently receiving 25,000.
As we have discussed in previous columns, the opposite of addiction is connection.  During the social distancing and sheltering in place, many folks in recovery and treatment for substance use find themselves isolated and alone. There is the increased financial stress of unemployment or working from home.  With recovery meetings cancelled, many find themselves without accountability, bored, fearful and stressed. Any of these may become a trigger for the recurrence of substance use.  In addition, isolation increases risk for overdose, experiencing dangerous withdrawal symptoms, reusing drug paraphernalia, and buying from unfamiliar dealers.  
Many recovery groups have quickly turned to online platforms such as Zoom, Go to Meeting, Google Meet, and a variety of apps.  Although virtual meetings have dramatically increased, there are some unexpected obstacles in accessing them. Many involved in substance use do not have access to the internet or previously accessed it in public spaces such as libraries, which may be closed.  Those who live in rural areas may have limited internet access.  People may have limited data minutes on their phones.  Older people in recovery may not be comfortable or familiar with online platforms.
There have been some benefits from the increased online services. Some people prefer the online services because they can meet in the familiar environment of their home.  Those who travel to services outside their community, find that online services reduce the transportation barrier. Phoenix Paramedic Solutions’ White County Quick Response Team has been surprised that some clients are much more receptive to virtual meetings and are more open when meeting online or by phone.
There are concerns about online confidentiality and security.  Some of the HIPPA restrictions have been relaxed by the State of Indiana to allow mental health and substance use treatment professionals to continue to meet with clients online and over the phone. Some virtual participants have expressed concern about sharing personal stories when you don’t know who else is in the online room.
As we face our new normal post quarantine, we need to consider how recovery and treatment services for those involved in substance use will need to change and adapt.  Will virtual and online services develop into an alternate way to support those in need of mental health and substance use services?  How will communities address increased levels of mental health/substance use needs once the CoVid crisis is over?  The future may be uncertain, but recovery is possible.

​
​