The United States is made up of strong and resilient people that can overcome obstacles and come out to the other side stronger. When we think back to some significant events like the Great Depression, the September 11th attacks that reshaped the globe, and the 2008 recession, it’s hard to deny the strength we have as a country. However, the COVID-19 pandemic may be one of the most challenging parts of global history to date and is something that’s brought us to our knees.
The world has experienced virus outbreaks before, but the only one comparable to what’s occurring today is the Spanish Flu of 1918, which claimed 50 million lives. Fortunately, today’s technological advances allowed us to produce a vaccine in record time that has patched the proverbial hole that was plaguing our ship and slowed the number of deaths we’ve encountered.
To date, the United States has dealt with an estimated 33,178,017 COVID-19 cases, totaling 594,381 deaths, according to the U.S. Centers for Disease Control and Prevention. While the numbers don’t equal the sheer devastation we witnessed in 1918, COVID-19 has reshaped the landscape of our country and caused us to lose many of the freedoms we once enjoyed in an effort to contain the virus.
For those battling addiction, changing their routine and locking them up inside is a recipe for disaster. Although we’re slowly returning to a sense of normalcy with the rollout of COVID-19 vaccines on a broad scale, the ripple effects caused by the virus will continue affecting our society for many more months and even years to come. For someone who’s been clean for many years or had just gotten sober, the change in their routine might have caused them to relapse, and they may be now starting over.
Although the virus itself has received a bulk of the media attention, and deservedly so, the topic of addiction and how it’s exacerbated by the virus hasn’t received much coverage. Lockdowns have been a useful tool in slowing the spread of the virus, but for some working to stay clean, it’s been an insurmountable task that’s left them feeling more alone than ever before. According to the Associated Press (AP), alcohol sales shot up 55 percent in the final week of March when compared to the same time frame a year before.
The Well Being Trust and American Academy of Family Physicians released a report and found 150,000 additional deaths will occur as a result of despair attached to drugs, alcohol, and suicide as we move forward. So again, to reiterate from above, despite the COVID-19 figures dropping dramatically because of the vaccine, the ripple effects will continue to plague the United States for the foreseeable future. Everything about this is unprecedented, and those who have lost their jobs, homes, or family members due to the virus might turn to drugs or alcohol to escape the pain of feeling isolated and alone.
Under conventional circumstances, the rate of relapse for someone who successfully completes the continuum of care in addiction treatment will relapse at a rate of 40 to 60 percent during their first full year sober. However, these numbers may fluctuate and be higher in some cases, wholly dependent on the severity of the disorder.
The first year of sobriety is the most important, and someone who makes it through their first year likely does so with the help of peers in programs like Narcotics Anonymous (NA) and Alcoholics Anonymous (AA). Unfortunately, those in their first year of recovery are at greater risk of relapsing during the COVID-19 pandemic, especially when they can’t attend AA or NA.
As you can see, COVID-19 has affected everybody globally. Whether you’re someone who’s lost a family member to the virus directly or the lockdowns caused a family member to relapse, overdose, and lose their lives, you understand that it’s been a challenging stretch in our long history.
However, as we mentioned above, the United States has gone through many pandemics and depressions and emerged stronger on the other side. For now, we need to focus on getting the virus under control so that lockdowns are a thing of the past and allow the people who need help for their addiction to get that help and get back on track.
COVID-19-Related Distress and Substance Use
McKinsey & Company, a global management consulting firm, has spent their time monitoring the virus’ outbreak and how American’s are affected mentally and emotionally, and how the pandemic is affecting substance abuse. In a recently released report, they go on to explain how this pandemic will have a “material impact on the behavioral health of society.” They include data from their March 2020 national consumer survey that monitored the signs of distress caused by the virus.
The results from their study found that individuals whose job was adversely affected were more likely to report feeling either anxiety and depression or depression but not anxiety. These people also reported in higher figures that they felt high-to-moderate distress. The levels of reported substance use were also revealing, and data from McKinsey & Company showed the following:
- One in seven people reported illicit drug use
- One in five people admitted to using prescription medication for nonmedical reasons
- One in four people admitted to binge drinking at least once in the previous week
Adam Leventhal, Ph.D. of the Health, Emotion, and Addiction Laboratory from the University of Southern California, is on record telling Business Insider that “people are dealing with trauma and stress, and we know that other stressors and traumatic incidents – other types of disasters – have lead people to increase their substance use.
Addiction and Relapse During COVID-19
The risk factors most commonly associated with relapse are stress, depression, isolation, and boredom. Dealing with any of these experiences is notorious for pushing someone into self-medicating. These risk factors were the norm even before COVID-19, but the forced lockdowns supercharged the issue and has accelerated relapse at unprecedented rates.
You might see it everywhere you go – social distancing. It could be on the floor in line at the airport, on the sign of a store you walk into or blasted on the television or radio. These words are seared into our memory to a point when even the pandemic passes; we’ll remember the phrase.
Well, social distancing has also led to a reduction in connections with other humans, which is a core psychological need. A person in recovery needs a strong support system, especially in moments they feel weak. Social distancing has robbed us of many essential resources.
The unemployment rate soared to 14.7 percent in April 2020, and a year later, the unemployment rate is 6.1 percent. Although the numbers have dropped significantly, it doesn’t account for those who gave up on finding a job and other factors. These figures also contribute to financial worries and additional stress, but they can also disrupt the structure and routine someone developed in recovery, which is vital to their sobriety.
Having a job also soaks up time and makes it challenging and nearly impossible to abuse drugs or alcohol. However, when unlimited free time enters the equation, it may lead to unintended consequences for someone recovering from addiction, especially for someone hunkered down at home alone and going through high-stress levels.
Metal Health During the COVID-19 Pandemic
As we discussed above, depression and stress are two of the primary factors that lead to relapse. With that said, COVID-19 has led to a historic increase in mental health problems. A person with a history of substance abuse is at an increased risk.
Below are some facts that will offer some insight about mental health and alcohol use:
- A person experiencing alcohol problems deals with anxiety rates twice as high.
- Processing alcohol in our body can permanently change stress responses and cause chronic stress.
- Most people in alcohol addiction treatment are high on the depression rating scale.
- You are twice as likely to develop an alcohol addiction if you experience major depressive episodes.
Relapse is always a serious concern, but because of COVID-19, those struggling with addiction are at an elevated risk of falling victim to their demons. This pandemic has affected substance abuse in a way that’s unimaginable. The increased alcohol sales we discussed above is a small slice of data that provides a clear window into the severity of the issue. Even those who don’t struggle with addiction have found themselves experimenting with illicit drugs or drinking more than usual because their mental health has been affected by lockdowns.
If you’re concerned about a friend, family member, or even yourself relapsing, you need to understand the signs. Relapse isn’t as cut and dry as you might think. Relapsing on drugs or alcohol is a process with many warnings before the action takes place. Many people “relapse” before they’ve had a sip of alcohol or used an illicit drug. Let’s explore this below.
Signs of Relapse
Even before the virus affected the world, drug and alcohol relapse was a part of the recovery process. Estimates show that more than 90 percent of people in recovery will relapse once before achieving lasting recovery. While some relapses are milder than others, there are many signs leading up to the event.
A relapse is sometimes referred to as a slip, and it doesn’t begin when you pick up a drug or drink. Instead, it’s a prolonged process that initiates long before a person starts using. The steps to relapse are a change in feelings, attitudes, and behaviors that eventually lead to the final stage, which is using drugs or alcohol.
If you or someone you love has been working tirelessly to achieve long-term sobriety and stay away from harmful drugs and alcohol, it’s vital to be aware of the warning signs of relapse. Identifying them can help you take action, slow them down, and not progress into a full-blown relapse.
Early in recovery, you’ll be dedicated to getting better. Everything feels right, and you know the hard work you’re putting in will soon pay off. However, you may notice a change in that attitude. For some reason, participating in your recovery program isn’t the top priority like it was.
Something is wrong, but you’re not quite sure what it is at this point, causing you to start reminiscing about the good times when you were using drugs or alcohol. Instead of remembering the misery your addiction caused you, you only remember how good it made you feel and think to yourself that using it once may not be bad.
Skyrocketing Stress Levels
An increase in stress caused by COVID-19 or any incremental amount of stress that builds up can also cause you to look for an outlet. For example, returning to the world after being away for several months in treatment is naturally stressful. When you couple that with the uncertainty of a pandemic and concern for your health, it’s enough to push you over the edge.
The primary issue is overreacting to these situations. Hopefully, the coping skills you learned in cognitive-behavioral therapy (CBT) are enough to keep you from going over the edge. If you start noticing extreme mood swings or exaggerated positive or negative feelings, your next step might be to relapse.
Make sure to reach out to a peer or someone familiar with your situation.
Reactivation of Denial
It’s vital to note that this isn’t denying you have a problem with drugs or alcohol. You’re in denial that the stress of the lockdowns is getting to you, and you’ve likely convinced yourself that nothing is wrong – everything is ok – however, it’s not. Despite feeling worried or scared, you’ll dismiss the emotions and won’t share how you feel with others. When you allow these feelings to fester, eventually, they’re going to win. It’s ok to admit you’re feeling down and discuss this with a close friend or peer.
Recurrent Withdrawal Symptoms
Post-acute withdrawal syndrome (PAWS) is when depression, anxiety, insomnia, and memory loss linger after you quit using drugs or alcohol. When you’re stressed out, these symptoms can return. The lockdowns have been extremely stressful, and a reemergence of these symptoms isn’t out-of-the-ordinary. These symptoms are extremely dangerous because they’ll tempt you to use drugs or alcohol. Many people might think to themselves, “if I feel horrible sober, why shouldn’t I just use?” Make sure to reach out for help immediately.
Changes in Behavior
The daily routine you devised early on in your sobriety may start changing, and you’ll replace your healthy behavior with compulsive alternatives. Lockdown has been tough for everyone, even those not dealing with addiction. If someone calls you out, instead of understanding where they are coming from, you may avoid them or become defensive.
Loss of Structure
Building a structured lifestyle is challenging, so imagine having it all taken away from you when you’ve worked so hard to build it. One warning sign of relapse is abandoning daily routines and schedules you’ve developed, which may be overlooked because of the virus. If you start sleeping late, skipping meals, or ignoring your hygiene, you should be cautious.
The Last Stage: Relapse
Just one won’t hurt – I’ll stop tomorrow. Does this sound familiar? Once you’ve gone through the emotions and steps we discussed above; you’ll start experimenting with small amounts of drugs or alcohol. Although you feel guilty and shameful, you’ll quickly spiral out of control and cause significant damage. You’ll need help getting sober again, but how do you prevent relapse?
Preventing Relapse During the COVID-19 Pandemic
Relapsing is always dangerous, but relapsing during COVID-19 may be even more dangerous because you’re alone. If you were to overdose after relapsing, no one would be there to find you and save you. We understand that the future of the world may seem grim right now, but there are many things someone in recovery can do to protect themselves. The following are ways to avoid relapse during COVID-19.
Understand Your Triggers
The most important step in straying from relapse is awareness of what triggers you. You must ask yourself what people, situations, or feelings will cause you to think about drinking or using drugs and what your triggers are. You can’t control every piece of your life, but knowing your triggers can help you avoid risky situations. Is sitting in the house too long causing you to think about using it? Go for a walk around the block and get your mind off it.
When you understand your triggers, you can create a plan and find ways to avoid the triggers and what you’ll do if you encounter the trigger. If being alone is a trigger of yours, call or FaceTime a friend and get your mind off of it.
Use Your Time Wisely
Free time translates to making poor decisions. Everyone has too much of it during a lockdown, but people in recovery are especially vulnerable. Try to fill this time with positive activities that are safe and keep you busy. Doing this will distract you from drinking alcohol or using drugs.
The following are safe alternatives to keep you busy during a lockdown:
- Creating art or writing music
- Completing puzzles
- Cooking and baking with new recipes
- Writing in a journal
- Taking online classes you might have been putting off
- Going on a walk or run around the block
- Picking up a new hobby or skill
- Learning yoga
- Playing card games or board games
Although these will keep you busy, they can also help you improve your mental and physical health.
Since you can’t physically be with friends and family, you can still virtually connect and be present in the moment. Always pick up your phone, initiate Zoom calls, or send messages through text or social media. You should always check on others to see how they’re doing as well. Even if you’re going through a tough time, you can imagine others are as well, so make sure to ask how they’re doing and offer your support.
Fortunately, you can get through these challenging times with the right activities. If you’re feeling down, don’t be afraid to reach out for help! Your friends, family, and sponsors will be happy to hear from you and feel great that you reached out for their support. Never hesitate to call, text, or get in touch with somebody and admit that you’re feeling down.
Stick to Consistent Meal Times
When you stick to a consistent routine for eating, you’ll avoid stress eating throughout the day. This can also help you maintain your physical and mental equilibrium, which will be understandably interrupted during lockdown. You should try to nourish yourself with healthy foods, but it’s ok to give in to comfort foods if it helps you pass the time. If you want a cookie, don’t feel shame – now isn’t the time to start a restrictive diet!
With the extra time, you can create new recipes to try with family and friends when it’s safe to be around people again. Make sure to put on some nice tunes or podcasts to keep your mind at ease and take you further from your anxiety about being in lockdown.