COVID-19 and the resulting social isolation pose a serious threat to individuals suffering from addiction, as well as their loved ones. According to the Addiction Center, research shows a connection between social isolation and addiction over the years, demonstrating that isolation is associated with worse treatment outcomes. Some even call addiction “a disease of isolation.” Early data from the start of the pandemic showed that opioid-related overdoses increased, and alcohol sales at one point spiked 55 percent.
In addition to isolation, the economic impact of COVID-19 may also have significant consequences on mental health, addiction, and relapse. Research shows that economic recessions and unemployment directly correlate with increased susceptibility to illegal drug use.
With that said, have you or a loved one relapsed? Or perhaps you’re seeking ways to avoid it? Please know that relapse is a normal part of recovery, a claim that is supported by the National Institute on Drug Abuse, which has found that 40-60 percent of individuals with addiction experience relapse at least once before achieving sobriety. Some even estimate the number is as high as 90 percent.
However, despite the fact that relapse is “normal,” this does not mean relapse comes without serious – even fatal – consequences. It also does not mean that relapse is inevitable. There are strategies to prevent it.
We sat down for a Q&A session with one of our in-house experts and our Clinical Director, Patrice Wishon, MSW, LCSW, NASW-CATOD, LCAS, CCS, who has over 30 years of experience in social work and mental health/substance abuse counseling. We asked Patrice a series of questions that have been commonly asked during today’s pandemic related to addiction, relapse, and mental health. Patrice shared her unique, trusted perspective, and provided recommendations on how both those with an addiction – or those with a loved one suffering from addiction – can cope.
Based on your knowledge/expertise, does the social isolation that has resulted from COVID-19 increase one’s susceptibility to substance misuse, addiction, or relapse?
Certainly it does. Based on what I’ve seen so far – and as is supported by data – the primary triggers for relapse are isolation and boredom. Community is such a huge facet of recovery. Right now, people are lonely at a time when they need support and human interaction more than ever. So much of your time in recovery is spent interacting with other people, whether it be loved ones, friends, or support groups during meetings who share in your experience. Not having access to people and meetings limits how they can spend their time, and many other activities that suppress the risk for relapse are just not available right now.
How has quarantine/COVID-19 impacted:
- People with an addiction who aren’t yet sober. Are they now at higher risk? I imagine it’s easy to put off asking for help if everything’s closed down. It’s also hard for folks to have accountability or ‘eyes on them’ during this pandemic. If you are a loved one of an individual suffering from addiction and believe it is time to stage an intervention, I’d encourage you to read our suggested approach, here.
- Individuals who are sober and trying to remain sober. These are the folks who, from my experience, suffer the most from lack of community. Being able to ‘go to a meeting’, or distract oneself from ‘being in your head’ are hard when you’re isolated. Many of the tools we teach involve “going and doing,” especially in early recovery.
- People with a dual diagnosis/comorbidity (i.e. depression and addiction). People who struggle with addiction and mental health issues may have increased symptoms and triggers for both conditions. Some will feel the weight of the current crises and have increased anxiety or depression. ‘Using’ has been a coping tool for many to address these mood symptoms. New coping tools have not been completely integrated, and therapy, meetings, and support groups are not being held in-person. This can add to feelings of isolation and loneliness.
- Family members of those with an addiction This is a tough one to answer. Families certainly have a multitude of things to add to their list of things to worry about, besides the addictive behaviors of their loved one. They may be distracted by their own fear and stress, but most probably they feel increasing concerns about what their family members are doing (and where). COVID-19 has also created a multitude of barriers to care for medical and psychological issues. Getting help now is definitely harder with all the precautions in place, but please know that many rehab and recovery facilities are still open and available 24/7, with strict protocols in place.
Have you seen more people relapse?
Addiction is a relapsing disease. What we are hearing is that clients are maybe relapsing faster, due to lack of ability to attend meetings and find a sponsor. Finding a sponsor that is the right fit requires conversation and ideally, meeting someone in person for a more personal interaction.
Are there multiple stages of relapse? Is there a “mental relapse” before the actual relapse?
Yes, there are. We often ask clients to think through a recent relapse to gather information about the experience. Together we work to identify what triggered the thought, feeling, or behavior that led to them using again, and then we dive into ways to prevent it the next time, based on their unique circumstances.
What are the warning signs of relapse that both those who are addicted – and their loved ones – should be conscious of?
There are many. Terence Gorski has a list of 37 Warning Signs. I believe one of the keys is to learn what your personal triggers and warning signs are (and if you’re a family member, having this awareness and knowledge of your loved one to the best of your ability). Some common warning signs I’ve seen that require immediate attention include:
- Not attending meetings (this is common right now given social distancing, but there are many digital support options that I’d encourage folks to consider).
- Not taking medication (according to the National Institute on Drug Abuse, this often leads to relapse)
- Lack of sleep
- Impulsive behaviors and irritability
If individuals relapse, how do you recommend they get back toward sobriety? Does it differ depending on the individual’s unique circumstances? When should they seek professional help?
Seek help immediately, whether it’s calling your sponsor, going to a meeting, or calling a therapist. You don’t necessarily need to go back to treatment, but you undoubtedly need to seek support in whichever ways have worked well for you in the past. The approach you take depends on the nature of the relapse in terms of the length, the amount of the substance you consumed, and the consequences that resulted from it. Here are some steps that commonly work well if you relapse:
- Talk about it right away; don’t keep it a secret.
- Immerse yourself in the activities you do when you are working your recovery program: take a shower, brush your teeth, do your work, manage your responsibilities, even pray… whatever works for you. It’s hard work, but it’s attainable.
Yes, these suggestions might seem obvious, but when you are in the throes of stress, many find themselves “stuck” and feeling helpless. While these are strategies they may have learned during recovery, it bears repeating and reminding during difficult times. Getting back on track with hard work and consistency is what helps lead to long term sobriety.
How do you recommend individuals try to avoid relapse?
Work with your sponsor, support group, or therapist to create a crisis plan. Anticipate the things that may trigger your relapse, and create your own personal relapse prevention therapy plan for how to deal with them. Share this with your support system so they are aware. Your plan can include:
- Your motivations for staying sober
- The most effective coping mechanisms you’ve used during recovery
- Self-care ideas that help you when you’re struggling
- Names of your support system and their phone numbers
How can family members support a loved one who has relapsed during COVID-19?
Encourage them to ask for help and to speak to their recovery support system, whether it be their sponsor or attending a meeting. Set appropriate limits with someone who is still actively using, such as not giving them money or letting them stay in your home. Certainly the approach is circumstantial; this advice is based on my own unique experience with individuals who live with addiction.
How can family members help loved ones avoid relapse?
Again, encourage their use of their recovery support system, provide positive reinforcement for positive behaviors, and set limits as appropriate.
Is it possible that individuals who are newly prescribed anxiety meds during COVID-19 could develop an addiction?
Some anxiety medications are fairly safe from abuse potential, while others have high abuse potential. If you already suffer from addiction – or perhaps have an addictive personality – and are speaking with your doctor about potential anxiety medications, I encourage you to be honest with them so they can recommend the right treatment for you. Also be aware that, even if you’ve never had an addiction, this doesn’t make you immune in the future. Be sure to educate yourself and listen to your doctor about the potential risks.
Individuals with addiction may hesitate at the thought of going to a recovery center, out of fear that they’ll contract COVID-19. What is your perspective on this? Are there alternatives? Is it still feasible for individuals to seek treatment?
I would encourage folks to still “go through the motions” of seeking treatment and ask questions. Approach it like you would if there wasn’t a pandemic: explore the different recovery center options you have and figure out which would work best for you. Most, if not all, programs right now have strict precautions and protocols in place to protect their clients. At Crest View, all potential clients are screened and right now we aren’t allowing visitors. We do allow for social distancing and require masks (we have them available). For many, treatment is still the most appealing and preferred option when compared to the unstructured, unpredictable life that active addiction can cause.
Is there anything else you’d like to share related to this topic that we should communicate in the blog article?
Substance use is a survival tool for many. Therefore, it makes sense that, in a time of widespread fear, many are resorting to tools of comfort, coping, and survival. It makes it all the more difficult when you only have a few positive, healthy coping tools that you are familiar with. Folks in early recovery need a lot of support from others to continue making sober choices.
Remember: whether it’s you or your loved one suffering from addiction, you are not in this alone. Crest View Recovery Center is here to help you, your loved one, and your family recover, rebuild, and find freedom. Whether you believe the time is right for a recovery program – or if you just have questions and/or need advice – we’re only a phone call away, 24 hours.