Alcohol consumption was on the rise before the pandemic. Between 1999 and 2017, the number of alcohol-related deaths in the U.S. increased by 100%, reaching more than 70,000 deaths a year. In fact, alcohol abuse (and abuse of other substances) are key drivers in the recent decline in American life expectancy. During the coronavirus period, alcohol abuse has accelerated. Americans have been drinking more and drinking more frequently. A recent Harris Poll conducted for the American Psychological Association found that nearly 1 of 4 adults reported increased drinking in response to stress during periods of school closing, social isolation, and pandemic restrictions. Learn what practical actions you can take, including building your support network and accessing medication-assisted treatment.
Why did COVID-19 trigger a spike in substance abuse? Four factors and a “perfect storm”
The pandemic created, unfortunately, a “perfect storm” for substance abuse and addiction relapse. The factors include emotional distress, difficulty accessing treatment, reduced availability of healthy coping activities, and reduced social support.
Emotional factors: The coronavirus, and the isolation measures that helped control the disease, created tension, worry, fear, depression, and distress. These emotional challenges increase the risk of substance abuse and gaming disorders. Research has shown that patients in recovery are more likely to relapse to problematic behaviors and substance abuse when stressed. Alcohol, cannabis, prescription medications, and opioids can be used for people seeking relief from anxiety, depression, or sleep problems.
For many people who had a lower level substance abuse problem, the stress related to the pandemic led to more frequent drinking, and consumption of larger volumes of alcohol, use of more drugs, and more frequently using drugs.
The difficulty of accessing treatment: Many people found it more difficult to access care during the pandemic. They may have been unwilling to get in-person help (such as would be provided by medication-assisted treatment) or restrictions imposed by their care providers might have made it more difficult to get care. The challenges in getting Naltrexone, Buprenorphine, Suboxone, Campral, Antabuse, and similar medications – combined with the difficulty accessing counseling, behavior modification therapy, and aftercare – increased the risk of relapse and self-destructive actions.
Reduced availability of healthy coping activities: All of us have coping mechanisms for handling difficult emotions. Unfortunately, during the pandemic many of our healthy coping mechanisms became unavailable. Going to the gym, visiting friends, entertainment options, traveling and other coping tools that did not involve substance abuse became unavailable, or less available. In an effort to self-medicate, many people increased their consumption of alcohol, drugs, or a combination of substances.
Reduced family and social support: Even before COVID-19, options for building family and parental support for people getting treatment for a substance use disorder (SUD) treatment were limited. The transition to telehealth (video meetings) during periods of physical distancing had made it more difficult to involve family members in the recovery process and made it more difficult to provide a social support network. More generally, social isolation tended to attenuate social and family support for all of us. For people struggling with substance abuse, getting support from family and building a sober social network is critically important to sustained recovery.
Get practical support to address substance abuse – 3 steps
Build your social and family support network. Family support can help reduce cravings and limit relapse. Stable relationships help reduce negative emotions and cope with risk factors.
Pay attention to your emotions. As part of “whole-person” treatment in addiction medicine, you can get learn to better recognize and modulate your negative emotions. You can learn practical coping skills including mindfulness, relaxation training, and other methods.
Consider your treatment options. We fully expect the spike in substance abuse to outlast the pandemic. If you observe that someone you love has changed their diet (eating irregularly, eating less healthy foods), is experienced disturbed sleep patterns, or has made unexplained changes to their daily routines – you should be concerned that they may have returned to substance abuse or are experiencing more acute substance abuse. Consider getting medication-assisted treatment.
Further Reading
A clash of epidemics: Impact of the COVID-19 pandemic response on opioid overdose. Click here.
Expert consensus on the prevention and treatment of substance use and addictive behavior-related disorders during the COVID-19 pandemic. Click here.
Stress in America, American Psychological Association. Click here.
Substance use disorder treatment, parenting, and COVID-19. Click here.
Treatment of opioid use disorder during COVID-19: Experiences of clinicians transitioning to telemedicine. Click here.