Pandemic lockdown escalates relapse risk for those battling alcoholism, other addictions
Opioid crisis is out of the headlines, but last year Virginia had more fatal drug overdoses than ever before.
Remember the opioid crisis?
Not long ago, it was an awful reality of modern rural life, a relentless calamity destroying lives and damaging families.
It still is. Last year, Virginia had more fatal drug overdoses — 1,617 — than ever before. But in a time of global pandemic, economic cataclysm and wide scale public protests over the police killing of George Floyd, the opioid epidemic has fallen off front pages and websites, and largely disappeared from news reports.
If anything, however, the uncertainty and turmoil brought by those recent events has increased the likelihood of substance abuse relapses, according to addiction recovery and treatment experts.
A DISEASE OF DESPAIR
“Addiction is a disease of despair,” said Jan Brown, the founder and executive director of the SpiritWorks Foundation and someone who herself has been in addiction recovery since 1987. “The pandemic has had a devastating impact. The isolation, the loss of jobs, maybe the loss of housing, the loss of community. That’s more than some people can handle.”
Ryan Banks, director of clinical services at Rappahannock Rapidan Community Services (RRCS), agreed that the isolation resulting from the pandemic lockdown has escalated the relapse risk for those fighting alcoholism or addiction.
“Someone who is completely alone can definitely find themselves in a spiral,” she said. “At first, it was mainly with alcohol because it was more accessible. But now it’s with all substances.”
Banks pointed out that if a person doesn’t have to go to a job, or isn’t seeing family or friends, a relapse can go unnoticed and usually doesn’t have immediate consequences.
GOING VIRTUAL
Complicating matters is the impact the COVID-19 lockdown has had on treatment and recovery programs and services. Peer support groups, such as Alcoholics Anonymous and Narcotics Anonymous, have had to shift online. So have the RRCS clinicians providing therapy to patients being treated for addiction or substance abuse.
While that has been more convenient for people who needed to drive long distances to sessions or struggled to find rides, it has made treatment considerably more challenging for those without a reliable broadband connection, or even access to a computer.
Jan Brown said her experience is that virtual support meetings haven’t worked as well as in-person sessions. The personal connections can be less fulfilling, she suggested.
“Their success has largely depended on the rituals of a group. It was a way, in pre-COVID times, to be part of a community,” she said. “I’ve gone to meetings for 30-odd years. I have a core group of women I associate with. The rituals we’ve developed are part of that. But online, we’re not able to give hugs or hold hands or some of the other things that identify our community.”
LOCAL SIGNS
There are signs that the anxiety intensified by the pandemic and resulting economic tumult are being felt in Rappahannock. Kathy Sickler, the school district’s social worker, said she’s been hearing reports of parents drinking alcohol more frequently than usual. But so far, they haven’t been receptive to her attempts to reach out to them.
And, when there was a spike in child protective services reports to the county’s Department of Social Services last month, alcohol or substance use was a factor in several of the cases — although Jennifer Parker, the department’s director, said she couldn’t tie that directly
to the impact of COVID-19. She added that she is concerned that more problems could arise later this summer when federal bonus unemployment benefits cease.
She also pointed out that state officials have warned local social services departments to be prepared for a rise in child abuse and neglect cases when school starts again in the fall. The concern is that more students will tell their teachers about incidents that occurred during the lockdown and over the summer.
RISKS OF RELAPSE
It’s still too soon to have a clear picture of the ramifications of the past three months on substance abuse in the region, according to both Brown and Banks. The reality is that with so many people still in some level of isolation, it’s much harder to see how many have fallen back into their old destructive lifestyles. It’s also been estimated that fewer than 20 percent of people with a substance use disorder actually seek treatment in the first place.
“It can be very difficult for people in the early stages of recovery,” Brown said. “One of the sad things is that we often expect the newcomer, who is still very ill, to be able to do more than they can. We’re waiting around for them to reach out to us.
“Still, we need to know you exist,” she added. “Then we can make sure you can get what you need.”
Banks said she has seen one positive aspect of how people have responded to the pandemic. “It has allowed people to talk about how things are impacting them. It’s opened up some conversations that weren’t happening before.
“There are more mainstream conversations about alcoholism and substance abuse. There probably have been some people who have reached out who normally wouldn’t have.”
There’s no question, in Banks’ opinion, that the need for substance abuse treatment is as great as ever, although the nature of the substances being abused has shifted in recent years.
Methamphetamine, for instance, is coming back. Fatal meth overdoses in Virginia jumped 55 percent last year compared to 2018. And fentanyl contributed to almost 60 percent of the fatal overdoses in the state in 2019.
“The crisis isn’t over,” said Banks.