Substance abuse is pandemic’s ‘forgotten crisis,’ doctor says

A cross-Canada survey shows alcohol and pot use increasing among people struggling with mental health issues during isolation.

It’s a trend that has substance abuse experts worried that an already overburdened system of support services may not be able to handle the long-term spinoff effects of the COVID-19 pandemic.

Dr. Alexander Caudarella, interim medical director of addictions at St. Michael’s Hospital, calls it the “forgotten crisis.”

Many traditional substance abuse services, such as detox centres and transitional housing or treatment programs, have slowed or shut down because of the pandemic.

A more formal and sustained response is desperately needed.

“Right now, the wheels are falling off and we’re not doing anything systematic about it,” Caudarella said.

Statistics Canada released a report Thursday that showed 17 per cent of Canadians older than 15 with “fair or poor” mental health had increased their use of cannabis and 28 per cent had drunk more alcohol from March 22 to 28 (than they otherwise would). That compared to seven per cent of people with “good” mental health reporting increased cannabis use and 14 per cent drinking more alcohol.

The inability to maintain traditional coping mechanisms, such as exercise or a reliable work routine, may cause people to develop a substance use problem or relapse into one. It’s a bit of an odds game, too, Caudarella said; the more people who start drinking in excess of recommended guidelines, the greater the number of people who will develop a problem. And the longer somebody misuses substances, the harder it is to turn back that clock — and the more likely they may be to branch out to other substances.

That’s why there is a need to start offering more support now.

Toronto has already seen some severe impacts of substance abuse since COVID-19 lockdowns began: Last month, the city recorded its highest number of monthly overdose deaths since September 2017, according to the Toronto Overdose Information System; Toronto

Paramedics Services responded to 25 fatal suspected opioid overdoses in April, compared with 27 in September 2017, along with 318 non-fatal suspected opioid overdose calls.

Caudarella suspects a “not insignificant” factor in the increase in opioid deaths is that people are more likely to mix substances and increase their use in this time of uncertainty.

“I think what really makes us in this field nervous is this is going to have dramatic long-term consequences or even bring about death during this pandemic,” he said.

A number of substance-abuse services are being creative when it comes to operating during this pandemic; many are shifting to virtual care; some hospitals and programs are developing day programs; and some supervised consumption sites are working hard to stay open.

Experts agree addictions services in Toronto need a more co-ordinated response from the city and province before things spiral out of control, escalations that could cost the system in future.

Dr. Dominique Morisano, a clinical psychologist and adjunct professor at the University of Toronto, hasn’t paused for a second since lockdown began. Her wait-list now is shorter than it was before the pandemic.

“Substances can be an easy answer in the short term, but they create more problems in the long term,” Morisano said. “It’s not enough right now and therefore it won’t be enough right after, unless we change something … we change resources for mental health and we change availability for mental health.”

The federal government announced a $12-million increase in funding for mental health services in March. Morisano said more is needed.

“There’s not enough public services for mental health, so it falls on the private system to cover mental health … Just talking about it, it’s necessary, but not sufficient,” she said. “I haven’t seen that much actionable change.”

If a person is worried about developing substance abuse problem or relapsing, they should reach out for help, Morisano and Caudarella both said. Substance abuse may not be widely talked about, but it’s a big problem, which people should not feel shame or guilt about voicing.