COVID-19 And Addiction Treatment
The world has entered an unprecedented time. Everyone is experiencing great uncertainty and changes are being put into place at a rapid pace. Even though many people are unsure of what to make of these changes, life must continue - as normal as possible. This means that people with addiction problems should still seek treatment.
In fact, people with addictions may need to seek treatment more than ever. The COVID-19 crisis is having a profound impact on drug use, drug supply, and the emotional health of people across the globe. Because of the adverse way that COVID-19 and the precautionary measures that many cities and countries are enacting, we must be increasingly cautious about drug use.
In this article we explain how COVID-19 affects addiction and addiction treatment programs. By the end of this article you’ll understand ow COVID can influence the lives of drug users. You’ll learn about the impact that COVID has on drug supply and how this affects the safety of street users as well as the risk factors presented by quarantine and other protocols that can make someone more prone to relapse.
COVID-19 Measures, Protocol & Precautions
COVID-19 has created a number of changes in the world. These changes vary from city to city, state to state, and country to country. It’s important to acknowledge that people living in different regions may not be affected the same way.
For much of this article, we will attempt to provide information that is applicable to the United States at large. However, remember that individual state mandates may differ from one another. As such, drug addiction and treatment programs may not be affected the same way in Washington, for example, as they are in Florida.
Nonetheless, we will discuss a few of the basic COVID-19 measures and protocols that have been implemented widely. These measures can influence drug supply, the addiction treatment process, and a person’s likelihood of developing drug addiction. We will discuss these ideas in more detail later.
Physical distancing. One of the most commonplace measures posited to help prevent the spread of COVID-19 is physical distancing, which has been implemented nearly everywhere. The World Health Organization has encouraged countries around the globe to implement social distancing and it’s uncertain as to how long this measure will remain in place for.
Business closures. Many businesses - mostly small-scale, family run businesses - have closed down. Some have closed down temporarily but others have closed down permanently. This includes small-scale and private rehab companies, many of which offer holistic and healthy programs.
Quarantine / Self-Isolation. There are a number of situations that might cause someone to feel the need to self-isolate. Catching COVID, of course, is the main reason. However, many people self-isolate if they believe themselves to be exposed. People may also have to self-isolate if they dece to travel, although most companies are closed to American tourists right now.
Border closures. One of the biggest factors affecting the drug supply during COVID-19 is the closure of certain borders. This impacts the availability of certain drugs and can influence price, quality, and the production of drugs that can be made locally.
Wearing masks. Masks are mandatory in many places in the United States, especially when entering businesses. The mask itself tends not to have much of an impact on drug and alcohol use, although people have found that they are, in some cases, less likely to have their identification checked which could enable younger people to develop alcohol problems.
These are the most common preventative measures that are used to prevent the spread of COVID-19. These factors can influence all aspects of a drug user’s life.
COVID-19 and Drug Supply
Starting from the beginning, we will discuss how COVID-19 affects drug supply. A steady supply of drugs is necessary for any community to have drug users. Without a drug supply, there will be no users.
Border Closures and Changes in Drug Supply
Are a lot of ways in which COVID-19 is affecting the drug supply. One of the main reasons that drug supplies are affected is because of border closures.
Many of the drugs in the United States are imported. This is especially true of cocaine and certain types of heroin, which are often imported from Mexico. Other types of heroin are imported from Asia.
When the borders close, a number of things happen to the drug supply.
Prices change. Like any economy, the drug economy is ruled by the concept of supply and demand. When there is less drug supply, the price goes up. If drug runners are still willing to risk traveling the border amidst a border closure, then the prices of importation will likely spike as well. This would further increase the price of drugs.
Quality change. Another thing that will happen when drug supply decreases is that the quality will change. A change in quality may occur alongside a change in price. However, in many areas the price may remain the same and the quality will drop. When fewer drugs are available, many drug dealers will dilute their supply and sell lower-quality drugs to their customers. This helps to ensure that their profits won’t drop.
The availability of certain drugs may change. If drug dealers are unable to acquire certain drugs, then they may have to switch their supply to drugs that can be obtained locally or legally. The presence of crystal meth, which can be made using ingredients purchased domestically, has increased since COVID-19 struck.
The issues related to border closure may also create further problems. For example, a drug dealer who is used to selling their customers a certain type of heroin may suddenly find that their supply is cut off. To compensate, they may adulterate other drugs in an effort to recreate the effects of their original heroin.
In these situations, drug dealers are rarely upfront about the products that they use. By the time the products reach the streets, street-level dealers may be entirely unaware of what they’re actually selling. This creates danger not only for the drug users but for the dealers themselves, who may unwittingly be falsely advertising their products.
Self-Isolation & Drug Supply
Self-isolation and quarantine may also create problems for drug supply. Certainly this creates problems for the individual drug user, who may have a hard time getting their fix.
For some, this may present a long-needed opportunity to sober up. However, for many others, this means alternating periods of withdrawal symptoms punctuated by the occasional delivery from a friend or a pitying drug dealer.
Large-scale drug dealers may also be forced to self-isolate. If this were to occur then the supply for an entire region may be affected.
Some may think that the limited availability of drugs may reduce substance abuse. However, it seems that the opposite is true. In March of 2020, when strict measures were first beginning to be implemented, the sales of alcohol rose by 55%. This indicates that, rather than attempt to sober up, substance users are stockpiling their substances for fear of not knowing when they might be able to acquire more.
Unfortunately, this has the added effect of increasing overall substance consumption. When there are large amounts of drugs or alcohol around, people may be more inclined to use higher doses. When this occurs, they are more likely to develop tolerance which can accelerate their decline into dependence.
While many street-level drug users are more concerned about getting their fix than practicing physical distancing, this is not always the case. While a solution can usually be reached quite easily, there are some who may find that their unwillingness to make physical contact will impede their access to drugs.
COVID and Pharmaceuticals
The COVID-19 pandemic has actually highlighted a number of issues that were already present in the pharmaceutical industry, according to the CEO of Capital Rx, a pharmacy benefit manager.
Many drugs were becoming in short supply even before the advent of COVID-19. More than half of these shortages were the result of problems in the pharmaceutical supply chain, mostly related to manufacturing or quality problems.
The current situation has intensified these issues and cast a glaring light onto these flaws. Up to 57 drugs are at risk largely thanks to a number of new export restrictions that have been placed in China, one of the world’s leading pharmaceutical companies.
In fact, many of the drugs that were initially advertised as being COVID-19 cures are now in short supply. In addition to this, a lot of common drugs ranging from cancer medication to HIV drugs and antibiotics are all at risk. This has led to people stockpiling their medication in an effort to keep symptoms at bay and avoid any potential withdrawal symptoms.
COVID-19 and Drug Risk Factors
One of the main ways that COVID-19 is affecting drug treatment is by making people more vulnerable to addiction itself. COVID-19 has led to a number of mandatory lifestyle changes that increase certain risk factors for depression.
Physical distancing measures, the social implications of wearing masks and being unable to see people smile or frown, self-isolation, business closures and other COVID-related crises can make people much more prone to mental health problems and addictive behavior.
These are some of the most common risk factors associated with COVID-19. We will discuss, below, how some of the individual protocol can contribute to these factors.
Mental health disorders (such as anxiety and depression). Mental health disorders are acknowledged as being one of the most common causes of drug addiction.
- Depression is marked by a decrease in energy, motivation, and self-esteem. Lacking self-worth, depressed people may use drugs to improve their confidence. Or, they may rely on stimulants or antidepressants so that they can artificially reproduce the motivation that they need to accomplish their daily tasks.
- Anxiety may also lead someone to use drugs or alcohol. Alcohol - or anything else that affects the GABA system, like benzodiazepines, is seriously addictive, being one of the only classes of drugs that can cause deadly withdrawal symptoms.
- Trauma. Trauma is widely acknowledged as one of the leading causes of addiction, and many people may find that COVID-19 has contributed to trauma in some cases.
Social isolation. Another one of the biggest issues that is affecting people because of COVID-19 is social isolation. Because of the way that people are being forced to physically distance from each other, as well as the closing of public venues, restaurants, and businesses, people are having a hard time connecting with each other. As restrictive measures prevent people from engaging with large numbers of friends or family, this can cause a number of problems that could influence drug addiction.
- Social isolation can contribute to many of the mental health disorders discussed above. These, in turn, can easily contribute to addiction rates.
- Social isolation means that people can’t attend group meetings, which includes meetings like NA or AA. These meetings are often the most important support for recovering drug users and alcoholics. While many of these groups are offering online facilities, many people don’t have the resources to access these online groups. In addition, some people find that online group meetings lack the emotional component that allows in-person meetings to be so effective.
- Social isolation can lead to feelings of loneliness which can lead to the desire to use drugs or alcohol. When one lacks social support and comfort, they may in turn seek these comforts from substances.
Fear and concern. Many people are overwhelmed with fear and uncertainty regarding the global situation. This consistent uncertainty, coupled with regular news reports confirming many fears, can make someone lean towards using substances in an effort to manage these fears.
Business Closures, Job Loss & Drug Risk Factors
Some people may find that business closures are creating risk factors for drug or alcohol use. Others may find that the loss of a job or decreased work hours are putting them at risk for using drugs and alcohol.
If someone runs a small business and has it shut down, they may encounter a number of problems.
- Financial difficulty. While financial difficulty may seem, on the surface, to be a reason to avoid substance abuse, it can certainly be a risk factor. When someone’s financial stability is put at risk, they may become stressed or depressed. This can lead to them using drugs or alcohol.
- Shame. If someone is running a family business and has it shut down, they may experience feelings of shame. Regardless of whether or not the shutdown was their fault, they may turn to drugs or alcohol in an effort to cope with the disappointment.
The business closures are affecting people who don’t run businesses themselves. Many people are finding that their favorite social gathering spots are closing. This makes it more difficult to find social fulfillment and may lead to people engaging in unhealthy behavior, like drug use, to fill the void.
Studies have also revealed that 39% of American adults have lost their jobs or had their hours reduced as a result of COVID-19. This means that people tend to have a lot more free time on their hands. If they don’t find something to fill their free time with, they may be prone to boredom which can contribute to substance abuse.
Substance Abuse & COVID-19
Another thing to consider is the implication of substance abuse occurring alongside COVID-19.
People who abuse substances may find that they experience a number of complications if they contract, or have contracted, COVID-19. Any drugs that are destructive to the body’s organs and tissues have the effect of damaging the immune system. This will make them more likely to contract the virus and, if they have already contracted it, less likely to be able to fight it off.
One must also consider that COVID-19 is a respiratory condition and that any method of consumption that involves the lungs could potentially worsen symptoms. Smoking, whether it is tobacco or heroin, can aggravate symptoms of the virus. Regular opioid use can also suppress respiratory function - one of the main symptoms of COVID-19 - which could aggravate symptoms.
It’s also important to note that some drug withdrawal symptoms mimic symptoms of the disease. People who are undergoing withdrawal from opiates may find that they have a number of symptoms such as a fever or cough that are similar to COVID-19.
On the one hand, this could lead to someone falsely diagnosing themselves with COVID-19. On the other hand, someone could contract COVID-19 and be unaware, convinced instead that they are simply experiencing drug withdrawal.
COVID-19 and Drug Treatment
One of the biggest issues related to drug and alcohol users during the pandemic is the changes that are taking place among treatment programs. While many treatment centers continue to accept new patients, this isn’t the case for all of them. What’s more, the treatment centers that are accepting patients often have a number of new rules in place that can affect the treatment process.
Many of these rules are the result of the joint efforts of the American Society of Addiction Medicine and the Substance Abuse and Mental Health Services Administration. They have produced a number of measures to be implemented in rehab centers to help improve the reliability and safety of treatment at rehab facilities.
This section of the article deals with the many changes that are taking place in the drug and alcohol recovery world.
Revised Screening Processes
Most rehab centers are going through with a revised, and more intensive, screening process. Rather than being questioned about their substance abuse and history, people are now being thoroughly screened about the possibility of having been sick recently.
A number of new questions are often being asked during pandemic screening processes. You will likely be asked:
- If you have traveled overseas in the last weeks or months, and if so, if you went through a mandatory 2-week quarantine
- If you have had a recent fever or if you’re displaying any symptoms of sickness
- If your family members are at risk of contracting COVID-19 (if they work in areas where they are frequently exposed to other people, especially high-risk people such as hospital patients)
If you are deemed a risk to the other clients or professionals at the facility, you will likely be denied. This is an attempt to avoid the introduction of the virus to otherwise vulnerable populations.
While these screening procedures are for the best interest of everyone, they may also interfere with an individual’s treatment. For example, many withdrawal symptoms may mimic symptoms of a flu (fever, sweating, coughing, etc.). If these symptoms are confused with viral symptoms, then an individual may be denied service despite being free from sickness.
Social Distancing at Rehab
Rehab facilities now must engage in social distancing. This helps to prevent the spread of the virus among anyone who may have brought it into the facility, including the professionals.
The social distancing measures tend not to have too much impact on the quality of treatment received. Most of the rehabilitative program involves talk therapy which can be done at a distance.
A number of new sanitation requirements are often being implemented in rehab facilities who comply with COVID-19 mandates. These may include:
- Required hand washing and sanitation for everyone at the facility - both clients and employees.
- Regular sanitation of all areas of the facility, including patient facilities, to prevent the spread of the virus.
Information & Exclusion Criteria
Many rehab centers are making a point of making COVID-19 information available to patients. This may include the introduction of pamphlets, posters, and other forms of media to inform and remind patients of the new rules that must be adhered to in order to continue receiving treatment.
Many facilities also have strict criteria which define the conditions under which patients or staff members will be discharged or have to go through quarantine.
- If a patient displays symptoms of the coronavirus then they will be quarantined until they are able to receive a test for COVID-19.
- Staff members who are feeling sick will be instructed to remain home and get tested for COVID-19.
Changes in Medication Dispensing
One of the many changes that is affecting recovery patients is the dispensing of medication. This is especially true for patients who are prescribed methadone, a prescription drug that saturates the opioid receptors to prevent people from relying on illicit drugs.
According to Sarah Andrews, M.D and manager of the inpatient substance abuse units at the John Hopkins Hospital, reports that some of the regulations related to the dispensing of this medication have changed since the pandemic began.
Methadone is typically distributed on a daily basis to prevent recovering drug users from stockpiling doses and using them to get high. However, in an effort to promote physical distancing measures, these restrictions have been slackened a bit and prescriptions are often being dispensed several doses at a time.
Virtual Rehab Treatment
Online and virtual therapy platforms have become increasingly popular in recent years, largely due to increased accessibility. Nowadays people can connect with a therapist or counselor through their cell phones, given that they have video capability, which brings the possibility of therapy to an unprecedented number of people.
Since Medicare has recently begun providing insurance coverage for people seeking treatment via online platforms, many rehab companies have begun to offer their services online. Many rehab facilities are restricting their outpatient services to online platforms to maximize social distancing protocols.
Without a doubt, COVID-19 has created a number of changes in our society. These changes have affected drug and alcohol treatment programs as well created new vulnerabilities for people struggling with drugs and alcohol.
Fortunately, a number of organizations are working hard to develop new regulations that allow people to seek treatment while remaining safe and healthy. By implementing new social distancing measures and hygienic practices, rehab companies are able to offer the same services without increasing the risk of contracting COVID-19.
If you or a loved one are struggling with a drug or alcohol problem, don’t hesitate to seek treatment. While you may be concerned about COVID-19, most rehab facilities are willing to accommodate new patients given that they adhere to the safety guidelines.