We have all experienced the pain and frustration of isolation. Even those of us without pre-existing mental health issues have found ourselves struggling with the uncertainty and stress of the covid-19 pandemic. Physical distancing has left many of us yearning for more social contact. Now imagine that you always struggle with feeling isolated, even when you are physically surrounded by your friends. Imagine how much more profound and acute those feelings of isolation would become in a quarantine situation. Isolation is known to be a significant risk factor for those suffering from addiction. As a result, covid-19 has created a perfect storm for those vulnerable to the disease.
First, let’s talk about the obvious challenges of the covid-19 pandemic. Kids unexpectedly out of school or summer programs, with possibly no childcare at home. Parents stressed by either having to adjust to working from home or, unfortunately, having no work at all. Everyone coping with social distancing and isolation. Daily routines interrupted. Life milestones cancelled or seriously altered. These are all very stressful issues that cause even the most stable and adjusted person among us a tremendous amount of uncertainty and anxiety. The result is that the most vulnerable of us are being even more profoundly tested.
Second, covidt-19 is taxing all areas of healthcare, including treatment and recovery systems. Virtually all avenues of treatment have been disrupted and severely curtailed. Physical distancing has limited options to seek in-patient recovery due to limitations on space as facilities limit admissions, or even close their doors for fear of spreading the virus in a communal setting. Access to therapy and/or medications to treat addiction has been severely reduced or cut off in some cases. Unfortunately, one pandemic has created a serious deterioration in the other.
Third, a common saying in recovery is that “addiction is a disease of isolation.” While social distancing isn’t easy for anyone, it is hitting people struggling with, or in recovery from, substance use disorders particularly hard. Social distancing conflicts with efforts to engage in a recovery community in almost every way possible, and studies have shown that isolation is associated with worse outcomes for addiction treatment. The necessary physical separation caused by covid-19 has resulted in many in-person support meetings either moving online (which, some say, is far less effective) or being canceled entirely, thus removing a vital source of support. Simply put, the social network and bonds of the recovery community are a critical tool for most sufferers to achieve or maintain their sobriety, and now they are being removed. Sadly, relapse is a common occurrence during the process of recovery, but experts in the field of addiction are fearful that an even higher rate of sufferers will relapse as a result of this pandemic.
As if all of this was not enough for us to worry about, with the adverse change in the economy and all the social unrest we are experiencing, we can anticipate a corresponding increase in the use of drugs and alcohol. Studies show that substance use increases in times of recession because of the psychological distress. Heightened anxiety is a near-universal trigger for substance use and it is difficult to think of a more stressful event than this pandemic. Those with mental health issues are disproportionately impacted, and if they can’t get the help they need during this difficult time, we can expect a frightening increase in substance use and related disorders and diseases. This combined with the less readily available means to cope with stress, and the diversion of medical resources to treat the pandemic, is a recipe for disaster.
When we think about adolescent and young adults suffering from substance misuse and addiction, we also must consider the unprecedented changes in their lives. Their routines and social lives have been disrupted and milestones like graduations, bar/bat mitzvahs, and even birthday parties have been significantly altered. They are being asked to adjust to many things, including not being in school or on summer programs, wearing masks, and not being able to be with their friends. Decades of research demonstrate that there are both risk factors and protective factors for substance use. Children are now at home, sometimes without parental supervision, with increased free time, and without the structure they usually have. In addition, childhood trauma is linked directly to substance use disorders, and covid-19 very well may expose children to traumatic experiences, including possibly dealing with the death or illness of a loved one.
I know from our support group for loved ones of those struggling with substance misuse and addiction that there is an almost universal heightened fear for the sufferer. We are all under extreme stress right now, and we know that our loved ones are particularly vulnerable, so we worry. We need to be cognizant of our loved one’s need for routine and purpose, for social connection and support. We need to remember that this is a disease, and make sure we are not feeding into any stigma associated with it, so that more people are open about their struggles and may be willing to ask for help when they need it.
We must be vigilant to the struggles of those around us, be they physical or emotional. Everyone struggles in some way, and we need to ensure no one feels that they are struggling alone. We also need to remember that physical social distancing does not equal emotional distancing. We can and must still maintain social bonds during this time of enormous stress and uncertainty, and in fact, we need to make those extra efforts to connect with others, particularly our most vulnerable.
We must work even harder to build and emphasize community in order to successfully weather this perfect storm.
Lianne Forman, a 28+ year Teaneck resident, is the executive director of Communities Confronting Substance Abuse, the organization she and her husband, Etiel, founded in 2018. Lianne, a corporate and employment lawyer by training, and Etiel have five children and two grandsons. Their daughter Elana is in recovery from addiction. Through their own family’s struggles, they founded CCSA, a charitable organization committed to community education, awareness, and prevention of substance abuse and addiction.