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Is COVID-19 Leading to More Relapses?

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COVID-19, otherwise known as the coronavirus, is a stain on world history that we won’t soon forget. The virus has impacted businesses, families and will continue to cause ripple effects in our society for the foreseeable future. Unfortunately, one of the less spoken of topics regarding the virus is its impact on our recovery community. Many of those who have spent years safeguarding their sobriety by attending 12-Step meetings have been left in the dark. We are in uncharted territory, and the worst part of it all is that there is no end in sight. While some states have allowed limited opening, others like California are strictly closed.

Although lockdowns across the world have been effective at slowing the spread of the virus, former drug and alcohol users have been put in a position that is detrimental to their sobriety. Fighting an addiction to drugs or alcohol requires strength, and even when a person has completed a rehabilitation program or is deep into their 12-steps, relapse is, unfortunately, a common occurrence. The most common situations that may invoke relapse include depression, boredom, self-doubt, and being around substances. 

The U.S. Centers for Disease Control and Prevention (CDC) explains that the pandemic may be stressful for people, even those who aren’t prone to relapse. The fear and anxiety around a new disease is overwhelming and may cause strong emotions. When you couple that with isolation, it can be a recipe for disaster. 

If you’re concerned about a loved one in recovery and how stress during an infectious disease outbreak might be affecting them, the CDC says to look out for the following signs:

  • Worsening of chronic health problems.
  • A change in your patterns of eating or sleeping.
  • Constant worry or fear about your health or the health of loved ones.
  • Fear or worry about your job, financial situation, or a loss of support you’re heavily reliant upon.
  • Worsening of mental health conditions.
  • Increased use of tobacco or other substances, such as alcohol or drugs.

It’s common to experience stress during the pandemic. However, fear and anxiety may become overwhelming and cause an influx of emotion, which leads to relapse. 

Everyone Reacts Differently to Stressful Situations

People with substance use disorders (SUDs) are at greater risk of relapse during the pandemic, according to the National Institute of Health (NIH). There is a surge of addictive behavior, including behavioral addiction during this time. Withdrawal emergencies and death rates are increasing, and those battling addictions are facing challenges accessing healthcare services. How someone copes with the stress may determine the outcome of their life. Although the changes occurring as a result of COVID-19 can affect anyone, the recovery community is the most vulnerable.

Those who respond more strongly to the stress of a crisis include:

  • Children and teenagers
  • Those who are at higher risk of severe illness from COVID-19, such as older people and those with underlying medical conditions.
  • Those caring for family members and loved ones. 
  • Essential workers in the food industry.
  • Frontline workers such as first responders or health care providers.
  • Those with existing mental health conditions
  • Individuals who lost their jobs, had their hours reduced, or had any other significant changes to their employment status.
  • Individuals who are socially isolated from other people, including those who live alone.
  • Individuals with developmental delays or other disabilities.
  • Those who don’t have access to information in their primary language. 
  • Individuals who are homeless.
  • Individuals who live in group settings.

Stress is the primary precursor for relapse, and during these stressful and trying times, an individual who is isolated may succumb to their urges. The person may feel like they can handle “casual use” until the times get better, but even using once could be fatal, in some cases. 

Although stress is a significant cause of relapse, other factors like depression and anxiety can also cause it. Being alone and away from friends and family when you’re trying to maintain sobriety can lead to racing thoughts that things won’t get better. You must remember, this isn’t permanent. 

Relapse Prevention – H.A.L.T.

Stress is proven to be interconnected with other relapse triggers, including hunger, anger, loneliness, and tiredness. These triggers have commanded their own acronym, HALT, now used as a method to fight relapse. Addressing the danger of these situations can help you avoid the risks of relapse during COVID-19.

  • Hunger: This may be a hunger for food or mental and spiritual engagement. A lack of nutrition is a dominant cause of relapse, and consuming a healthy diet creates a sense of physical well-being. Food also plays a role in managing mood, behaviors, and emotions. 
  • Anger: Recovery may lead to resentment for prior actions, and the damage addiction might have inflicted on their relationships or jobs. These emotions may flare up during the lockdown when we’re left with little else to think about. You should contact a loved one or your sponsor to discuss how you feel. Remember, these emotions are understandable, so don’t get down on yourself. 
  • Loneliness: Those battling sobriety may feel lonely enough as it is, but when you add a global pandemic into the equation, these feelings may become overwhelming. The same a person might feel for their addiction is amplified when they have no outlet, which could lead them to the only friend they think they have left, which is their substance of choice. 
  • Tiredness: Exhaustion affects us in different ways, but for the majority, it depletes our patience, ability to think clearly, and how we cope with daily situations. Excess tiredness can lead to anxiety or depression, or alter our moods in a way that leads to hopelessness. 

If you ignore these basic needs, you are at much higher risk of self-destructive behavior that leads to relapse. 

Signs of Relapse

An estimated 40 to 60 percent of those going through recovery will relapse at some point before achieving meaningful and lasting sobriety. That number is estimated to be as high as 90 percent, but during COVID-19, when we’re feeling more isolated than ever, it’s essential to pay attention to the warning signs of relapse. These include:

  • Declining hygiene
  • Poor sleeping or eating habits
  • Taking up relationships with past friends who are using
  • Bottling up emotions
  • Lying
  • Skipping or avoiding virtual support meetings

What To Do If Someone Relapses During COVID-19?

Those close to relapsing express their cravings for drugs and alcohol, as well as relax on their self-imposed rules. You might notice they romanticize past substance abuse or mention they’re using in a controlled fashion. If you believe a friend or loved one has relapsed during the COVID-19 pandemic, a return to treatment might be the only option. Fortunately, drug and alcohol treatment centers are fully operational during this pandemic, and seeking help could save their lives. 

You must show support during this time and be positive to create a safe environment. Open and honest communication and active listening create opportunities for the person in question to listen and get the help they need. You must stand firm and hold the individual accountable while offering optimism and encouragement. You can get through this challenging time with the right support.

Sources

NIDA (October 2020) Can Addiction Be Treated Successfully? from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

Coronavirus (COVID-19) (October 2020) How to Prepare and Protect Yourself. from https://www.coronavirus.gov/

CDC (July 2020) Coping With Stress. from https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

CDC (October 2020) Learn About Mental Health. from https://www.cdc.gov/mentalhealth/learn/index.htm

NIH (June 2020) COVID-19 and Addiction. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282772/

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