Most people are having a hard time dealing with the pandemic, but what about those who have substance abuse disorders or who are in recovery? For these groups, the COVID-19 outbreak entails additional psychological and physical risks, noted Rebecca A. Clay of the American Psychological Association (APA), a scientific and professional organization that represents psychologists in the US.
For instance, the stress and anxiety correlated with sickness, job loss, and routine disruptions may make those in recovery relapse. Social distancing could lead to overdosing if no one is around to call their local emergency hotline or administer naloxone—a rescue drug. Individuals with substance abuse disorders are also more likely than the general public to be homeless or be incarcerated, making social distancing more difficult or impossible.
People with substance abuse disorders may also experience discrimination if hospitals become too overwhelmed to take care of the needs of other patients, cautioned the National Institute on Drug Abuse (NIDA),
Report Examines Current Health Issues In the US (2016)
Non-profit organization Kaiser Family Foundation conducted a survey from April 12 to April 19, 2016 involving a sample of 1,201 adults aged 18 and above, reported Jamie Firth, Ashley Kirzinger, and Mollyann Brodie. The most serious health issues facing the use were cancer (43% of those who answered “extremely serious”), heroin abuse (35%), contaminated drinking water (35%), lack of access to mental health care (33%), obesity (33%), and diabetes (31%).
Other health complications the respondents mentioned were abuse of strong prescription painkillers (28%), heart disease (27%), environmental contamination (26%), lack of access to health care (25%), lack of access to affordable healthy food (21%), and alcohol abuse (19%). Regarding their personal experience with prescription drug addiction, 44% said they personally know someone who has been addicted to prescription painkillers, with 26% reporting that the person they know is an acquaintance.
21% said it’s their close friend, 20% answered it’s a family member, and 2% said it was themselves. On the other hand, 55% said they don’t personally know anyone who has been addicted to prescription painkillers. When asked if the lack of access to care for individuals with substance abuse problems is a problem or not, 58% said it was a major problem. Those with personal experience with Rx painkiller addiction (61%) were more likely than those without experience (56%) to say it was a major problem.
Further, 52% of people who are addicted to heroin said there is a lot of prejudice and discrimination surrounding heroin abuse in the country compared to 38% of those who are addicted to prescription painkillers.
Most people said the federal government is not doing anything to combat the increase in people who are addicted to prescription painkillers (66%) and heroin (62%), along with state governments (67% and 61%) and doctors who prescribe prescription painkillers (63% and 56%). Other contributing factors were police officers who enforce drug laws (37% and 36%) and individuals who use prescription painkillers/heroin (73% and 77%).
When asked if the respondents know that health insurance plans are required under the law to provide mental health benefits, 43% said insurance plans can have separate rules or required to have the same rules (correct). 14% either refused or don’t know the answer. When asked if health insurance plans are required to provide coverage for substance abuse treatment, 53% said insurance plans can have separate rules and 30% answered that they are required to have the same rules (correct). 17% either refused or don’t know the answer.
What Can Psychologists Do to Help Those With Substance Abuse Disorders?
1. Encourage Patients to Utilize Online Support
John Kelly, Ph.D., of Harvard Medical School and the Recovery Research Institute at Massachusetts General Hospital, said, “This is a very vulnerable time for people. Some are living alone and cut off completely.” Psychologists should encourage patents to get online support since it’s not possible to conduct in-person recovery meetings.
For example, most Alcoholics Anonymous and Narcotics Anonymous programs moved online and donations are now given via PayPal and Venmo. Other options can include private Facebook groups, In the Rooms, SMART Recovery, and more. Connect, an evidence-based app, can help people with substance abuse disorders to reach out to peers and counselors.
Bruce Liese, Ph.D., of the University of Kansas, currently pilots an immediate access for the organization SMART Recovery. Liese and other trained volunteers have dedicated cellphones patients can call 24 hours a day if they need help and support in managing their feelings, preventing relapse, or staying motivated.
2. Utilize Harm-Reduction Practices
Psychologists should balance their patients’ need for social distancing and the need to have another person nearby to come to their aid if they overdose. With that, Rachel Winograd, Ph.D., of the Missouri Institute of Mental Health, urged psychologists to encourage patients to use videoconferencing or a service such as Never Use Alone. The service sends emergency services if the patient fails to respond a few minutes after calling the hotline.
3. Build Resilience and Temper Expectations
“We should be reminding people of what they have already managed to get through in their lives,” said Tom Horvath, Ph.D. Both psychologists and patients should also have realistic expectations. Winograd added that they just need to make it through the pandemic and revisit their aspirations. Presently, psychologists do not need to constantly talk about slips to their patients, she said.
What Can Patients With Substance Abuse Do to Cope With the Pandemic?
For most people, routines help establish a sense of rhythm, stated Tyler Oesterle, M.D., M.P.H., of the Mayo Clinic, an American non-profit academic medical center. But for those in recovery—particularly those in the recovery process—routines and structures help them cope with the uncertainties.
During recovery, patients can develop a new at-home routine to structure their day and purpose. They can also exercise to reduce stress or spend a bit of time outdoors while adhering to social distancing measures. Patients with substance abuse disorders can videoconference with their friends and loved ones and practice mindfulness exercises such as deep breathing.
If you are a friend or partner to someone with a substance abuse disorder, it is recommended to ask about their activities and feelings other than their personal recovery journey and to encourage healthy behaviors.
The pandemic poses additional challenges for people with substance abuse disorders. Psychologists should encourage them to seek online support and connect with their loved ones via video call. Meanwhile, those with substance abuse disorders should structure their day and practice healthy habits that aid in their recovery. While the general public experiences the pandemic differently, people with substance abuse disorders should be provided with extra care and help to prevent relapse.