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Online Treatment, Virtual Check-Ins: Dealing With Addiction In A Pandemic

In this March 27, 2020 photo, a patient picking up medication for opioid addiction is given hand sanitizer at a clinic in Olympia, Wash., The clinic is meeting patients outdoors and offering longer prescriptions to reduce risk of coronavirus infection. (Ted S. Warren/AP Photo)
In this March 27, 2020 photo, a patient picking up medication for opioid addiction is given hand sanitizer at a clinic in Olympia, Wash., The clinic is meeting patients outdoors and offering longer prescriptions to reduce risk of coronavirus infection. (Ted S. Warren/AP Photo)

Editor’s Note: This hour discusses addiction and mental health.  If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting 741741. 


We look at addiction and substance abuse during the coronavirus pandemic and the resources available to those who are suffering.

Guests

Dr. Lipi Roy, clinical assistant professor at NYU, specializing in addiction medicine and substance use. NBC News medical contributor. ( @lipiroy)

Dr. Joseph Lee, medical director of the Hazelden Betty Ford Youth Continuum. ( @drjosephlee)

MJ Gottlieb, founder of the the Loosid app, which helps navigate addiction and maintain sobriety. ( @MJGottlieb)

Addiction Resources

Dealing With Addiction In A Pandemic

Recovering from addiction is difficult in the best of times. During a global pandemic, it’s even more daunting.

Access to in-person care has become more and more scarce. Many recovering addicts are separated from their support networks. Most 12-step meetings can’t take place as they once did. So many are stuck in their homes, where the temptation to relapse may be stronger. And thousands have lost and continue to lose their jobs and, thus, the health care that pays for their treatment.

We spoke with Drs. Lipi Roy and Joseph Lee, as well as sobriety app creator MJ Gottlieb, about how people with substance abuse disorders are coping with the pandemic, and what they and their loved ones can do to find support right now.

Interview Highlights

On how the pandemic is exacerbating some addicts’ struggles with substance abuse

Dr. Lipi Roy: “COVID-19, this pandemic, has created an environment where everybody is under even more stress than normal. And you mentioned environmental stressors such as unemployment, food insecurity, domestic violence, all of these issues were certainly stressors before. But now this pandemic has just amplified all of these issues. And we already know that environmental stressors, traumatizing experiences, are already risk factors for drug use and addiction. So we as a society really need to work harder to make sure that these vulnerable men and women get the care that they need and deserve.”

 

On what addiction treatment centers are seeing during the pandemic

Dr. Joseph Lee: “It’s incredible how COVID-19 has affected so many different people in different ways. People who are pretty strong in their recovery actually have been incredibly resilient because, as you and Dr. Roy have pointed out, addiction is a disease that exists in isolation and loneliness, and our mission is all about love and connection and healing through that. And so there are people who’ve been able to patch together communities and support who are strong in recovery, who understand suffering and loneliness, and those people are very admirable in this time. But there are a lot of people who are new to recovery and they have to access virtual services, or it’s hard to get help.

“There are also people who are maybe on the warning zone for developing a substance use disorder, and they relied on their jobs or an exercise routine or their social cliques to kind of stave off serious addiction. And those supports are now falling apart. And so we see people who are returning to use; we see people who have developed new use and are recognizing it for the first time; we see people who have hidden their addiction for a long time due to shame and stigma; and their family members are seeing it for the first time. And so we’re seeing all comers.”

On the difficulty of isolating while dealing with addiction

Dr. Lipi Roy: “When I learned that motto, that common phrase that’s used in the addiction field about, “It’s really not sobriety, it’s connection,” my life just shifted. And once I started working with patients with various at various stages of substance use, I really got it. Those in-person connections, building trust — which is a huge step to decreasing stigma — that’s all getting disrupted now with the pandemic. We in the public health community are actually telling people stay home, don’t meet up with people. It’s one thing to not do so socially. But when it comes to clinical and health matters, where people with SUD addiction rely on meeting their counselors, their doctors, their nurses, their care teams, definitely now, COVID-19 and isolation is posing unique challenges.”

On how some recovering addicts are more vulnerable than others right now

Dr. Joseph Lee: “One thing I say a lot is that economic prosperity may not trickle down, but suffering certainly does. And it does affect certain populations disproportionately. For example, people who need medications for opioid use disorder are having a harder time getting it. People who need psychiatric services are having a harder time finding those services. Last year, we started to work on a virtual program and we’ve moved thousands of our patients to a virtual onramp to do intensive outpatient care group, individual family treatment. But, you know, we’re a larger nonprofit. There are a lot of nonprofits who are struggling with the infrastructure and the platform. The stigma leads to a lack of resources, both in terms of access and insurance, first for people who want to get help, but also just the infrastructure is not well supported. So people aren’t finding a lot of venues to get the help. These times are making it hard for a lot of people in the community, and the demand is huge.”

On how loneliness can lead to substance abuse

Dr. Joseph Lee: “What people should understand is that as addiction develops, there’s a lot of shame about the use. And so people start to hide things, and there are secrets. And so even if they’re socializing with people, they have a secret life, and that double life and who they are, there’s a gap between that that really grows and stretches and then finally breaks. And that’s when usually people get help. And I think in our COVID-19 pandemic, a lot of people are experiencing the same thing. They’re experiencing similar levels of loneliness, a lot of people are in their homes. And I hope that at the end of this, we don’t take for granted how important connection is and how important we are to each other, because I think we have taken that for granted and it’s reflected in our social discourse and all the issues that we talk about. But these things are so vital.”

On why addiction treatment is so hard to access — and, often, so under-funded

Dr. Joseph Lee: “It’s a downstream problem, also rooted in stigma. Stigma isn’t just about personal shame or judgment from other people or your friends. Stigma has to do with resources and infrastructure. If you walk into a beautiful hospital and you want to get care for mental health or addiction issues for your loved one, and you walk into this beautiful hospital in a beautiful building and you ask for mental health or addiction services, you’re going to get sent to the back annex. And that’s what most people in America experience is that what they suffer with is a second-class disease for second-class citizens. And when you have that kind of infrastructure, as we’re all vigilant about COVID and we’re planning around what to do for this emergency and that, people with addiction and mental health issues fall through the cracks. And so the caller is absolutely correct. We have to do more to make it easier for people to access these medications and other routes for recovery.”

On how those struggling with addiction are connecting virtually right now

MJ Gottlieb: “What we’ve seen since COVID is a dramatic increase in specific sections of the app that cater to our hotlines and groups. I think it was a 1,970 percent increase in the first three weeks because people suddenly weren’t able to have that connection. So they had to move virtual. Now, you could go to 12-step groups, which I’m a huge advocate for, but you can only go to so many per day. So, we have over a thousand groups within Loosid, whether it’s sobriety and anxiety and depression or daily gratitude or hotlines. I’m having a bad day. I just relapsed and need advice. And so, meaningful conversations can happen. And it’s just so important to have that connection and engagement and to show people that they are not alone.”

Are virtual “meetings” as effective as in-person ones?

MJ Gottlieb: “They are. Let me tell you why. I think they’re complimentary, but in my 8-plus years of sobriety, what I found is when you relapse, when you feel like using, 9 times out of 10 the ego gets in your way and you don’t want to call your sponsor or do you don’t want to call your friends. You don’t want to call your network because you’re ashamed. We talked about shame, right. And we need to kill that stigma. And so what you’re able to do is you’re able to tap into a group of thousands, tens of thousands of people who don’t know you, but they understand exactly what you’re going through. And you’re saying, hey, I just relapsed, and there’s no judgment because you’re not being afraid that your friend or your family member or your sponsor or a member of your group in a 12-step fellowship is going to judge you.”

From The Reading List

Forbes: “ Collision Of Crises: How Covid-19 Will Propel Drug Overdose From Bad To Worse” — “‘It’s like getting a hug from God. A warm feeling.’ That’s how ‘Robbie,’ my 27-year-old patient, responded when I asked what he enjoyed about heroin. A tall, lean young man wearing a wrinkled white t-shirt, Robbie had soft hazel eyes and an embracing demeanor.”

New York Times: “ Could All Those ‘Quarantinis’ Lead to Drinking Problems?” — “The boredom of staying home and the intense anxiety produced by the pandemic have given rise to Twitter jokes about drinking before noon as alcohol sales have spiked.”

Yahoo: “ Alcohol addiction and the coronavirus: Why this doctor says telemedicine is key right now” — “The coronavirus has impacted everyone’s way of life, but for those struggling with alcohol addiction, the past few months have been especially challenging. Alcohol sales have reportedly soared and experts worry that even those who have never grappled with alcohol dependency could develop unhealthy habits during the pandemic.”

Addiction Center: “ COVID-19 is Causing People to Relapse” — “As the coronavirus (COVID-19) pandemic continues to unfold, the world is locking down, forcing millions out of work and many into isolation. While social distancing isn’t easy for anyone, it is hitting one group particularity hard.”

The News-Herald: “ Coronavirus pandemic creates additional challenges for those with substance abuse disorders” — “As the country has grappled with the novel coronavirus pandemic, those struggling with addiction are facing additional challenges.”

The Winchester Star: “ Coronavirus pandemic triggers spike in local overdoses, suicide calls” — “Area overdoses and calls to suicide prevention hotlines have soared since the start of the coronavirus pandemic, Rep. Jennifer Wexton, D-10th, was told during an online meeting with local drug treatment and mental health providers on Tuesday.”

NBC: “ Tech tools help overcome drinking addiction during quarantine” — “If you’ve been drinking more over the past month or two you’re not alone.”

Harvard Health Publishing: “ A tale of two epidemics: When COVID-19 and opioid addiction collide” — “I am a primary care doctor who has recovered from — and who treats — opiate addiction. I work in an inner-city primary care clinic in Chelsea, Massachusetts, which currently has the highest rate of COVID-19 in the state, due, in part, to poverty.”

BBC: “ Coronavirus: Lockdown leaves addicts ‘close to relapse’” — “Social-distancing restrictions have also made it difficult for many counselling services to operate.”

Buzzfeed News: “ The Coronavirus Is Keeping Addiction Counselors From Their Patients. So The Industry Has Transformed.” — “No one gets turned away. That was the principle for Options Recovery Services, a Bay Area addiction treatment network: If you showed up asking for help, you got it.”

USA Today: “ ‘Deaths of despair’: Coronavirus pandemic could push suicide, drug deaths as high as 150k, study says” — “The federal mental health czar is calling for more money to expand services to help people suffering amid the social isolation imposed by the coronavirus pandemic, as a new study estimates related deaths from alcohol, drug overdose and suicide could reach 150,000.”

Washington Post: “ Opinion: How the coronavirus is creating other threats for addicts” — “Fear, economic distress and isolation could trigger anxiety and depression in anyone. For people who have opioid use disorders, the coronavirus pandemic is a tinderbox of potential triggers and double binds. Disjointed, often punitive approaches to assistance could leave many addicts at heightened risk of relapse or greater exposure to the virus.”

This article was originally published on WBUR.org.

Copyright 2020 NPR. To see more, visit https://www.npr.org.