When COVID-19 came in the spring of 2020, the whole world changed. By March, half of all people on Earth were living in lockdown conditions.
What did we do when we no longer went to work, school, gyms, restaurants, doctors’ offices, playgrounds, or anywhere that wasn't home?
Many people, it seemed, turned to drugs and alcohol. Researchers spotted spikes in positive drug tests ordered by doctors. Many more people produced samples that tested positive for cocaine, heroin, methamphetamine, and fentanyl.
As we're writing this article, the pandemic isn't quite over. But many of us have returned to work, and our children have gone back to school. Looking back on the statistics can help us understand what went wrong during this unusual time and what we can learn to help us in the future.
The Scope of Pandemic Substance Use
Few people shouted about their drug use from the rooftops. Since most people were isolated at home, it was easy to keep substance use secret. But researchers uncovered evidence that many people were using more drugs during the COVID-19 pandemic than ever before.
In one study, 47% of people said they were using more drugs during the pandemic compared to before, and 38% said they thought they were facing a higher overdose risk: supply chain issues and/or increased use made them more likely to purchase drugs from new dealers that they didn’t know well.. People reported being concerned that their purchases were contaminated more often during this period.
More than 93,000 drug overdose deaths were reported in 2020, the highest amount ever recorded. Some people who worried about overdoses were clearly right to do so.
Many people who had never used started during the COVID pandemic. More than 10% of adults who had never used drugs before started during the pandemic.
Adolescent drug use remained stable during the pandemic, though, which was one bright spot. Adolescents may have had fewer drug use opportunities with their parents at home all the time, reduced peer pressure, and more difficulty buying drugs when they weren’t going to school.
5 Reasons People Turned to Drugs & Alcohol During COVID
Individuals have all sorts of reasons to lean on substances. And many people likely had multiple, conflicting influences that pushed on their day-to-day habits. But these are a few common themes researchers teased out in their studies of COVID-19 drug use.
Before COVID-19 lockdowns, it was sometimes difficult to keep drug use a secret. That changed when our homes became our gyms, restaurants, and offices.
During the lockdown, people could drink or do drugs on the job without detection. Bosses might look for impairment signs on Zoom calls, but they couldn't smell booze on someone's breath or see track marks on a worker's arm.
Fewer social interactions meant fewer consequences. Your friends, family, and coworkers might never see your drunken nights and hungover mornings. Without those checks in place, it became easier and easier to over-indulge .
Concerns about virus transmission combined with enforced isolation and a heavy diet of social media fueled more use to numb. People felt:
Some turned to obsessive habits to manage their fears. They cleaned every surface of the home again and again to remove all germs. Or they washed their hands until they bled.
Others leaned on substances to give them a temporary break from their worsening mental health.
The days seemed to bleed into one another when we never left our houses. We didn't have special occasions to look forward to. We didn't even have children's plays or office parties on the calendar.
Many people felt like their common boredom-busting activities, like watching TV, were "pointless" in the face of the pandemic. They desperately needed to do something else, but they struggled to find anything meaningful to do.
4. Lack of Coping Opportunities
Many common stress-busting outlets weren't available during the pandemic. Gyms were closed, people couldn't meet with friends, and parks were closed. If someone was accustomed to going for a run with a friend during a tough time, that avenue was closed for them, too.
When the old coping opportunities weren't available, people had to innovate. And for some, that meant using substances more than ever before.
Adjusting to a completely different lifestyle wasn't easy for anyone. But some people faced challenges that were hard to fathom.
For example, 76% of people working in intensive care units had symptoms compatible with traumatic stress disorders. Every day, they worked hard to save patients. And despite their work, many people died. Of female ICU workers, almost 25% qualified for a substance misuse issue.
Addiction Treatment During the Pandemic
Lockdowns also made it harder for people to get help if their substance use spun out of control.
Few hospitals and clinics were operating normally during the pandemic. Some closed their offices entirely, while others had so many appointment requests that they couldn't keep up with the volume.
Officials responded by lifting some requirements. For example, doctors could use telemedicine appointments to assist people using buprenorphine. Before COVID, those appointments had to be held in person.
Many people with substance use disorders find they need residential treatment to break the habit. Moving into a treatment facility offers people:
- Separation from the triggers: Secure, sober environments make relapse less likely.
- Structure: Nurses manage medications so doses are never skipped. Therapists require them to use coping skills regularly, and being surrounded by others in recovery provides accountability.
- Get wraparound help: Therapy sessions, support group meetings, and other tools are all in one place, making it easier for people to get their individualized needs met..
Because residential facilities were associated with higher risk of COVID spread, many shut down during the lockdown, reducing access for people with substance use disorders seeking treatment. .Many patients were simply too fearful about entering such a facility and putting themselves at risk about 30%.
Most people turned to an outpatient-based system instead. And in California, providers treating substance use disorders said more than 50% of their patients used telehealth appointments.
Most providers who completed this survey felt individual counseling in this model was as effective as in-person models.
Support Systems & Lockdowns
12 step meetings and other support groups are a critical part of recovery for many people with substance use disorders. In self-help based groups, people connect with others in recovery, through individual sponsorship relationships and in group meetings. Social connection is an essential ingredient for many.
Support group meetings are often held in churches, community centers, and other spaces that were closed during the pandemic. And meetings with people from multiple households were banned in states with lockdown rules. But innovation solved some of these problems.
The electronic platform Zoon grew by 354% during the pandemic. People used electronic meetings to connect with coworkers and attend classes. Some used this same platform (or something like it) for support group meetings.
A digital support group meeting doesn't begin with hugs and handshakes. But electronic platforms allow people to do the following:
- Raise their hands to speak
- Applaud for speakers
- Hold side conversations
- See others’ faces
Of those who used virtual support group meetings, almost 65% said the format was at least as effective as in-person gatherings.
Where Do We Go From Here?
The pandemic changed almost everything about daily life. Many lessons were hard, and others were painful. But as we coped and changed in other ways in our lives, people with substance use disorders and their supporters and providers also coped and changed.
For many people, virtual support group meetings and telemedicine remain the preferred form of care, these days. Other people are thrilled at the idea of leaving this unusual time behind, and returned to in-person meetings or therapy as fast as they were allowed..
No matter where you fall on this spectrum, know that you can get help. Assistance for substance misuse is available both in person and via telemedicine. Support groups can be found in both formats too.
Help is waiting for you. You just need to get started.