In the early stages of the COVID-19 pandemic, the American Medical Association (AMA) issued recommendations to help reduce the stress that people with opioid use disorders are likely to feel due to stay-at-home orders, and to “save lives, reduce harm and get people the treatment they need.” The primary goal was to avoid a potential surge in opioid-related overdose deaths as the country began to lockdown.
By July, the association released a report showing their earlier concerns were valid: There was a dramatic increase in fatalities involving illicit opioids, methamphetamine, heroin and cocaine in the last few months. In fact, according to reports by the Overdose Detection Mapping Application Program, which works with first responders and hospitals in counties across the country to track fatal and non-fatal overdoses, drug overdoses increased 42% in May compared to the same month last year.
Consequences of isolation
“People have lost jobs, they are unable to socialize, in-person therapy and group support is not available in some areas, and we’re dealing with sadness, fear, anxiety and uncertainty — all these things put people with substance use disorders at great risk,” says Dr. Fadi Nicolas, chief medical officer of Sharp Mesa Vista Hospital and Sharp McDonald Center.
Along with the consequences of isolation that many feel, such as loneliness, boredom and lack of support — which can increase addictive behavior — people with opioid use disorder also face additional challenges, including:
- The absence of others in the home to help them remain in or seek treatment, call for emergency help or administer naloxone, an opiate overdose antidote drug, in the case of accidental or intentional overdose.
- Lack of access to trusted substance suppliers, leading to greater risk of purchasing and using synthetic or unknown dangerous substances.
- Reduced access to treatment, including individual therapy, support groups and prescribed medications to assist with recovery.
Signs of substance use
According to Dr. Nicolas, it is important that people stay connected during the pandemic. Loved ones of those with a substance use disorder can often recognize the signs of substance use. From unexplained trips out of the house and familiar patterns reappearing, to a marked shift in behavior, interests, mood, sleep, weight and hygiene, all may indicate that there may be an increase in substance use or relapse for someone in recovery.
“Families will likely recognize the changes,” Dr. Nicolas says. “A loved one might begin to ignore COVID-19 precautions and stop spending time with family, scheduling care appointments, attending virtual support groups and practicing self-care, all the things they know aid them in their recovery.”
Dr. Nicolas says that it is important that family members recognize that the pandemic creates a unique and far more challenging situation for everyone involved. If someone you care about has a substance use disorder, focus on taking the following steps to help yourself and your loved one:
- Educate yourself about substance use disorders.
- Seek support through your family, friends, religious community and programs that help families of loved ones with addiction disorders, such as Nar-Anon.
- Take breaks when needed; for example, taking a walk in the neighborhood.
- Discuss the situation — it’s OK to tell the person that you love them, but cannot stand by and watch their substance use and the damage it’s causing.
- Practice self-care.
- Set clear boundaries.
- If a loved one uses opioids, keep naloxone — which can be purchased at pharmacies — on hand in case of overdose.
Access to care
While Dr. Nicolas reports that Sharp addiction recovery programs have remained open during the pandemic, many services have transitioned to virtual delivery. Patients in the outpatient programs are likely to be seen at least once per week in person, and also participate in video conference groups and individual therapy. Other services, such as detoxification and residential programs, are provided in person.
“We are all — patients and care providers alike — becoming more comfortable with the virtual platform and improving our ability to communicate and connect online,” Dr. Nicolas says. “And there are some advantages to virtual services, such as expanded accessibility.”
If emergency care is needed, Dr. Nicolas encourages family members and friends to call 911, take the person in danger directly to an ER and, in the case of a possible opioid overdose, administer naloxone.
“It’s important to know that it is possible and safe to receive effective treatment for dependency disorders during the COVID-19 pandemic,” he says. “We are monitoring COVID-19 updates and advisories daily, and practicing all protocols — including health screening, masking, social distancing, and regular cleaning and disinfecting — to ensure the health and safety of our patients, staff and caregivers.”
Talk to your doctor if you are concerned about your or a loved one’s use of substances. Sharp McDonald Center, Sharp Grossmont Hospital and Sharp Mesa Vista Hospital all provide substance use programs to help define a recovery path that works best for you.