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Recovering addicts more at risk of relapse amid coronavirus, experts warn

People struggling with addiction in the US are more at risk of relapse as their routines get disrupted and their lives are put on pause because of the coronavirus pandemic, experts have warned.

“The message we’re receiving is stay away from people. Isolate. Don’t be around people, and [for] people that are in recovery, that’s like a recipe for disaster,” said Denny Kolsch, a licensed mental health counselor, who is in recovery, and founded a mental health and addiction treatment facility in Florida.

Although it’s only been a few weeks since local and state governments in the United States started taking drastic measures to limit the spread of the virus, health professionals have already seen relapses or near-relapses as people experience more urges and cravings to use drugs and alcohol.

Kolsch said one person relapsed on fentanyl and heroin after losing their new job when their workplace suddenly shuttered. And in every group therapy session over the last two weeks, the conversation has turned to Covid-19 – “Every single one of ’em,” Kolsch said.

Elie G Aoun, a psychiatrist who serves as vice-chair of the American Psychiatric Association’s council on addiction psychiatry, was surprised to discover that one of his patients had filled a prescription for oxycodone even as he was prescribing a treatment for addiction to the drug.

“I’m not saying that this is because of the coronavirus crisis, but the social distancing and the isolation that this person was experiencing is what he used as an excuse to justify why he did that,” Aoun said.

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On the flip side, mental health professionals feared that people would be forced into abstinence because of supply chain disruptions, potentially suffering lethal withdrawals or overdosing when they use again.

Under normal circumstances, Americans dealing with addiction rely heavily on their community and routine for support when they decide to get sober. But now, there’s no gym, no coffees with friends or sponsors, and few in-person gatherings.

Workers, meanwhile, are getting laid off in droves, and some people are spending most of their day cooped up with their significant others, sometimes while fighting or experiencing abuse.

Others are completely on their own. One of Aoun’s patients, who is sitting at home not talking to anyone, is feeling more and more depressed, a major trigger for his alcohol use and gambling, Aoun said.

Andrea St Clair, a mental health and substance use disorder professional at an outpatient program in Seattle, worried about people who may be missing even the most mundane interactions such as handshakes or hugs.

“I think it’s definitely a time where people are subject to having more thoughts, more triggers, more urges,” St Clair said.

The excessive downtime right now “is not helping,” said Jimmy Hamm, who owns a sober living home in New York City. Usually, he tries to fill his clients’ schedules so they’re busy and out of the house most of the time. Now, though, his Manhattan residence is in the middle of a Covid-19 global hotspot, and because of the virus, he’s not even allowing the men he works with to go on walks without a staff member.

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“We keep telling them, ‘listen, we’re not punishing you. Listen, we’re all suffering here. But be grateful that you all have each other,” Hamm said.

Even so, Hamm makes sure that his clients attend meetings – one at his sober home and two by video every day. With social distancing and self-isolation, support groups, meetings and mental health professionals have mostly moved online.

“We want to acknowledge how hard this moment is, but we also want to encourage people to take advantage of the resources and solutions that are still available,” said Jamie Tworkowski, founder of To Write Love on Her Arms, a not-for-profit that in part helps people struggling with addiction. “We don’t want anyone to think, ‘Oh, I just can’t get any help right now because I’m alone in my house.’”

The jury’s still out on whether telehealth and online recovery resources on such a massive scale can effectively replace in-person contact for addiction treatment. At least two patients have told Aoun that they don’t want to use his new online platform, and even if people do seek care or support, some of them may have additional screens in view, pulling their attention from the group they’ve joined virtually, St Clair said.

Some of Hamm’s clients are tuning out during the virtual meetings, he said. Others seem to enjoy them. Regardless, Hamm didn’t know what people would be doing without that lifeline.

“I mean, to be honest, I have a mixed bag about it, too,” he said. “But it’s the only option we have.”

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