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In the year since the World Health Organization declared COVID-19 a global pandemic, the effects of the pandemic on mental health from stay-at-home orders and physical distancing measures have become clearer. For people managing alcohol or substance use disorders (SUDs), the pandemic has presented unique challenges, including substantial changes to support systems that were previously in place.
Raina McMahan and Windia Rodriquez, certified addictions recovery coaches at the MGH Chelsea HealthCare Center, discuss some of the ways that the pandemic has put a strain on those struggling with SUDs and the network of care that is available to those who need help.
Binge drinking during quarantine has become one of many negative health consequences of the COVID-19 pandemic. What are some social factors related to changing lifestyles that may contribute to higher rates of binge drinking and return to use of alcohol?
McMahan: Isolation due to loss of community is the biggest factor that exacerbates loneliness and depression. This can make people in recovery feel alone, reminiscent of the feelings they may have experienced during times of active addiction. This can be extremely triggering, can bring back some of our past unhealthy coping skills and can possibly end in a return to use.
People are incredibly bored, and with everything we need being delivered to the house, including alcohol, it makes it quite easy to give into temptation. Most people are working from home, and this pandemic has been difficult for your average nine-to-five employee, and it’s even more difficult for people without stable housing or people who have lost their employment.
It’s a hard time for everyone. I see how a “Friday-night escape” can turn into a “weeks-long binge.”
For people who are in recovery from alcoholism, what are the specific challenges presented by the pandemic?
Rodriquez: There are no in-person mutual aid meetings, which has caused so much isolation for people. There are virtual meetings, but for people who are just attempting recovery or have attended meetings regularly for years, it doesn’t have quite the same effect as an in-person meeting. It’s a computer screen instead of being greeted by hugs, hellos and maybe some coffee. In-person meetings are so crucial because of the fellowship and bonding that occurs after the meeting. A fellow person in recovery asking you to have dinner or grab a coffee after the meeting makes us feel a part of something and gives us back the community we lost during active use.
Another challenge of staying home so often is that we have lost some of the purpose that we find when leaving the house every day to go to a job, school or other meaningful activities. Having to quarantine can remind us of when we were active in our addiction and being “stuck” in one place due to a disease. Dealing with these feelings and not sinking into the despair of it all has been crucial to us in recovery.
McMahan: Another thing that is so crucial to recovery is finding fun and joy in life again. We have done so much work on discovering what our new hobby is and what we enjoy doing. For example, maybe going to a dance class was a great release or a rock-climbing gym. These activities have stopped, and we have been stuck inside without them.
There have been positives to this—a silver lining, if you will—that being forced to stay inside, in our homes, has given us a greater appreciation of things we may have been missing before. More time spent with family, the time we used to spend in one- or two-hour commutes every day—these are now times to reflect and look inward and decide if there’s any changes we want to make once things open back up.
Also, the most amazing thing about these support groups on Zoom has been that I can try any meeting anywhere in the world at any time. This has been so beneficial in finding the best support for you and trying all different kinds of support groups.
Without in-person meetings, what resources remain available to people in recovery?
McMahan: At the beginning of the pandemic, all in-person meetings were moved online. This presented a huge set of challenges as not everyone is equipped with the technology or knowledge of these platforms to successfully attend a virtual meeting. As recovery coaches, we were scrambling to try to walk people through setting up Zoom accounts and to get people connected to some sort of virtual support. We had to get very creative.
As the pandemic went on, some meetings moved back to in-person, but had a 10-person limit, for example. There was an underground movement of having meetings at people’s houses or in backyards, parks, etc. People had to balance staying safe from COVID while maintaining their recovery. For some, the possibility of returning to use was higher than the risk of catching the virus.
There is a phenomenal meeting in Charlestown, MA, nicknamed the “COVID Defiance Group,” because they fully recognized early on that virtual meetings will not work for everyone. This group met at the bleachers in Charlestown in the summer; however, throughout the winter, it’s been a struggle to continue them. Shannon Lundeen, program manager of Addiction and Recovery Services at the Charlestown Coalition and a person in long-term recovery herself, worked to get funding for supply tents and heaters to continue this meeting in the freezing winter.
All of the different types of meetings are reflective of what we recovery coaches believe in: that everyone is unique and may need different pathways to support their recovery. For some people, virtual meetings work; other people absolutely need that in-person support.
What are healthy alternatives that people in recovery can use to cope with stress related to the pandemic?
McMahan: In the warmer weather, it was easier for people to cope. We could go for a socially distanced walk with a friend, head to the beach for the day or spend an afternoon in the backyard reading a book. But with frigid temperatures and early sunsets, we’ve had to get creative and resort to virtual wellness activities such as yoga groups and meditation. We still rely heavily on other people in recovery for support. Reaching out to a friend in recovery to talk about our struggles is crucial in getting through those difficult moments.
Rodriquez: Making sure we get some exercise and are not just sitting in front of Zoom meetings all day is important too. More importantly, trying to schedule in something fun or joyful into our day or week is important. This pandemic has given people a chance to discover a new hobby that maybe we haven’t had time to do before, such as drawing, jewelry making, baking or cooking. Self-care will look different for everyone, so it’s important to find that thing that makes you feel content and make sure you find time to pursue this.
How can families provide support to family members who are struggling with SUDs during this time?
Rodriquez: As recovery coaches, we always feel that families with a loved one who is struggling should seek help for themselves first. This is because substance use disorder is so complex that instead of helping, family members could be doing harm by trying to control, fix or manage the disease.
Family members should take care of themselves first and foremost. When their loved one is seeking support for their SUD, they can rely on family for a ride to a doctor’s appointment, help connecting to online recovery meetings or just for a listening ear. By taking care of yourself first, you have enough energy to give to your loved ones.
There is still so much stigma around this disease that family members don’t feel comfortable talking about it with other people. There are some great support groups for families, such as:
We try to remind families that recovery is a process, not an event; do your best to be patient, support them as best you can and appreciate the process your family member is going through.
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