Why is COVID-19 Causing People to Relapse?



Some areas of the globe are still in tight lockdown due to the Coronavirus (COVID-19), which has caused a surge in substance abuse relapse cases. [1] Social support and therapy treatments are crucial to the stable, structured environment needed to remain sober.

That means areas facing extended lockdowns or strict isolation policies will cause significant problems for medical care practitioners, support groups, and individuals in recovery.

Without in-person meetings to attend, it can be much easier to make excuses and miss telehealth appointments with therapists or support group meetings that have moved online during COVID-19.

Below are a few of the pertinent problems facing people recovering from substance abuse during COVID-19.

Social and Physical Isolation

Feeling alone is one of the top causes of relapse. Another is missing support meetings. [3]

These situations are hard to avoid during a pandemic that has caused entire cities to be locked down for months. Physical isolation is necessary to keep at-risk people safe from COVID-19, but the side effect is that healthy, in-person social interactions are harder to find.

Online support is available, but it does not provide the same kind of mental encouragement as meeting in the flesh. Even family members and close friends are forced to remain distant during this time.

Inability to Escape Relapse Triggers

Being stuck at home can be a large source of triggers. Most people recovering from addiction have bad memories attached to specific locations, people, and activities.

Being around them again can cause a flare of cravings, which is hard to overcome when it is impossible to leave the situation.

In those instances, reaching out to a reliable source of support is vital (e.g., crisis chat, crisis support phone line, friends, family, etc.).

Vulnerability to COVID-19

For people in recovery who experienced significant physical illness related to their addiction (e.g., suppressed immune system, organ damage, infectious disease, etc.), there might be an increased vulnerability to COVID-19.

This can cause an increase in stress and a need for further isolation, even in neighbourhoods where lockdowns have lifted. That necessary isolation can lead to an additional sense of loneliness, which is something to be avoided at all costs during recovery. [1]

1. Increased Life Stressors

A few of the life stressors facing people worldwide caused directly by the pandemic include the following:

  • Unemployment or forced unpaid time off
  • Financial instability
  • COVID-19 related anxiety (e.g., being afraid to catch it, etc.)
  • Mourning and loss from losing a loved one
  • PTSD from COVID-19 related events (e.g., getting very sick, having a loved one die)

2. Boredom

For a large percentage of people, boredom was the initial thing that pushed them to start trying addictive substances in the first place. This could potentially make boredom a trigger.

For anyone unemployed or working from home during the pandemic, the combination of stress, isolation, and boredom can lead to cravings and intrusive thoughts of relapsing. [3]

3. Lack of Recovery Resources

Most therapy offices are still only available in a telehealth capacity, with their physical locations still closed to the general public even after over half a year.

Also, communities are facing an unprecedented lack of funding due to changes in local economic stability, which means there might not be as many programs available.

To counteract this, some areas are increasing emergency funding to substance abuse hotlines and telehealth resources.

The Signs of a Relapse

It is incredibly important to be able to recognize the signs of an impending relapse so that you can reach out to support before that happens and get help to counteract the risks and cravings.

These signs may appear with varying degrees of severity and can be hard to spot right away if you have co-occurring issues such as mental health or physical disorders.

However, if you find yourself noticing any of the following, it is best to contact your medical provider for assistance.

  • A change to eating or sleeping habits (e.g., insomnia, lack of appetite, a sudden increase in appetite, sleeping too much, etc.)
  • Lying to avoid being honest with your therapist, family, or friends
  • Ignoring and suppressing emotions without release
  • Opening up lines of communication with friends or family or are still using
  • Purposefully missing online or phone meetings
  • An abrupt change in hygiene habits
  • Talking about substance in a positive way

How to Avoid Relapse Triggers

There are ways to avoid triggers that may lead to a relapse. Knowing what they are is going to make the process more comfortable.

Avoiding them when possible will make things slightly more manageable, but when you are stuck in a small space over long periods of time, avoidance becomes much harder to accomplish.

When it gets too tricky to ignore the triggers outright, there are a few things you can try to keep intrusive thoughts of relapse from turning overwhelming.

1. The Importance of Staying Social

Video chats and phone calls with loved ones, joining online forums, attending support meetings on apps like Skype, and joining online hobby groups are excellent ways of staying social while in lockdown.

Having a human connection, even if it is through a screen, can make a massive difference in terms of recovery. Feelings of loneliness can sabotage your success, so it is recommended that you do whatever you can to find ways to stay social.

Triggers are easier to overcome when there are outside perspectives and encouragement available.

2. Finding Support Online

Treatment and support programmes have moved mostly online, and that makes it easier to find one. Instead of being limited by local groups, you can join one that is national or international. Many online resources have been created to deal with the rise in relapse cases due to COVID-19.

You can take advantage of them whenever things get overwhelming. Having a schedule for attending meetings and having one-on-one contact with trusted people in your support system can help you work through triggers.

3. Helpful Distractions

One of the most tried and true methods of overcoming any unwanted scenario is having a healthy distraction. This can take the form of chores, a hobby, or recreational activities like games and movies.

Allowing yourself to become distracted long enough for the trigger or intrusive thoughts to lessen can make it much easier to bear.

Every time you can distract yourself instead of focusing on the triggers, they can become less potent. This is reminiscent of exposure therapy.

Treatment During Lockdowns and Medical Clinic Closures

For people who rely on having in-person treatment, the COVID-19 lockdowns and social distancing regulations can be devastating. Most mental health centres have developed telehealth alternatives to help counter the risk factors associated with prolonged isolation during recovery.

Multiple online support sources that can be local or international, available to provide support and assistance to anyone feeling distressed:

1. Telehealth

A lot of formats are included under the umbrella term of telehealth. They include phone calls, video calls, chat rooms, online forums, and even email communication. Most clinics and mental health support centres have been switched over to partial or full telehealth since early 2020.

This is not going to change soon for most of the world. These formats can be a lifeline for anyone in recovery to help avoid relapse.

2. Video Call

These can be one-on-one or group video calls. Most therapists are using either video or traditional phone calls as a way to replace in-person sessions. After a long time in isolation, seeing another person can be a huge mental boost even if they are on a screen. Video calls can provide positive social interactions that are rare and far between during the pandemic lockdown.

3. Chat Room

There are private chat rooms that have been used to replace local in-person group meetings. These are usually confined to a small number of people and are subject to rules similar to those of the regular meet-ups. Support groups, 12-step programmes, and other group therapy forms have been transitioned to chat or video call rooms using various apps and sites.

4. Online Support Group

These can take many forms. There are private forums, video conference rooms, and even some support groups that communicate solely via emails. Whatever you are comfortable with, there is a support group medium that will work.

Now that some lockdowns have lifted, there are even outdoor meetings that have started to pop up again, but for anyone with medical issues that leave them vulnerable to COVID-19, online support groups are the best option. Consistency is essential, so no matter which one you choose, do not make up excuses that let you ignore correspondence or scheduled meetings.

Helping Loved Ones in Danger of Relapse

Encouraging them to continue following good habits such as sticking to sleeping schedules, eating healthy foods, and attending online support meetings will be helpful. They need to know without a doubt that you care and are there to support them.

Making daily check-in calls, video chats, or other forms of communication can be an excellent way to keep that connection open and make it clear that they are not alone.

References

[1] https://www.acpjournals.org/doi/full/10.7326/M20-1212

[2] https://www.drugabuse.gov/drug-topics/comorbidity/covid-19-resources

[3] https://www.tandfonline.com/doi/abs/10.1080/02791072.2008.10400627

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