COVID + Addiction

By Nancy Kennedy

The gradual resolution of the COVID pandemic is bringing relief, gratitude and a return to near-normalcy for most Americans. But for others, the impact has been severe and progressive, worsening with time rather than improving. That group includes persons who are struggling with addiction: those who are presently addicted to drugs or alcohol, those who have recovered and those who are at risk of starting to use and becoming addicted.

The pandemic and the resulting shutdown brought a lot of challenges for this population, says Carin Fraioli, LSW, CCDPD, vice-president for clinical operations, Gateway Rehab Center. “The isolation of the pandemic was especially difficult, and led to relapse for many who turned to drugs or alcohol for comfort and escape. The anxiety about contracting COVID was perhaps higher for this group, many of whom have chronic medical conditions that already raised their risk. They could not see their physicians or their mental health providers. There was grief for those who lost loved ones to COVID 19. The closing of businesses meant job loss and reduced income for many people, creating more stress. For persons struggling with substance abuse, the loss of their usual resources was a major difficulty: treatment centers, group support meetings, and 12-step meetings were suddenly unavailable. There was nowhere to turn, even as the stress worsened. With increased stress, there is a greater risk of using in order to cope.”

Fraioli says that the COVID 19 pandemic took structure away – structure that persons with substance abuse disorder rely on. For many, their support networks disappeared and are still not back to normal. Another factor is the increased income that some people saw due to the increase in unemployment checks. “With more money in their pockets, some people began using a lot more. They could afford more. The majority of those we treat are using opioids, and they are using a lot more now than a year ago. Lots of people who have been here in the past have returned. Addiction is already a very isolating disease and the pandemic increased that isolation tremendously.”

Alcohol use has greatly increased, the CDC reports. Social drinking increased during the pandemic and turned into addiction for many people, Fraioli says. “PCPS tell us that alcohol consumption has skyrocketed since the pandemic.”

The National Institutes for Health reports that the pandemic brought about a surge of addiction to drugs and alcohol, and an increase in addiction-related overdoses and deaths. “We have a lot of anecdotal information on this but not data, not yet,” Fraioli comments. “PCPs and front line workers – EMTs, paramedics, police and ER physicians - are reporting that opioid overdose deaths are peaking again. This is a setback for Pittsburgh, a region that has been making excellent progress in reducing OD deaths since 2017. The pandemic may have set that pattern into reverse.”

As an organization, Gateway Rehab has focused on how to get people the services they need, and how to do this safely. “We also had to protect our staff,” Fraioli says. “We had to be flexible and creative, constantly re-configuring as things changed. We essentially created a new model of care, using the hospital model as a guide. I’ve been impressed by how well our team came together, communicating and doing the best we could for our patients.

“One of the positive impacts of the pandemic has been the increased use of telehealth, with virtual treatment sessions. It’s been great but in person is still the ideal and we expect to offer a hybrid. ZOOM is great but it’s not the same as being in a roomful of supportive people. With telehealth, we now have new ways to reach people so the help we offer goes further.”

At Gateway, the goal has been to keep people healthy and safe, Fraioli says: “If you are concerned for yourself or a loved one, reach out now to professionals. There is help available and we see a lot of success. Get the help you need; don’t try to go it alone. Pittsburgh is fortunate in having many agencies to help. Not sure where to turn? Ask your PCP, your church, or find resources online.”

To learn more, visit gatewayrehab.org.