by Jenna Drennen
As our nation continues to grapple with the challenges the COVID-19 pandemic presents, those struggling with mental illness or addiction face an especially unique and arduous set of obstacles. The social isolation decreased access to health care, financial stress, and political and economic instability characterizing the past year left many people confronting an increase in depression and anxiety, and those vulnerable to substance use disorders at greater risk of relapse and death. As more data emerges addressing the toll the pandemic has taken on the collective mental health of our nation, it is clear that the established COVID-19 death toll may, in fact, be much higher, with so-called “deaths of despair” increasing over the past year. The mortality rate attributed to suicide, alcohol-related deaths, and drug overdoses sheds some light on the growing mental health and substance abuse crisis gripping our nation and the profound impact the COVID-19 pandemic continues to make in fueling this crisis. Last month the Center for Disease Control and Prevention reported that a recent survey indicated that one in four adults had considered suicide during the previous thirty days. Compounding this statistic, the CDC affirmed the pandemic might be responsible for the substantial rise in deadly drug overdoses associated with the past year. While drug overdoses and suicide attempts appear to be occurring more frequently across the country in recent months, they are also more likely to result in death. Given the increased isolation necessary to combat the pandemic, a person who accidentally overdoses is more inclined to be alone, making it unlikely help will be called or life-saving medication (such as Narcan) administered.
For those struggling with substance use disorders or navigating early sobriety, the ongoing pandemic creates unprecedented challenges and often insurmountable barriers to treatment. It is acknowledged that the opposite of addiction is not sobriety, but rather human connection. Much like other mental health disorders, addiction is, above all else, a disease of isolation. By definition, substance use disorders favor the relationship between an individual and a substance over any relationship with another human being. As a substance increasingly becomes the focus of an addict’s life, important relationships dissolve, and social isolation results. Addiction requires this isolation to thrive, and for an already vulnerable population of addicts, the necessary social isolation the pandemic demanded also served to fuel their disorder.
For those struggling with substance use disorders, staying sober can be a daily challenge, even under the best circumstances. For many addicts, the cornerstone of their recovery process centers on a structured routine based on readily accessible support systems within the community. Group therapy is considered one of the most effective, evidence-based approaches to treating addiction. In-person, 12-step support groups such as AA and NA are often essential structural components of a recovering addict’s routine. Research shows 12-step programs lead to longer stretches of abstinence compared to other types of treatment programs. While the mass closures of neighborhood establishments such as churches and schools proved essential in slowing the spread of COVID, the 12-step community that depended on these institutions to meet regularly were left scrambling and vulnerable. The shift to a virtual format allowed many recovering addicts to maintain their support network and routine. Still, it failed to meet the needs of a substantial population that was new to recovery and required a level of care and connection that virtual meetings couldn’t offer. The increased stress, financial hardship, disruption of routine, and loneliness the pandemic fueled also served as triggers for those struggling with sobriety. These triggers become dangerous when used to justify using or drinking. For people battling substance use disorders, and especially those new to sobriety, the recovery process is not always linear. Relapse is common and can be a part of the recovery process, but relapse has the potential to be deadly, with the risk increasing amidst our COVID era socially distant and profoundly isolated environments.
For those battling mental illness, the pandemic proved to be equally problematic. Apart from the stresses last year presented, individuals vulnerable to depression and anxiety were forced to contend with one of their biggest fears: uncertainty. When predisposed to anxiety, the fear associated with uncertainty frequently leads to a flood of panic and catastrophic thought patterns. Integrated with the stresses and isolation the pandemic propagated, these thought patterns have the potential to spiral and fuel depressive episodes. A recent survey conducted by the CDC estimates that one in three adults show signs of depression and anxiety directly linked to the COVID-19 pandemic. A significant lack of mental health and financial resources, coupled with decreased social and emotional support, exacerbates this collective psychological distress nationwide.
As mental healthcare shifts to a predominantly virtual format, significant limitations to access and quality of care remain. Concerns surrounding privacy, technological constraints, appropriate crisis intervention, and the ability to establish intimacy and trust via a digital format can be strong deterrents. Because digital lacks the intricacy of real-world interaction, warning signs can be overlooked, signaling a more serious psychiatric episode requiring close and direct treatment or in-person intervention. With access to appropriate mental health resources remaining limited, risk of suicidal ideation and self-harm inevitably increases.
As we continue to navigate the “new normal” the COVID-19 pandemic ushered in, a valuable opportunity arises to assess and redefine what we want that “new normal” to look like going forward. The challenges this pandemic presented also illuminated a mental health and substance abuse epidemic that far predates the virus. Highlighting the inequities and disparities plaguing mental health and addiction treatment nationwide, the COVID era offers our communities an opportunity to reexamine and improve existing mental health services and more fully address the epidemic of mental health challenges facing our nation. It is clear we need a concerted effort to make mental health a priority while battling the stigma that mental healthcare and addiction treatment continue to carry. More proactive outreach needs to be taken to reach those struggling with mental health issues and substance use disorders. Early intervention remains critical and essential to lessening the pandemic’s impact on the collective mental health of vulnerable populations. When addressing substance abuse and mental health challenges, research indicates that early intervention allows for a less complicated treatment path, a lower level of care, and an increase in positive long-term outcomes. Ensuring vulnerable individuals have the opportunity to establish a relationship with a therapist or community support network better equips them with a set of coping strategies to prevent or recognize a potentially deadly impending mental health crisis or relapse. These early interventions cannot regularly occur until the disparity between necessity and access is more fully addressed and mental healthcare resources are more equitably brokered on a systemic level.
If someone you know struggles with a substance use disorder or mental health issue, listen to them and continue to reach out often. Think twice about posting jokes or memes on social media referencing “needing” alcohol. This humor may seem benign to someone who does not grapple with addiction or mental illness, but the normalization and glamorization of excessive alcohol consumption in response to adversity can be a dangerous trigger for those struggling with sobriety and/or depression. In identifying and embracing how we can support one another, we effectively transcend the isolation and loneliness so many of us face and foster hope for a brighter tomorrow.
“A sad soul can kill you quicker, far quicker, than a germ.”-John Steinbeck
If you or someone you know is struggling with a substance use disorder, contact the Substance Abuse and Mental Health Services Administration’s (SAMHSA) national helpline at 1-800-662-HELP. This service is available 24/7, 365 days a year, and offers free and confidential treatment and referral services for individuals and families facing mental health and substance use disorders.
Jenna lives in Firestone with her husband, two kids, and a house full of animals. She enjoys, running, gardening, and climbing mountains in her spare time.