In-person fellowship is a staple of the recovery community and many 12-step programs, so when COVID-19 shut-down orders were put in place, recovering alcoholics and addicts were left wondering what to do and where to go.
Without daily meetings due to stay-at-home orders and social distancing, the ability to stay sober became trickier than ever for many students in recovery.
“I think the biggest thing I was told in recovery — once you get sober — is to stay in the middle, don't isolate, and go to meetings. Now we're being told to self-isolate because of the pandemic,” Libby P., a sober Orange Coast College student said.
When the COVID-19 lockdown was first put in place and people were not allowed to go out, Joseph DeSanto, a board certified physician with over 12 years of addiction treatment experience and eight years of personal sobriety, started to see isolation in addicts and alcoholics that led to relapse.
The lockdown meant that people who had maintained a good sense of sobriety, not using or drinking, couldn’t attend 12-step meetings, which was when DeSanto started seeing patients and friends relapse.
“You don't have that face-to-face interaction. And when you talk to somebody on the phone, you lose accountability. So we started seeing relapses,” DeSanto said.
The 12-step face-to-face meetings had not stopped since Alcoholics Anonymous, an international fellowship of men and women who have had a drinking problem, was founded in 1935.
“So we're talking 80 years of just nonstop, uninterrupted meetings. There was never, ever an interruption, even during war time,” Hannah A., a sober OCC student said.
And while online Zoom 12-step meetings are an OK substitute, they can be less effective if you don't have the groundwork, or a foundation, of what sobriety should look like, according to DeSanto.
“The online meetings on Zoom have been awesome, but I'm also at home with my 2-year-old son. That can be challenging, trying to go to online meetings when I have him here,” Libby said.
Before quarantine, there were some 12-step meetings that had child care where someone else would watch children during the meeting, according to Libby, but that’s not an option right now.
“All of a sudden you have all these people trying to get a sense of comradery and fellowship online, which is really kind of empty,” DeSanto said.
He added that on top of that, a lot of people who have addictions have ADHD, so it’s harder to pay attention in online meetings and they get distracted, DeSanto said.
“I feel like I can be on Zoom and still be zoned out doing whatever I'm doing at my house. It's just another way for me to like practice discipline,” Emily J., a sober OCC student, said.
The shock of isolating and being stuck at home made people listen to their own heads, DeSanto said.
“Listening to your own head is usually what got us in trouble in the first place,” he said.
One change DeSanto said he is noticing is that people’s drugs of choice are changing, for example he is seeing heroin addicts go to alcohol and vice versa.
Another effect of COVID-19 that DeSanto is seeing is people's normal connections or plugs or dealers not picking up the phone.
“A lot of these people are cartels. They went back to Mexico because they thought they were going to get locked in the country or vice versa,” DeSanto said.
As a result of these connections disappearing, addicts had to reach out to unfamiliar dealers and are getting different strengths of drugs, which leads to drugs now popping up on the market that people don’t know about and can lead to overdoses and deaths, according to DeSanto.
“When you get people relapsing on fentanyl and combos of drugs and then booze, that's when the deaths occur,” DeSanto said.
Aside from the relapses and overdoses, another group of people in recovery being affected are those with mood disorders, like major depressive disorder, DeSanto said.
DeSanto said that people with mood disorders are at risk of suicide — threatening suicide or committing suicide, some successful, but most not.
“One doctor killed himself. One doctor relapsed. And these are doctors with double digit sobriety drinking for the first time in 20 years and literally falling over in the bathtub and hitting their head and bleeding out. It's like, what the hell is going on? So we lost a guy, a good friend of all of ours — couldn't even go to a damn funeral,” DeSanto said.
There is also a lot of fear surrounding the virus and what could potentially happen. “Addicts and alcoholics have a tendency to kind of catastrophize everything — think of the worst possible outcome, and then focus on that,” DeSanto said.
One student said a fear of catching COVID-19 at a hospital caused them to detox from opiates at home, with no medication and no doctor or nurse supervision. The person detoxing said not being able to go outside because of COVID-19 made it harder to readjust after the physical withdrawals started subsiding.
Libby recounted her experience detoxing at home years ago before she got sober.
“It's miserable. When you're in a hospital setting there's more barriers like people to talk you out of it, but when you're at home all it really takes is one thought and then it's so much easier to get high when you're detoxing at home because it's painful. It's hard,” Libby said.
The detox centers of hospitals typically operate in a separate wing or separate from the other hospital patients, DeSanto said. He said the detox centers have not closed down and he has not heard of any of them being limited in any capacity.
DeSanto said he has been impressed at how quickly the government lifted the restrictions on how doctors can prescribe detox medication, which are typically controlled substances.
Usually patients need to give a urine sample and have a check of the records about when a patient had their last prescription (to not unknowingly overdose a patient), DeSanto said.
Now, doctors are allowed to prescribe controlled substances over the internet and across state lines, he added.
These restrictions being lifted increases the opportunity to get treatment and to do it in your own home by being prescribed medication that helps patients detox.
Unfortunately, with that comes people that are going to abuse the system and seek doctors who will write prescriptions and then get high with it, or sell it for drugs, but, “we hopefully are putting enough things in place to weed those people out,” DeSanto said.
“Getting sober and staying sober, especially through these hard times, is an accomplishment and should be recognized and celebrated,” Hannah said.