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Managing Addiction During the COVID-19 Crisis

A Q&A with Dr. Adi Jaffe

What are the biggest challenges faced by someone with addiction while in isolation?

It’s quite similar to what most of us face while in isolation: The interruption of what we normally take for granted. We know that people who rely on drugs, alcohol, or compulsive behaviors are typically using it in a habitual way to deal with stress, depression, anxiety, and feelings of inadequacy. The struggle we’re going through right now (this crisis), has eliminated traditional approaches for support. A lot of people end up relying even more heavily on the little bit of coping that they have available, and that can lead to more drinking, drugs, and porn use, etc.

What risks are there for people with severe addictions who have to go cold turkey?

For people who struggle with heavy alcohol, benzodiazepines (Valium, Ativan, Xanax), or heavy-duty opiate use, there’s no doubt that withdrawal — the cessation of using — can bring about a whole Pandora’s box of physical complications. If you’ve been a long-term user in large doses, you can get seizures. There’s a risk of having grand mal seizures and dying because of withdrawal. This is one of the reasons most areas have kept alcohol and liquor stores open.

We’re on the other side of this to some extent. What I mean by that is we’ve been on lockdown [in North America] for about two weeks. Normally, we expect [symptoms] to happen within the first three to four days of heavy withdrawal. So, if you’ve passed that phase, this isn’t really a concern for you so much. But if you’re holding on trying to measure your drinking or trying to reduce it so you don’t have to deal with seizures, it would be really important to make sure that’s taken care of. This could be a time to turn to your primary care provider or doctor and ask for gap help to help minimize or maybe even eliminate withdrawal symptoms.

Is it possible that pandemic-related stress such as job loss and isolation, may cause some people to relapse?

Absolutely. I’ve been hearing many stories, not just about relapse but about exacerbation of use. People are isolated. They have almost nothing to do, which can create massive levels of boredom. Throw in job loss and this can lead to feelings of helplessness and hopelessness, severe anxiety and stress. [For someone struggling with addiction], this can mean going more heavily towards pills, alcohol, drugs, and other unhealthy, maladaptive coping strategies because there’s not much other support available for them.

Many of us, including children, are spending even more time on our screens. Are we at risk of developing or worsening digital addiction, and if so, how can we mitigate it?

I think we have to give ourselves a little bit of space right now. When we look at addiction-related issues, I always talk about biology, psychology, environment, and spirituality. There’s an incredible environmental psychological stressor happening. So yes, people are turning to screens more, but I don’t know that we’re using it maladaptively when that is one of the primary sources of coping that we have right now. I’m sitting and talking to dozens and dozens of people almost every day through Zoom and FaceTime. People are having group meetings through these channels.

I think the question is, what are you using these tools for? If you’re using them in a way that helps constructively address the environmental and psychological struggles you’re dealing with right now, then it’s just a tool. If we’re starting to use it as an escape, that’s where pornography, gaming, and gambling [come in]. Those things can certainly have longer-term negative impacts. But for children and adults right now, I think we have to relax some of our rules a little bit. These are unchartered waters. None of us alive has ever been in a situation like this, so just trying to go about things as if it’s just another day is not that wise.

What words of support would you give someone who is struggling right now?

When we work on feeling joy and contentment in everyday life, there are some factors that need to be present. And the degree that they’re missing can really predict how we feel about ourselves. It’s the analogy we’ve all heard before: Are you a glass-half-full/glass-half-empty kind of person? But one of the things that’s missing from the conversation is, what is the glass itself? In order to be ready to accept joy, contentment, and satisfaction into your life, the glass must be constructed of safety, sustenance, and shelter. With those things missing, it’s like there’s a leak in the glass and it doesn’t matter how much joy you fill it with.

A lot of people are struggling with shelter, safety, and sustenance. So, the first piece of advice is to put as much of that in place as you can. You might lose some of the comforts that you normally had, but make sure you’re taken care of.

I urge everybody to take a step back and not dwell too much on where things are going to be in a few months because there are so many unknowns. Instead, [create predictability in] the things that we can control. Have a daily ritual. Have a measure of movement, feeding, exercise, meditation (if that’s part of your world, and it probably should be during this time). Create a structure [to the day], even if you’re stuck in your apartment. That structure will bring a measure of predictability [and] comfort to your daily life over and above waking up in the morning, seeing how many people have passed, and trying to react to that. Rituals make us feel safe. Even if you don’t know what’s happening in three months, you can know what’s happening at 3 p.m. today because you have your habitual skeleton of a day structure put in place, and that will go a long way towards helping you.

How can someone access support meetings like AA (Alcoholics Anonymous) or NA (Narcotics Anonymous)?

The good news is everything has moved online. There are almost no in-person meetings.

If you go to NA or AA or Smart Recovery in your area, they will inevitably have online meetings, but the nice thing is you don’t even have to stick to your area now. You can look up online Smart Recovery meetings and have meetings from anywhere in the world, just adjust to your time zone. Same with AA [and] NA. IGNTD has seven live online support groups [in English only], and we’re giving away two weeks of free support to anyone who wants them because everybody needs help right now.

Pay attention to the people you [follow] for self-help resources. I can almost guarantee that they’re offering something free, or near free. A lot of the big names including Oprah and Deepak Chopra are offering free resources.

What can spouses or family members do right now to support someone who is living with addiction?

This is becoming a huge issue right now. Families that would have physical distance before are experiencing difficulties [being in closer quarters]. Addictions can become problematic and very much at the forefront of the conflict and struggles within the family.

It’s not that easy to know how to talk to somebody who’s sitting in your house drinking all day when you don’t want them to be drinking. But there are tools, and the professionals in the field know of ways to help you deal with that. A lot of online resources are free or cheaper right now.

Often family members say, “Well, there’s something wrong with my loved one. There’s something wrong with the person struggling with addiction. They need help.” But I’m here to let you know you need help as well. Look inside for a bit. Do you need help communicating with your loved one, figuring out how to get them in the right headspace, or getting them focused on positivity? Do you need your own anxiety, depression, and stress relief in order to be able to show up to your relationship with your loved one as the best version of yourself?

When you’re on a plane, they tell you to put your own mask on before helping anybody else and there’s an important lesson here: if you’re not able to support yourself, you’re going to be no good to anybody around you. Helping the person in your life with addiction is not really relevant if you’re falling apart either, so make sure you get some help for yourself.

What advice can you offer to people who are worried that the pandemic may trigger or cause an addiction?

Think of your daily activities in the moment as still relevant to the way you’re going to show up to the rest of your life after this is done. If you have to rely on coping strategies like binge-watching more TV than usual, drinking more than you would normally, smoking more weed, whatever it is that you’re using to cope, I want you to give yourself a little space and a little leeway. Don’t necessarily believe everything you’re doing right now will parlay into the rest of your life when these restrictions lift.

But, at the same time, I want you to recognize that we can’t fall into habits. For instance, if you’re drinking more heavily right now, there are some quick tools that you can [use to] help yourself. I tell my clients who are struggling with drinking to dilute your drinks, make them weaker, and alternate by drinking water. Keep yourself hydrated. If you can, alternate days when you drink and don’t drink, smoke and don’t smoke. Doing that will make it less likely that you’re going to be struggling after this crisis is over. This is especially true for things like opiate pills and benzodiazepines, things that you can develop a physical dependence on, which can be a separate struggle later.

I want to encourage everybody to understand this crisis is going to be over at some point. We might not know exactly when or what it’s going to look like in the end, but trust it’s going to be over. Like so many times in humanity when we thought we could never go back to regular, everyday life, give this a couple of years and you’ll have a completely different perspective on it.

Dr. Adi Jaffe holds a Ph.D. in psychology from the University of California, Los Angeles (UCLA). He teaches courses at UCLA that address addiction specifically, research statistics or biological psychology and behavioral neuroscience more generally. Well known for his online and academic writing, Dr. Jaffe’s views on addiction and his research on the topic have been published widely in both academic journals and popular magazines and websites. He has appeared on several television shows including Good Morning America, The Dr. Oz Show, The Doctors and Larry King Now and in numerous documentaries discussing current topics in addiction. Learn more about him and his work at www.adijaffe.com and www.igntdrecovery.com.