As the global Covid-19 pandemic closes in on its anniversary, with over 38 million already infected and a million dead, directly or indirectly, no one has been untouched by the scourge. But some communities are more vulnerable to its effects, like those suffering from drug addiction and those on the path of recovery from it.
Global news agencies report that the pandemic has hit the people struggling with substance abuse hard, as interventions get more difficult and the general sense of despair prevails. BBC had reported under the headline “Coronavirus: Lockdown leaves addicts ‘close to relapse’” in May this year, citing problems like social-distancing restrictions that have made it difficult for many counseling services to operate.
With infections continuing to rise and social distancing measures still in place in most countries, the worst fears are coming true. Data from the Washington, D.C. based Overdose Detection Mapping Application Program (ODMAP) shows a significant spike in the number of fatal overdoses during the pandemic. According to its data, drug overdoses are rising by roughly 18 percent year-on-year in the US alone. The report also states that over 60 percent counties participating in the information-gathering project reported increases in drug overdoses.
Globally, dependency on drugs and even alcohol is also increasing as per various media reports, even though there are no concrete research data. According to the American Medical Association, over 40 states in the US have reported increases in opioid-related deaths during the pandemic, even as the US experienced a record 71,000 such deaths in 2019.
Another research report titled “Covid-19 and addiction” published in the science and health resource Elsevier by Indian medical researchers concludes that, “Covid-19 and addiction are the two pandemics which are on the verge of collision causing major public health threat… the resumption of de-addiction services and easier accessibility of prescription drugs are needs of the hour.”
In Nepal, good data on those with Substance Abuse Disorders (SUDs) and recovering addicts is hard to come by as well. But most of APEX’s contacts working in drug rehabilitation say relapse cases have been increasing during the pandemic. It does not help that Dashain, traditionally the time of the year that sees biggest growth in drug use and relapse, is at hand.
“We generally identify three conditions a recovering drug user might relapse,” explains Basanta Kunwar, former Senior Superintendent of Police and currently the director of Narconon Nepal Rehab Facility. According to Kunwar, relapses are usually caused by chemical craving (craving for addictive substances), environmental craving (craving to recreate the environment drugs are taken), and absence of life objectives. One or more of these problems make a recovering addict go back into drug-abuse.
“The Covid-19 pandemic is singularly unsuited for recovering drug users,” Kunwar says. “We have been unable to host live counseling sessions. Nor do those recovering from abuse have much to keep themselves busy with. There is fear and frustration everywhere.”
Drug rehabilitation is a lengthy process. But rehabilitation approaches comprise of carefully sequenced plans. The pandemic makes it tough to follow this sequence. The crucial social support programs and therapy treatments are on hold because of physical distancing norms. Also, families of recovering addicts are struggling to maintain a structured environment needed for them to remain sober.
“Only 15 percent of those undergoing Narconon’s rigorous programs relapse,” Kunwar says. “But we expect the percentage to increase this year.”
Bishal Tamrakar, 27, who first successfully undertook a drug recovery program when he was 17, accepts that the present time is dangerous for recovering addicts. “I just came to know that two of my friends have already relapsed during the pandemic,” says Tamrakar who has been clean for four years since his last seven-month intervention program at a local rehabilitation center.
“In these depressing and boring times, recovering drug users might easily resort to smoking marijuana or drinking alcohol,” Tamrakar says. “What you must keep in mind is that they usually consume these substances in huge amounts, and when they stop working, they resort to stronger drugs.” Tamrakar says the festive season has always been risky for recovering addicts as they start using ‘light substances’ for merriment without realizing that they could relapse into addiction.
Riddhi Rana, director of Maya Nepal drug/alcohol treatment and rehabilitation center, also anticipates “an explosion” in relapses during the pandemic-time festivities.
Suyash Rajbhandari, director of the narcotics anonymous (NA) based The Recovering Group, worried too. “We call this the high season for drug users and this year, the number of relapses are sure to go up,” says Rajbhandari. “There’s been 60 percent relapse rate among those associated with us.”
The proverb—an idle mind is the devil's workshop—is especially true in the case of drug users, Rajbhandari says. “For us, loneliness is bad company and the current situation has left most of us utterly alone,” he adds.
Most modules in the 12-step intervention program used by The Recovering Group are not being executed. The group requires recovering addicts to do regular follow-ups and attend NA meetings even after they leave the center. It also used to run a day-care center where recovering addicts could keep themselves occupied during the intervention.
The meetings have shifted online due to social distancing protocols and lockdowns, and many program participants fail to attend the virtual meets. Most recovering drug users were unable to rejoin regular meeting and counseling sessions even after the end of the lockdowns; they are not allowed to use motorbikes for up to a year after they leave the center, and public transport stresses them out.
The pandemic has rendered many recovering addicts and their families helpless. The environment now has more triggers and stressors that push them towards drugs. Loneliness, unemployment, uncertainty, too much time to dwell on the past—they really are up against it.
“It is not their fault,” Rajbhandari says. “The recovering drug users are susceptible to even small triggers or stressors while they are on the long and difficult road to recovery. Right now, there are just too many triggers around. At this time, we need to be even more understanding and accommodating of those struggling to put their addiction behind.”