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Incidents Of Substance Abuse Rise During Pandemic And Treatment Methods Evolve

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The COVID-19 pandemic has affected incidences of substance abuse, and how people struggling with addiction are treated. 

Social distancing and isolation have become everyday features of the pandemic. These stresses, along with factors like job loss, have resulted in more instances of substance abuse. That’s according to Northwestern Medicine Licensed Clinical Social Worker Marissa Kirch. She said more people are drinking greater amounts of alcohol, or taking up the habit if they haven’t before.

“There’s alcohol easily accessible to them at earlier times than before and they don’t have to worry about getting up the next day or being available at a certain time, so that definitely increased a lot since the pandemic has begun.”

Opiate abuse is also on the rise among adults, with more people dying from overdoses. Dr. Tom Wright is the chief medical officer of Rosecrance Health Network. He said in some cases a negative change in mental health can be a factor.

“It’s not a particular event that they’re attempting suicide at that point in time, but they’ve just sort of stopped caring about their life, so they just sort of continue to use more and more, and use to the point where it’s an overdose and they end up dying from it. Maybe not intentionally, but indirectly would be the best way I could put it.” 

Wright said more teenagers have taken to vaping nicotine or smoking marijuana. This has led to some complications.

“At our residential adolescent unit, we’re seeing a lot more kids coming in with psychotic disorders. What I mean by psychotic disorders is disorders that sort of show up by hallucinations, hearing or seeing things that aren’t there, paranoia, that kind of thing. We know that marijuana can uncover or make that worse in teenagers.” 

The pandemic has also made it more difficult for some patients to seek care. Kirch said she already sees this when trying to get someone into inpatient or residential treatment.

“Even just to get a phone screening so you can be considered for the wait list can be a little bit of a wait," she said. "So we’re having a pretty large challenge of just getting our clients into this higher level of care and getting them to stay sober long enough to complete their requirements to be eligible for a higher level of care.”  

Wright said for other patients, financial difficulties have affected access to care.

“A lot of people have lost their jobs. Unemployment is high, lack of insurance, lack of coverage for some of this. So I think that’s prevented a lot of people from seeking as much treatment as they probably should at this point in time.”

Beyond these concerns, a fear of infection and the need to social distance means that new precautions have had to be taken. Wright said some patient treatment has had to shift to a virtual setting. But Wright said some of this can’t be done remotely. 

“There are some of our clients, particularly if they are severely mentally ill or really great need, they need to have that face-to-face contact," he said. "And so we continue to do that, but we do it in rooms that allow for physical distancing, and certainly wear masks, and things like that.” 

For less severe cases of mental health and substance abuse, there’s been a shift to telemedicine. Kirch said videoconferencing can help her and other social workers notice signs of withdrawal or drug abuse.

“I can tell just by what I’m seeing on their screen that there may be alcohol in the background or I can tell that they’re sitting on the floor of a house that looks uncleaned, or whatever the case may be.” 

Kirch also noted that telemedicine has also helped patients who’ve gone “off the radar.” 

“I think that they’re more likely to answer those calls knowing exactly who they’re going to be speaking to and knowing that we care enough that we keep calling them. We keep checking in on them. “

As for the future, Wright said staff and patients at Rosecrance are continually monitored for COVID-19 -- but recent immunizations have helped.

“Most of our clinical staff that has direct care responsibilities have been able to be vaccinated as part of 1A, the 1A tier.”    

He says this is especially important if new outbreaks pop up. As for Northwestern Medicine, Kirch said they may offer more telemedicine even after pandemic restrictions loosen.

“I think some of those things can continue to be utilized with the added value of them coming in in-person and seeing us face-to-face and being able to get actual eyes on them, being able to actually drug screen them in person and have that connection that you’ve built more easily and strongly in-person.” 

But even as progress is made against COVID-19, these health systems will need to ensure both that they can account for the rise in substance abuse, and offer enough treatment to the patients they already have.