"It's Really Easy To Lose Hope": Substance Use Disorder During Covid

"I can't even fathom somebody getting into recovery during the pandemic"

Covid caused unprecedented stress for people around the US, and with that stress came increased substance use. 

I wanted to know more, so I talked to dealers, users, advocates, and experts about how lockdown and a global pandemic affected the illegal drug industry.

Here's what they told me.

This is the third of three articles.

Unless a full name is given, a pseudonym is being used.

The problem

Drug use in the US during the Covid-19 pandemic led to an increased number of overdoses around the country, with states across the country and the CDC reporting record deaths from overdose over the past year.

Gary Pratt, who runs Rural Recovery in Great Barrington, Massachusetts, told me those numbers might just be the beginning. He believes the full extent of the pandemic's effect on substance use disorder hasn't been fully appreciated yet—and that it won't for years. 

"I fully anticipate it," Pratt said. "When you look at the opioid overdose statistics for Berkshire County, there was a 44% increase in opioid fatalities in 2020."

Drug Policy Alliance Research and Academic Engagement Deputy Director Sheila Vakharia cautioned against reading too much into those statistics, telling me that deaths from overdose had been on the rise even before the pandemic began, though "those increases were only exacerbated by the shutdowns."

She added that other factors, including isolation—which necessarily keeps users separated from each other in moments they might need help—and the quality of the product can also contribute to the rise in deaths. 

"The factor that plays out in overdose is the drug supply quality," Vakharia said. "You don't have to be a user to be at risk for overdose. You can use one when you buy a product that's from the market that's been contaminated or adulterated or whose contents you don't know or whose tolerance you don't have." 

Read about dealing during Covid

“I try to be judicious as best I can”

Not everyone sees their use as a major problem—even when it exceeds what they feel is a responsible limit. After all, just using substances doesn’t mean you’re going to develop a problem.

“I know a couple of people that will use opioids recreationally a couple of times a year and enjoy it and not destroy their life, not start robbing people, not start stealing, lying about anything that's associated with the substance use disorders,” Pratt said. “Same with alcohol, same with marijuana, same with psychedelics like that happens through substance use disorders."

Ken, who helped run mutual aid operations for Occupy City Hall in New York City last year, began using cocaine two to three times a week during the height of the pandemic. He was working 60 hours a week, said Ken, and ended up partying more than usual as a release.

“I cut back for about a month in the spring and would like to make a conscious effort to continue that,” Ken said. “But lately I’ve been reconnecting with friends who also enjoy drugs and seeing concerts again so there are more social reasons to indulge.”

While Ken would like to curtail his use, he said that he doesn’t have a “strong impetus to stop.”

“It doesn’t seem to negatively impact my life and I don’t feel compelled to do anything more regularly at the moment,” Ken told me. “I try to be judicious as best I can.”

To Ken, substance use is sometimes a substitute for more healthy behaviors that aren’t accommodated for in our society’s priorities.

“In a country where access to affordable healthcare is so limited, and mental healthcare especially, sometimes unfortunately the best therapy you have available to you is doing ketamine or other psychedelics and working on yourself,” Ken said.

Read about drug use during the pandemic

"I can't even fathom somebody getting into recovery during the pandemic"

Pratt told me that he treats the disorder behind addictive behavior rather than targeting specific drug addictions.

"The underlying substance use disorder is pretty much universal, regardless of what the substance is being used," Pratt said. "Not everybody is going to develop a substance use disorder.”

Isolation and the social distancing guidelines from the pandemic contributed to a decline in people seeking treatment, said Pratt. Pratt worked at the Clinical Stabilization Services in nearby Pittsfield—an outpatient facility that helps patients after detox—until last September. When the pandemic hit, Pratt told me, the effects on people in the program were quickly apparent. 

"We started to see a lot more people staying out, and to continue to use and not seek treatment," Pratt said. 

Social distancing depersonalized the resource center's work, Pratt said, to the point that it reduced bed space and personal treatment options. He also found the use of the Zoom platform for meetings a necessary approach to treatment that was nonetheless off-putting. 

"While that was a great stopgap, it's still not the same as having interpersonal relationships and shaking somebody's hand or giving them a hug or sharing a coffee with them after a recovery meeting or something like that," Pratt said. "It bolsters that feeling of isolation and with the feeling of isolation comes the hopelessness and the desperation, the fear, the anxiety—all those things that people tend to use over to begin with."

The pandemic's effect on users in need of help was clear to Pratt, who has been in long term recovery since 2008. 

"I can't even fathom somebody getting into recovery during the pandemic," Pratt said. "It seemed like such a dire situation to begin with and it's really easy to lose hope that things are going to really get better."

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