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One Day at a Time: Substance use spikes as the pandemic wears on

For those suffering from substance-use disorders, staying sober is a marathon. The last year was a perfect storm of external assaults on everyone to one degree or another. The traditional roadblocks to overcoming addiction — economic insecurity, inadequate healthcare, lack of emotional connection and the troubles of social isolation — all were exacerbated by COVID-19 and its accompanying shift from normalcy. 

Metrics across the board for addiction are running negatively, according to Herren Project executive director Kevin Mikolazyk. The combination of anxiety, depression, health issues and unemployment that marked the past year are making the road to recovery more of a challenge.

The Herren Project is a nonprofit, founded by former professional basketball player and Fall River native Chris Herren, whose public battle with addiction and subsequent recovery led to the organization’s formation. It offers a host of free resources geared toward the prevention of substance use disorder. 

The last time they crunched the numbers — from April to August 2020 — requests for their services had spiked 190%, with pleas for family aid being the most prominent. 

“It is still trending in that direction,” says Mikolazyk. “More people are struggling than ever before. A big part of recovery is togetherness and personal connection. When that was taken away, it threw a lot of people for a loop.”

Mikolazyk says he’s seen people with many years of sobriety fall back. A specific trend, which many in the recovery industry said is novel, was the sharp uptick in drinking and drug abuse among middle-aged and older women. In response to the restrictions that began last spring, the Herren Project started a nightly online meeting that at times had 80 people.

“You could have been doing good in your recovery and then suddenly you lose your job, and it becomes that much more difficult,” says Mikolazyk. “And I don’t think we’ve even seen the worst of it.”

Like the rest of the country, Rhode Island before COVID-19 was handling another kind of public health crisis. After years of relative success getting a handle on the opioid epidemic (Rhode Island saw a fatal overdose decline between 2016 and 2019), the well-publicized uptick in the early months of 2020 arrived, followed by the arrival of COVID-19, which is being credited by public health experts as the prime reason for last year now set to become the deadliest for overdoses on record.

Although finalized data from 2020 will not be available for some time (there is usually a backlog as cases are determined by the state’s medical examiner), Rhode Island is on pace to eclipse the earlier record of 336 fatal overdoses logged in 2016 by about 30%. The most recent data on the RIDOH website shows 332 deadly overdoses in 2020 (September through December’s numbers are incomplete). July was the deadliest month ever recorded.

The pandemic has stretched addiction recovery resources to their absolute limits.

“The longer you can keep someone in a therapeutic environment, the better their chances. The current system is not set up for that,” says Mikolazyk. “Even if you have great insurance, you may get 30 days [of residential treatment] and they’re going to place you in outpatient treatment, which basically puts you back in the old environment … it takes a long time to learn new behaviors and coping mechanisms.”

Early research shows overall alcohol consumption has increased by 50%. A spokesperson for Alcoholics Anonymous Rhode Island says the organization has been engaging in more public outreach since early last year. AA meetings have for a long time been ubiquitous in local church basements and social halls. “Now some people don’t know where to go,” he says.

The spokesperson, who opted to remain anonymous, said the groups have rolled with the punches, updating members as state guidance is amended.

“It’s changed a couple of times, the way everything else has. We follow the governor’s guidelines in our meetings,” he said. “Of course, we’ve had people who say, ‘We have a right to hold our meetings.’ And that’s a valid point. But on the other side of the coin, it’s a valid point to say that it may not be wise to be [meeting in person].”

Public information officer for the state’s Behavioral Health Division, Randal Edgar, said that 12-step meetings are now considered an essential service. 

“Many did initially close down, but under RIDOH guidance for faith-based organizations, they began holding in-person meetings again, following guidelines such as social distancing, wearing masks and staying home if sick,” he says. “Twelve-step programs are all about relationships, so not meeting in person makes it hard for people to stay connected. But providers have gone out of their way to make it work.”

A survey of local meetings shows that some have gone completely digital. Others have continued their on-site gatherings. 

One generational parallel he has noticed is younger people finding the online format more desirable than in-person meetings, especially when it comes to speaking up, which many find difficult early on. The elderly are also adapting, he said, and appreciative of the ease in which they can log in to a Zoom meeting from the comfort of their home. 

“As much as it’s been an adjustment for a lot of people, it has opened up a doorway for some who can’t get out to where they want to get to.”

There are few silver linings. But one positive development in recent months is the increased willingness to donate to the non-profit organizations that labor in the recovery trenches. This could be due to the consequences of addiction touching more families personally. The Herren Project relies on these monies along with foundational grants to continue its work. “Generosity has actually gone up during COVID,” says Mikolazyk. “And it’s not necessarily the wealthy who are giving more. It’s actually the lower and middle classes.”

If you or someone you know is struggling with substance use, here are some resources: aainri.com/newcomers or herrenproject.org

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