Author Dayna Smith-Slade, MAC
Reviewer Kristen Fuller, MD
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The COVID-19 pandemic has taken more lives in the United States than World War I, the Vietnam War, and the Korean War combined (Hennein & Lowe, 2020; American Psychological Association [APA], 2020). In addition to the death toll impact, there are significant public health impacts in homes and communities on a global scale.
As a substance abuse counselor and employee assistance professional during this time, I have observed several notable changes in mental health and substance use since the onset of the pandemic in 2020.
The necessary social distancing and quarantine measures . . . significantly amplified emotional turmoil by substantially changing the social fabric by which individuals, families, communities, and nations cope with tragedy. The effect is multidimensional disruption of employment, finances, education, health care, food security, transportation, recreation, cultural and religious practices, and the ability of personal support networks and communities to come together and grieve.
By now you have seen and/or experienced the impact of the “emotional turmoil” and “multidimensional disruption” as stated above. The impacts include, but are not limited to, social isolation, constant close quarter living, unpredictability of how our lives have changed, collective grief of loved ones, missed celebrations of milestones (e.g., graduations, weddings etc.), stress (work and home), fear, financial insecurity, job changes, decrease in healthcare insurance for substance use treatment, waiting list for substance use treatment, untreated mental health disorders, changes in access to medication, changes in drug supply, and an exacerbation of pre-existing medical conditions. In general, peoples’ eating and sleeping habits, hygiene, activity levels, and daily routines changed. Life changed as we knew it.
As a result, and not surprisingly, several research studies on the effects of the pandemic have found increased anxiety, depression, stress, and substance use in the general population.
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What did that look like from my role as a mental health provider and substance abuse counselor? By May 2020, some of my clients were already experiencing daily anxiety attacks, insomnia, lack of motivation, energy, and focus, domestic disputes, frequent crying spells, co-worker conflict, decreased appetite, and increased headaches/migraines (just to name a few).
Three months later, my caseload was exploding and was busting at the seams with those in need of services. The intensity and severity of my clients’ presenting problems were growing. Clients were presenting with thoughts of hopelessness and suicide. My colleagues were having the same experience with their clients.
Rehabilitation centers and mental health providers scrambled to safely develop protocols and embrace technology to effectively meet the needs of their patients. Telehealth/telemedicine was an acceptable practice prior to the pandemic; however, it became the go-to modality of care and was backed by the US Department of Health and Human Services to allow for insurance reimbursement.
While providing services via telehealth, my colleagues and I noticed that the symptoms of people with pre-existing mental health conditions worsened and people with no prior mental health conditions were experiencing symptoms for the first time.
Similarly, people with a history of a moderate to severe substance use disorder, in full sustained remission, were facing challenges to maintain abstinence prior to the advent of virtual support groups and people with a mild substance use disorder were increasing their frequency and amount of drinking alcohol, smoking cannabis, and experimenting with other mood-altering substances often progressing to the point of needing some level of treatment.
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In addition to the pandemic, an epidemic, which predated the pandemic, was happening concurrently; the opioid overdose epidemic. Increases in drug overdoses and overdose related deaths to synthetic opioids (primarily fentanyl) accelerated during the COVID-19 pandemic.
Data from the CDC National Center for Health Statistics indicate that there were an estimated 100,306 drug overdose deaths in the United States during the 12-month period ending in April 2021, an increase of 28.5% from the deaths during the same period the year before.
Overdose deaths from psychostimulants such as methamphetamine also increased in the 12-month period ending in April 2021.
It is not my intention to simplify or to conflate all increased drug use or mental health symptoms directly with COVID-19; however, there are undeniably some effects from living through a pandemic.
For example, shifts in drug availability may also be to blame for increased illicit opioid use deaths; if heroin isn’t easy to access, someone might begin take fentanyl, which is much more potent. Another common example is a person turning to alcohol to relieve symptoms of anxiety and promote sleep slowly progressing to increased frequency (sometimes daily and throughout the day) and amount.
Experts agree based on research and clinical observation that pandemic-related strains, from economic stress and loneliness to general anxiety about the virus, and lack of healthy coping skills to manage progressively worsening symptoms, are significant influences for the increases in the observations stated in this article.
The ground is fertile as we continue to learn how we all continue to navigate through this pandemic. Evidence based practices are being researched, developed and implemented for the most effective and safest way to treat mental health and substance use during theses times.
These have been challenging times for us all. I have witnessed the most valiant and courageous efforts in my clients and colleagues. I am grateful to be a part of the community that is striving to make a difference.
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