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Addiction and Lockdown - The Perfect Storm?

As someone who was lucky enough to have achieved sobriety after their first stint in treatment I wonder, from time to time, whether I am actually an addict. I sometimes ask myself whether I was just going through a particularly rough phase in my life or whether I'd now be able to control my use of substances after having seen where persistent and excessive use leads. However, being stuck at home all day has in part answered that question. The nationwide ban on the sale of cigarettes (in South Africa) has somehow induced cigarette cravings in me, and I am a non smoker. Is this perhaps my inner addict crying out for any hint of a psychoactive substance or some way to break the rules?


I can only imagine how challenging this period must be for those that are in the throes of active addiction. The family members of these addicts are not to be forgotten as they have to endure the chaos that addiction brings with no escape route from their homes available to them. While all parts of society weigh in on whether the lockdown is doing more harm than good, one thing is for certain, for addicts and their families it is exceptionally dangerous. Listed below are some of the reasons why.


Withdrawal:

The most pressing and perhaps the most obvious problem facing addicts in lockdown is the danger posed by withdrawals. While most types of drug withdrawals are only fatal in a minority of cases, other classes of drugs produce withdrawal symptoms that are often deadly. Going "cold-turkey" off of alcohol as well as benzodiazepines poses the real risk of inducing seizures which are commonly lethal. Opiate withdrawals without medical supervision after long-term use can also be extremely dangerous. It goes without saying that outside of the risk of death, withdrawals can be an extremely taxing and traumatic experience for the addict as well as their family and friends.


Substitution and Experimentation:

A nationwide lockdown has undoubtedly affected the supply and availability of many drugs and subsequently a fair amount of addicts may be struggling to get their fix. Facing a shortage of their preferred substance/s, addicts may be circumstantially pressured into trying drugs that they haven't used before but are available at the moment. When the global pandemic eventually passes, addicts are highly likely to continue using these new substances and will face even greater dangers to their health from a more diversified cocktail of drugs.


Rise in Domestic Violence:

The ban on the sale of alcohol was definitely a step in the right direction to mitigate the evil addressed in this point but unfortunately it has not been enough. It does not take an active imagination to see that individuals, who are increasingly abusive while intoxicated, might become disgruntled and frustrated when deprived of their drink or drug. This frustration is almost certainly amplified when their freedom of movement is restricted and the consequence of this is that those around them are in imminent danger. In the first 3 weeks of lockdown, the South African Department of Health's dedicated gender-based violence and femicide hotline received more than 120 000 calls, double their usual volume for a 21-day period. Abroad, the UK's largest domestic abuse charity, Refuge, has seen a 700% surge in calls in a single day and a 25% increase in calls from abusive men seeking help to change their behaviour.


Difficulty Accessing Support:

The vast majority of addicts in recovery attain sobriety by making use of and connecting with a variety of support structures. For those who are fortunate enough to afford it these tools include group therapy sessions at a treatment centre and individual counselling sessions with addiction specialists. While many centres and professionals have made the effort to port their services to digital platforms to accommodate their clients during lockdown, the warmth and connection provided by physical human interaction is difficult to emulate. The outlook for those who can't afford private treatment is grimmer still. Yes, many free 12-step meetings are available online but how many addicts who rely solely on these for support are able to afford the data required or have access to digital devices?


Increased Triggers:

Outside of the context of domestic violence, being stuck at home with one's family, friends and/or romantic partner might provide a fertile breeding ground for triggers. Again, it is not a stretch to say that the feelings of frustration and uncertainty produced as a result of the global pandemic can bring out the worst parts of our character. Consequently, interpersonal conflicts with co-inhabitants may regress into old patterns even where previous issues have already been resolved. These are the types of disagreements that addicts tend to struggle with and their inability to cope with these might've flamed their initial periods of drug use.


Post-lockdown Excitement:

Social media is rife with South Africans excitably airing what their first activity post-lockdown is going to be. These range from an outing to a restaurant to a run in the park. However, a lot of the attention is centred on how eager people are to go out party. This atmosphere is perilous for addicts as many will be looking forward to a binge of epic proportions to celebrate their newfound freedom. The potential results of this fact are daunting, with a plethora of overdoses surely on the cards.


References:

South African domestic violence statistics - https://www.news24.com/SouthAfrica/News/lockdown-gender-based-violence-call-centre-receives-120-000-calls-in-3-weeks-20200511

UK domestic violence statistics - https://www.theguardian.com/society/2020/apr/12/domestic-violence-surges-seven-hundred-per-cent-uk-coronavirus

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