The COVID-19 pandemic was difficult for everyone, including people who use drugs or alcohol to cope with stress. Some people experienced increased substance use and some found it more difficult to achieve or maintain recovery from substance use during COVID-19.
But there were some silver linings, says Dr. James MacKillop, director and chair of the Peter Boris Centre for Addictions Research, which is affiliated with St. Joseph’s Healthcare Hamilton and McMaster University.
Here are five important lessons that the medical community learned:
1. The pandemic did not uniformly result in the expected increase in alcohol and drug use. While COVID-19 had negative consequences for some people, there were opportunities for resilience and recovery for others, says Dr. MacKillop. “A negative trend was the increase in opioid overdoses, but several ongoing studies show notable reductions in harmful drinking of alcohol and no evidence that the pandemic created entirely new substance use disorders in individuals who had no concerns prior to the pandemic. Cannabis use appears to have increased, but those increases may be due to the concurrent timing of legalization and the availability of legal home delivery,” he says.
2. The pandemic hurt marginalized populations most. Unfortunately, people with a low socioeconomic status continued to be at greatest risk for harmful health consequences from using substances, according to Dr. Jennifer Brasch, lead, addiction psychiatry for the Mental Health and Addictions Program at St. Joe’s. For example, opioid drug deaths went up dramatically — in 2021, there were approximately 21 opioid related deaths per day in Canada compared to eight in 2016 and 12 in 2018. “Life is still extremely hard and stressful for people living in poverty,” Dr. Brasch says.
3. Digital health support reduces barriers. The pandemic caused a scramble to transition to virtual meetings and telemedicine strategies for managing substance use disorders. This made it easier for many people to access care, says Dr. Brasch. People no longer had to spend time and money to travel to the hospital, which was helpful for people unable to leave work for long periods or who live a distance from the hospital.
4. Digital health support isn’t for everyone. Some people felt that if they couldn’t go to a therapeutic group session in person, it didn’t feel real … and they just stopped going to Zoom meetings, says Dr. MacKillop. “For future planning, the risk is we overinterpret the success of digital health during the pandemic and that it becomes the default setting.”
5. Community is still important. “The pandemic really laid bare the importance of connection and community in terms of helping people avoid, and recover from, substance use,” says Dr. Brasch. “That loss or lack of community can be a big factor in preventing people from being able to move away from substance use.” During recovery, she says, it’s important to connect with a social network of people to enjoy spending time with, and who support a person’s efforts to stop using alcohol, cannabis or other substances.
Guide to St. Joe’s treatment programs
As the regional lead for mental health and addictions care, St. Joe’s offers several services for adults with moderate to severe substance use disorders.
• Womankind Addiction Service is a comprehensive service for women and individuals who identify as women seeking change with their substance use. It offers a safe, inclusive, and caring place with a range of gender responsive programming and supports. Women can live at home or stay at Womankind to participate in their 4-6-week treatment program.
• Men’s Addiction Service Hamilton (MASH) provides a safe place for men who are struggling with substance use problems. It offers 24/7 crisis telephone support, a residential withdrawal management service, recovery programming and referrals to treatment programs.
• Rapid Access Addiction Medicine (RAAM) Clinic assists those with substance use disorders, primarily addictions to opioids and alcohol. This service aims to see people quickly, offering assessments, counselling and medications to help people who are ready to stop using alcohol or opioids.
• Concurrent Disorders (CD) Program is an outpatient program for individuals experiencing both mental health and substance use disorders. Recovery can be more difficult for people with concurrent disorders. This program offers virtual drop-in groups and psychiatric care.
• Young Adult Substance Use Program is a three-month program for young adults looking to make changes in their substance use. The program includes groups that support self-discovery and self-management. There is also a Loved Ones Education Group to support family and friends of young adults with substance use problems.
Philanthropy has been essential to enabling St. Joe’s to expand its mental health and addictions care programs, renew its treatment facilities, and fund ground-breaking health research, too. To make a gift to support mental health care in your community, please visit stjoesfoundation.ca/donate or call St. Joseph’s Healthcare Foundation at 905-521-6036.
