Helpful info and links to Support Groups during COVID-19

Compiled by Sunshine Behavioral Health

What Is COVID-19?

COVID-19 is one of many viruses that cause respiratory illnesses in people, including some forms of the common cold. Although it has similar symptoms to some strains of influenza, COVID-19 is caused by a different type of virus.

COVID stands for coronavirus disease. This novel coronavirus was discovered in Wuhan, China, in December 2019. In four months it has become a pandemic, a worldwide epidemic.

By March 22, 2020, more than 335,000 COVID-19 cases were reported worldwide, of which almost 15,000 had died. In the United States, more than 33,000 cases were reported by that date—about half in New York state—with more than 400 deaths.

What Is Social Distancing?

To flatten the curve of new cases and avoid overwhelming the health care system, much of the United States is in virtual lock down due to social distancing: work from home if possible, stay six feet away from other people, make no unnecessary physical contact, and avoid public places and groups of 10 people or more.

People with symptoms of possible COVID-19 are told to self-isolate so they won’t spread the virus and overwhelm available services needed for emergencies. That includes staying away from doctors’ offices, clinics, and hospitals. Individuals with a substance use disorder (SUD) are usually not considered emergencies unless they are experiencing an overdose.

Rehab centers also want to avoid overcrowding and risking COVID-19 infection. Alcoholics Anonymous and similar groups—famous for welcoming everyone and having meetings almost every day, and often several times a day—are limiting the number who can attend, foregoing the communal snacks offered at many meetings, or canceling face-to-face meetings indefinitely.

Social distancing is making many people feel more isolated. When someone with substance use disorder (SUD) is cut off from support and services, or even the promise of them, they may feel more isolated, mentally as well as physically. That’s when they are most likely to turn to the bottle (booze or pills) or the needle to cope.

According to the U.S. Centers for Disease Control and Prevention (CDC), individuals with mental health conditions, including substance use disorder, are less likely to handle stress well. Their inability to cope may have triggered their SUD in the first place.

They also may have poorer health due to their SUD, which may make them more susceptible and less able to fight off the coronavirus and other health problems.

Why Can’t People Meet Face-to-Face?

It is not known exactly how long COVID-19 lingers in the air or on surfaces because it is different times for different materials: up to three hours in the air, four hours on copper, 24 hours on cardboard, three days on plastic and stainless steel. Symptoms may not occur for between three and 13 days after exposure, though five days seems to be average.

No one with a seasonal type of flu should engage in the sort of behavior or contact that social distancing is meant to prevent, either, but the reasons COVID-19 requires more extreme measures are:

  • Because COVID-19 is a novel (new) coronavirus, the human body has no natural immunity to it.
  • Because COVID-19 seems to be twice as contagious as the flu.
  • Because COVID-19 symptoms take longer to show, people may be infecting others before they realize they have it themselves.
  • Because there is no vaccine available, there is no buffer of protected people.

Without these precautions, it is estimated that as many as 2 million people in the United States could die. According to one simulation model, more than 1 million could still die unless social distancing and other measures continue until a vaccine is available.According to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), the earliest a vaccine will be ready is “a year to a year and a half, no matter how fast you go.”Hopes that COVID-19 is seasonal and will go away on its own in the warmer months do not seem likely, either.So, what should a drug-addicted or alcohol-addicted person do in the time of a pandemic such as the COVID-19 novel coronavirus? There may be options as close as your palm, lap, or desktop: telehealth.

 

Online Groups


The first recovery tool that many people try for Substance Use Disorder is a 12-step program such as Alcoholics Anonymous or Narcotics Anonymous. These programs aren’t treatment and don’t claim to be, but they do help some people abstain from drugs and alcohol.

Although they are called 12-step programs, attendance or membership does not require that you “work” or practice the 12 steps. Progressing through the steps is encouraged, but attending meetings regularly—one popular saying is 30 meetings in the first 30 days—is the true benefit.

Unfortunately, while it may be possible to work the 12 steps while practicing social distancing, physically attending meetings may not. Even if government authorities haven’t banned meetings of more than 10 people, many 12-step groups have stopped them on their own during the COVID-19 pandemic.

Twelve-step meetings involve sitting together in small rooms, sometimes with more than 10 people and less than six feet between each person. Communal food is consumed. And members sometimes want or require human contact—shaking hands, hugging.

Fortunately, many 12-step groups and similar organizations offer virtual meetings online: via video conferencing or Skype, speakerphone, email, or text. It’s not the same as face-to-face contact, but such communication may be a welcome lifeline.

Alcoholics Anonymous

Alcoholics Anonymous, the original 12-step program that meets in churches, hospitals, and community centers also has a visible online presence:

  • AA Online Meeting is a Skype-based (voice only), English-language AA meeting in three different time zones in Europe and Asia.
  • The e-AA Group has email recovery meetings and discussion forums.
  • The Alcoholics Anonymous Online Intergroup lists more than 150 English-language AA groups, about a dozen with audio or audio-optional meetings.

Narcotics Anonymous

Based on AA, this group uses a similar 12-step program and meeting structure but is open to individuals who are addicted to substances other than alcohol. It has more than 150 groups with online meetings.

SMART

Self-Management and Recovery Training (SMART) Recovery is an explicitly secular alternative to 12-step programs that states it is evidence-based and “self-empowered.” Online meetings are held every day, including text, audio, or video.

Women for Sobriety (WFS)

This women-only group has “online chat meetings” led by women who are “certified as chat leaders”, “are well-versed in the WFS New Life Program,” and have been continuously sober for at least a year.

LifeRing Secular Recovery

LifeRing offers three types of online meetings via smartphone, electronic tablet, and laptop or desktop computer. Most are text only, but some have voice and video. It is recommended you arrive early for your first meeting as you may have to download and install an app (Adobe Connect for text, sometimes an add-in, and Zoom for voice/video). In addition to the scheduled online meetings, there is also a 24-hour chat room.

​XRHealth

In response to the isolation caused by the COVID-19 pandemic, the Virtual Reality (VR) telehealth company XRHealth is scheduling VR telehealth support groups, including for substance abuse, as soon as April 1, 2020.

Mobile Apps

Although an article in the Journal of Medical Internet Research found only seven out of 74 commercially available recovery apps had evidence-based features, and some might encourage substance abuse behaviors, the piece discusses a large and rapidly changing field. New apps are emerging all the time and the article only discussed a few.

Here are two apps that seem promising and were not included in JMIR’s analysis:

  • reSET-O. This is a prescription cognitive behavioral therapy app. It is not a replacement for treatment with a health care provider but a supplement to increase how long individuals with opioid use disorder (OUD) stay in outpatient treatment programs. It is also intended to be used in conjunction with other treatments, such as MAT with buprenorphine and contingency management (an incentive program that rewards clean drug tests with prizes).
  • HipoChat. This mobile app lets individuals in recovery keep in contact with all the people who help them stay sober—designated relatives, friends, support group members. It allows recovering people to alert others that they need urgent support with just the touch of a finger. People can also use this app to schedule online treatment sessions.

Coping with Long-Term Social Distancing

It’s not just those with substance use disorder who will have trouble waiting for COVID-19 to go away on its own or for a vaccine to be available. Everybody will have to find ways to cope with increased levels of stress, depression, anxiety, and fear.

Understandably, being cut off from social interaction, daily routines, and possibly income may cause loneliness, boredom, cabin fever, anger, and—if the individual has a SUD—the desire to use drugs or alcohol to mask the feelings.

Here are some some suggestions from the Substance Abuse and Mental Health Services Administration (SAMHSA):

  • Practice relaxation techniques—stretching, going for a walk, exercising, meditating, or praying—that you enjoy.
  • Engage in a fun activity, especially after doing something stressful or difficult.
  • Talk with someone—a friend, coworker, or family member—by phone or Skype.
  • Keep a journal of positive or hopeful things.

If an individual experiences intense symptoms of anxiety, worry, fear, depression, or post-traumatic stress disorder (PTSD) for two weeks or more, they should consider consulting their health care provider, if available, or a mental health or suicide prevention hotline.

References

  • who.int – Q & A on coronavirus (COVID-19)
  • jamanetwork.com – What Is A Pandemic?
  • worldometers.info – COVID-19 Coronavirus Pandemic
  • cdc.gov – Mental Health and Coping During COVID-19
  • health.harvard.edu – Coronavirus Resource Center
  • vox.com – Why COVID-19 is worse than the flu in one chart
  • npr.org – How The Novel Coronavirus And The Flu Are Alike … And Different
  • imperial.ac.uk– Impact of non-pharmaceutical interventions (NPIs) to reduce COVID- 19 mortality and healthcare demand
  • newyorker.com – How Long Will It Take to Develop a Coronavirus Vaccine?
  • ccdd.hsph.harvard.edu – Seasonality of SARS-CoV-2: Will COVID-19 go away on its own in warmer weather?
  • healthit.gov – Telemedicine and Telehealth
  • modernhealthcare.com – Telemedicine underused in treating addiction- Telemedicine underused in treating addiction
  • congress.gov – H.R.6 – SUPPORT for Patients and Communities Act
  • findtreatment.gov – Treatment options
  • katu.com – DEA exemption allows for telemedicine addiction treatment during coronavirus outbreak
  • mayoclinic.org – Cognitive behavioral therapy
  • ncbi.nlm.nih.gov– Dialectical Behavior Therapy: Current Indications and Unique Elements
  • drugabuse.gov– Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine)
  • aaonlinemeeting.net – AA Online Meetings
  • e-aa.org – Meeting and Event Links (The e-AA Group)
  • aa-intergroup.org – Online Meetings Directory (Online Intergroup, Alcoholics Anonymous)
  • na.org – Narcotics Anonymous Meeting Search Results
  • smartrecovery.org – Online Meetings & Events (SMART Recovery)
  • womenforsobriety.org – Community (Women for Sobriety)
  • wfsonline.org – Women For Sobriety Online
  • lifering.org – Joining a Meeting
  • lifering.org – Online Meeting Schedule
  • benefitspro.com – Instant Insights: How the Coronavirus Affects HR, Benefits, and Retirement Professionals
  • mhealth.jmir.org – Smartphone Apps Targeting Alcohol and Illicit Substance Use: Systematic Search in in Commercial App Stores and Critical Content Analysis
  • fda.gov – FDA clears mobile medical app to help those with opioid use disorder stay in recovery programs
  • drugabuse.gov – Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana, Nicotine)
  • healthcareitnews.com – DrFirst and GoHipo partner to combat substance abuse relapse via mobile telehealth
  • samhsa.gov – Tips For Social Distancing, Quarantine, And Isolation During An Infectious Disease Outbreak
  • samhsa.gov – Disaster Distress Helpline
  • findtreatment.samhsa.gov – SAMHSA Behavioral Health Treatment Services Locator
  • findtreatment.gov– Types of Treatment
  • suicidepreventionlifeline.org – National Suicide Prevention Lifeline
  • cdc.gov – Mission, Role and Pledge
  • emergency.cdc.gov – Coping with a Disaster or Traumatic Event
  • cdc.gov– Coronavirus (COVID-19): Manage Anxiety & Stress
  • cdc.gov – Coronavirus (COVID-19): What You Need to Know
  • nami.org – NAMI Updates On The Coronavirus
  • nami.org– COVID-19 (Coronavirus) Information And Resources
  • nih.gov – National Institutes of Health (Home)
  • nih.gov – Coronavirus (COVID-19)
  • who.int/en – World Health Organization
  • who.int – Constitution
  • forbes.com – Addiction Treatment Facilities: Are They Prepared For The COVID-19 Coronavirus Outbreak?
  • latimes.com – Amid coronavirus, recovery community urges: Even if you skip 12-step meetings, stay connected
  • psychcongress.com – Under Coronavirus Threat, Patient Connection Will Take on Different Form
  • usatoday.com – “The only thing missing are the hugs”: How people fight addiction amid coronavirus social distancing

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