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Substance Abuse During Trying Times

A: Even the strongest and most balanced of us are starting to feel a bit of cabin fever by this point in the crisis. And a gradual slide from normal social drinking becomes “what harm is there in having just one more?” which then becomes the new normal. Normal is a sliding scale. What was abnormal yesterday is acceptable today. Sometimes this is a good thing, such as when previously anti-social behavior is finally frowned upon by the majority. Think of not wearing seat belts or driving while intoxicated. But it is also often that negative behaviors take on a patina of acceptability in one’s mind.


Does the following inner dialogue sound familiar to you?

“I don’t have to drive home. I’m already there! So there’s no problem in popping open another brew/doing another bump/eating another edible.”

“It will affect your sleep cycle. Better not.”

“No one expects me to be alert and functioning until mid-morning anyway.”

“You did this last week/a few days ago/last night. And you felt miserable all the next day.”

“But I feel miserable right now!”

And so on.


Every aspect of our lives seems to be governed by the virus. Where we go. Where we don’t go. When we eat. When we sleep. What we consume---whether it be food, entertainment, or substances. And it is happening to everyone. We visit our friends on social media and discover that they are in the same boat. It justifies our behavior. Safety in numbers and all that. It’s OK to do this because everyone else is. We’ve all heard the excuses. Bad behavior is contagious. But so is good behavior. Which is the reason for programs, whether they be 12 Step Programs or some other form of social safety net.


Here is the problem though. These meetings are structured so that individuals can come to them and be in a like-minded group so as to support one another. Because of the virus these meetings have, as so many other aspects of our lives, gone online. And the comfort of being in the group feels diminished. Zoom meetings can feel cold, but they don't have to. Remember it is what you are bringing to the meeting that will make the difference. Also, it takes time to adjust to any new technology. Consider as you get used to using Zoom, what kind of benefits occur from being in cyberspace? Can you be more open? Less knhibited? Less distracted? Make the meeting work for you. 


Reaching out for help is never something to be ashamed of. We are social creatures. We need others. And at this point in time others exist primarily via our computer screens. If you used to attend a self-help group and have let it lapse because you don’t feel comfortable doing it in cyberspace, give it another try. A lot of the kinks have been worked out of what were cobbled together ways of adapting to this new normal. If the crisis has caused cracks in your stability and you are finding yourself overdoing it in ways that used to be abnormal for you, consider reaching out for help, from a group or from a licensed practitioner. There are several different types of adjuvant medications that may help treat stress better, and also decrease your risk of relapse.


But either way, seek help. There is no shame. It is part of the new normal. A group or a therapist can help you through what has been a challenge for all of us.


Good luck!

David Salvage, MD, FAPM

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