2021 drug overdose deaths hit all-time high: How to look for addictive behaviors

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The pandemic shuttered small businesses, caused a bevy of product shortages and has taken the lives of nearly a million Americans. It has also contributed to increased substance abuse as a way to cope with the stresses and losses of COVID-19, according to the American Medical Association, Centers for Disease Control, American Psychological Association and recent studies.

In fact, a May 11 CDC report revealed that drug overdose deaths in the U.S. reached an all-time high in 2021, increased 15% from 2020. Last year, more than 107,600 Americans died from drug overdoses compared to 93,655 deaths in 2020. Pre-pandemic, in 2019, the U.S saw about 70,630 drug overdose deaths, according to the CDC.

“During the COVID-19 pandemic, we’ve observed a significant rise in mental health problems including depression, anxiety and addiction,” said Dongju Seo, Ph.D., associate professor of psychiatry at Yale School of Medicine.

Chris Foresta, a recovering heroin addict from Las Vegas and author of “Redemption Bridge: My Story of Addiction and Recovery,” said he has witnessed pandemic-related addictions firsthand. “So many of my friends have relapsed during the pandemic,” he said.

Why addictions have increased

Foresta explained that connection is the most important thing people struggling with addiction need to stay sober or avoid addiction, and that the past two years “have been a pandemic of isolation for most of us. Isolation is very dangerous for addicts.”

Eliana Leve, director of the Hazelden Betty Ford Foundation’s New York services, agreed: "Addictive behaviors are often linked to emotional and social deficits. The isolation and uncertainty during the pandemic exacerbated those deficits by taking away opportunities to experience social connectedness and personal growth."

While not everyone is addiction-prone — “Based on individual predispositions and availability, some people tend to be more vulnerable to certain types of addictions than others,” said Seo — individuals who are have struggled especially the past two years.

In addition to robbing them of social opportunities, the pandemic has also interrupted the structure some had in place to mitigate temptations and manage stress.

“Daily routines provide solace, and when these routines are disrupted, they exacerbate depressive moods,” explained Alan Cavaiola, Ph.D., director of addiction studies at Monmouth University and the author of “A Comprehensive Guide to Addiction Theory and Counseling Techniques.”

Uncertainty only makes matters worse. “Anxiety tends to be future-focused, and no one knew how long the pandemic would last,” Cavaiola said, adding that many of his patients were also impacted when programs like Alcoholics Anonymous moved from in-person to virtual formats. “There’s a sense some weren’t getting as much from virtual meetings,” he said.

Which addictions are on the rise?

Experts have seen a rise in substance addictions, such as alcohol, tobacco and opioids, but explained that a host of other addictions are up, as well. “Behavioral addictions such as gambling, online gaming, sexual addiction, overspending and binge eating have also increased dramatically during the pandemic,” Cavaiola said.

And while all forms of addictions are thought to have increased, the more affordable and accessible ones have grown, especially.

“Some addictions are more common than others due to availability, accessibility and price,” said Dr. John Kelly, Ph.D., a professor of psychiatry at Harvard Medical School and program director of the addiction recovery management service at Massachusetts General Hospital.

For example, Kelly estimated that alcohol accounts for 75% of all addiction cases in the U.S. primarily because it is “a psychoactive, legal drug that is widely available and accessible.”

How families can be on the lookout for addictive behaviors

While there’s no doubt substance abuse has increased during the pandemic, "it often takes years for someone to develop an addiction," explained Tami Mark, Ph.D., a health economist with nonprofit research group RTI International. The good news is this gives gives family and friends time to notice signs of addiction in those close to them.

“You may notice a deterioration in self-care, like grooming, exercise and sleep, increased missing of appointments and commitments, or an inexplicable shortage of funds,” Leve said, adding that another red flag is the person trying to minimize or excuse such behaviors.

“It’s worrisome if someone who was once interested in hobbies or activities no longer has a passion for these interests,” said Cavaiola. “Moods can change dramatically, and over time people become less functional.”

Foresta experienced this shift during his experience with addiction. “My family realized I had a problem when I wasn’t managing my life anymore,” he said. “Despite making good money, I wasn’t paying my mortgage or taking care of myself. I went from having a successful career and family to sleeping on the floor of a friend’s garage.”

“I never reached out to anyone, but luckily my family reached out to me.”

How to approach a loved one who may be struggling with addiction

Foresta warned that family members need to be careful in how they approach someone struggling with addiction as because, if handled poorly, reaching out can make matters worse. “Families don’t cause or create addictions, but they certainly contribute,” he said.

For people struggling with addiction, feeling shamed or blamed may only exacerbate the issue, as most are just trying to numb difficult emotions in the first place.

“Family members should make their approach empathetic and non-judgmental by asking about how their loved one is feeling about things. If you can get them talking about that, they will often open up about much more," Foresta explained.

Cavaiola also stressed the importance of expressing "concerns in a loving way. Arguing, berating or demeaning the person usually increases defensiveness. Similarly, enabling the substance use by taking over (a loved one's) responsibilities or giving (them) money doesn’t work and will usually only make things worse.”

He added that interventions “should be done in consultation with an addiction counselor who is trained and familiar with the process.”

Timing is another important consideration. When possible, "wait ... for a time when the person is likely to be more receptive to input from significant others in their life, such as after a regrettable incident or an accident related to (the addiction), where there is remorse and potential desire to change,” Kelly said.

As Foresta put it, “I didn’t want to change until the pain of my problem became worse than the pain of my solution.”

What to do if you’re the one struggling with addiction

People slipping into addiction may struggle to realize what's happening, Leve explained. “Active addiction is very much a disease of self-deception.”

Warning signs include the addictive behavior causing relationship conflict, missed days of work, poorer functioning or increased health problems, like hangovers. If you're unable to cut down or stop when you place limits on your use, that's another problem, Kelly said, adding, "Awareness and action are key."

Above all, Foresta stressed that people living with addiction need to get to the root of whatever is causing the difficult feelings in the first place. “No one sets out to become addicted,” he said. “It sneaks up on you when all you were trying to do was numb your pain. People who work through their pain in healthy ways, such as through a therapist, are much less likely to become addicted.”

Talking about your feelings is "the best ways to course-correct," Leve echoed. "Secrets keep us sick. ... Reach out to peers in recovery, speak to a supportive family member or friend, go to 12 steps or other mutual support meetings, reconnect with helpful mentors or sponsors, and seek professional help if needed."

Addiction occurs far more often and in many more people than some might realize, especially after two years of a pandemic “There is no shame in seeking help,” Leve said. “Addiction is common, and so too is recovery.”