COVID-19 Q&As: Rachel Rabin on coping with addiction during the pandemic

“This new normal, and all the uncertainty that comes with it may elicit feelings of stress, depression, loneliness, anger and anxiety… which are prominent risk factors for the onset and maintenance of addiction”
Rachel Rabin’s research program focuses on developing a better understanding of the neurocognitive and social cognitive dysfunction in individuals with substance use disorders in both psychiatric (e.g., schizophrenia) and non-psychiatric populations.

The COVID-19 pandemic is a time of increased anxiety, uncertainty and loneliness for many. For people dealing with substance abuse issues, the challenges presented by the pandemic can exacerbate their addiction.

Rachel Rabin, an Assistant Professor in the Department of Psychiatry and a researcher at the Douglas Research Centre, is an expert on addiction. In this Q&A, Rabin discusses coping with addiction during these trying times. Rabin is funded by Healthy Brains, Healthy Lives through the New Recruit Start-Up Supplements program.

How is COVID-19 impacting people with an addiction?

The COVID-19 pandemic is a challenging time for everyone. This new normal, and all the uncertainty that comes with it may elicit feelings of stress, depression, loneliness, anger and anxiety. These emotional states are concerning given that they are prominent risk factors for the onset and maintenance of addiction.

Addiction is defined as a chronically relapsing disorder characterized by compulsive drug-seeking and drug-taking despite harmful and even catastrophic consequences. Unfortunately, for individuals who have achieved long-term sobriety, the likelihood of relapsing during this crisis may be exacerbated due to uprooted routines, social isolation, and the lack of access to their habitual treatment practices (e.g., much of their care is currently done virtually if at all).

In addition, there is evidence that individuals with addiction may be “wired” to respond to stress differently than non-addicted individuals which may reflect altered neural circuitry in the frontal lobe and brain reward pathways.1 This dysfunction can contribute to enhanced sensitivity and heightened reactivity to emotional distress, particularly stress that is unpredictable and uncontrollable. These aberrant stress responses can function as conditioned stimuli eliciting strong cravings which can ultimately culminate in a relapse.

How does having an addiction impact the severity of COVID-19?

COVID-19 clearly does not affect all individuals to the same degree. Based on currently available information, older adults and people of any age with serious underlying medical conditions might be at greater risk for more severe complications associated with COVID-19.

For example, co-occurring conditions, including chronic obstructive pulmonary disease, diabetes, hypertension, and other respiratory diseases have been found to worsen COVID-19 prognosis.2 Thus, COVID-19 could pose an exceptionally serious risk to subpopulations of substance users, such as tobacco and cannabis smokers as well as those who smoke crack cocaine or methamphetamine, who may have compromised pulmonary functioning.

Opioids, such as heroin, pose another risk. This class of drugs acts in the brainstem to slow breathing, leading to lower levels of oxygen in the blood. This in combination with the reduced lung capacity common with COVID-19 is a potentially fatal combination.

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The opinions expressed in this post are those of the authors. They do not purport to reflect the opinions or views of the FASD Prevention Conversation Project, its stakeholders, or funders.

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