In America today, almost 20 million adults suffer from addiction of some form. Now with our country and world under lock down, data is revealing that alcohol and other addictive substance sales are rising. Anecdotal data from addiction coaches regarding relapse and how at-risk individuals are dealing with stress related to social isolation and the pandemic is alerting Substance Use Disorder (SUD) programs of the urgent need to help their patients. 

Addiction is a disease of isolation and recovery programs are feeling the strain of not being able to directly connect with their program members more than ever. In fact, the “Disaster Distress Helpline” at the Substance Abuse and Mental Health Services Administration (SAMHSA) saw an 891% increase in call volume compared to March 2019, according to a spokesman for the agency, which was directly related to the pandemic. As SUD programs begin their transition to virtual care to address urgent need, they must also consider related conditions and how their patients can report on their overall health and wellness. For example, the majority of SUD patients have history of mental health issues such as anxiety and depression and over 50% of SUD patients have a chronic underlying condition- making them more susceptible to COVID-19 infection and complications, due to compromised immune systems.

To help identify the factors patients should be reporting on and the dimensions that impact vulnerable populations like SUD patients, we must first understand the multiple levels leading to relapse. These eight wellness dimensions are as follows:

1. Environmental: Alone at home and no human face-to-face contact. This drives them back to their memories and an environment which led them to SUD in the first place.
2. Financial: Employment issues given economic downtown heading towards recession.
3. Occupational: Healthcare workers, grocery people, drivers and more are under more pressure and stress than ever, a major mental health risk factor.
4. Social: Isolation means no human contact which often leads to high rates of depression.
5. Physical Health: Gyms and community centers are closed preventing some from access to exercise.
6. Emotional: Phone, video and text can only get you so far.
7. Intellectual: Some SUD program members are forced to work from home or not able to work at all because of COVID-19 preventing some from realizing full intellectual capabilities.
8. Spiritual: Churches, temples and places of worship are off limits. Independent practicing is can be tougher and not as engaging / uplifting.

While technology can help accommodate with some of those factors like meditation, motivational videos and podcasts, nothing is as ideal as in-person interaction and communication. Thus, leading them to strike-up old habits and seek alternatives to enhance their mood.

With new digital tools that can combining several core tenets of a SUD program into a single, easy-to-use tool, individuals are empowered with personalized guidance and clinically-validated addiction treatment resources at home. Subsequently, these offerings can provide health systems and addiction recovery clinics with the capabilities to take health services online. When SUD programs look to bring on a new tool to transition their programs online, they must consider a program that can incorporate:

• Health status check-ins to track patient progress through prompts to enter mood, symptoms, log medication side effects, and complete health journal entries.
• Medication guidance to help address their therapies for chronic conditions or other mental health issues to optimize medication treatment.
• Care network collaboration to connect individuals with their support system including family, sponsors, support group, and health providers.
• Sober timer to track sobriety date / time and celebrates key milestones.
• Wellness activities to intelligently prompt wellness activities in response to an individual’s current health status including readings, meditations, exercise, sponsor contact, etc.

Addiction treatment centers should work very closely with the tools they select and the community organizations and resources they offer. These comprehensive resources and digital tools whether to help with employment, isolation, or even food insecurity can help their program members stay on track with their mental health and sobriety.

As we move through this pandemic, government officials should continue to proactively monitor COVID-19 in parallel to the addiction epidemic in the US. These combined efforts can help draw awareness to SUD programs and patient needs for technology-enabled care models that are more commonly reimbursed for through virtual care and telehealth models.