For young adults experiencing substance use disorder, the pandemic proves particularly challenging

After getting her wisdom teeth extracted at the age of 17, Ohio native Tracey Helton Mitchell was given an opioid prescription that not only alleviated the pain from the removal but also provided relief from the depressive symptoms she had been experiencing.

“It wasn’t that I became addicted to [opiates] right away,” she explained to In The Know. “It was more like I liked the way that they made me feel and I bookmarked that experience.” 

But when her prescription ran out, Mitchell turned to heroin to chase a similar high and soon found herself in and out of jail. Homeless and with little money earned from the sex work she had been doing to support herself, she lived during a time when many of her friends around her similarly struggled with substance use disorder and overdosed, she said. 

“I really was starting to think like, ‘Is this what’s going to happen me?’” Mitchell recalled. “Like somebody is going to have to try to find my parents or my friends from my mugshots and tell them that I died from an overdose somewhere.” 

Now sober for 22 years and an addiction specialist, Mitchell sees a resurgence in substance use that eerily draws a comparison to a wave of opioid use in the 1990s. Much of it can be attributed to the the current pandemic, which has amplified the challenges facing those who are recovering from or experiencing substance use disorder. 

“I think substance abuse has gone through the roof,” Mitchell, whose experience with addiction was documented in the 1999 film “Black Tar Heroin: The Dark End of the Street,” said. “At the beginning of the pandemic, especially alcohol abuse was very widely embraced.” 

In fact, 40 percent of U.S. adults said they were struggling with their mental health or substance use by late June, according to the CDC. Thirteen percent of those who participated in the agency’s survey said they had specifically started or increased substance use amid the pandemic, while another 31 percent acknowledged experiencing anxiety and depression symptoms. Equally concerning is the fact that the percentage of respondents who reported having seriously considered suicide was “significantly higher” among those between the ages of 18 and 24, minority racial and ethnic groups, unpaid adult caregivers and essential workers compared to those who did not identify with any of those demographics. 

“In some cases, these individuals were already addicted pre-pandemic, and the pandemic has either exacerbated their addiction or merely made it come to surface,” Lin and Aaron Sternlicht, both of whom are New York City-based therapists and addiction specialists, said in a statement to In The Know. “Especially for the first few months of the pandemic from March to June when much of the United States was quarantined, family members who were stuck together for 24/7 may have recognized their loved ones’ substance abuse problem whereas, in the past, it may have been more difficult to recognize.”

Much of these issues have also come to light as a result of social isolation — a byproduct of government-imposed quarantines that have shut down schools, theaters, restaurants and other recreational areas where people tend to congregate. Among millennials and Gen Zers, the lack of social interaction can be harmful as they navigate adulthood, Gregory Lewis, an assistant professor at Indiana University, told NPR in a July interview. Those in their teens and early 20s need socialization for development — the more interaction they have with others, the more confidence they have in themselves, he said. 

The pandemic, however, has exacerbated the loneliness that many, mainly those already experiencing substance use disorder, feel, Dr. Steven Powell, the chief medical officer of telehealth company PursueCare, explained to In The Know. 

“Oddly enough, I’ve had more of my male patients — some of the male teens and adults or young adults — seem to struggle more than the females,” he said. “I’m not sure why that is, but I have definitely seen that, in puberty, you really start to see the world around you, connect with friends, go on dates, things of that nature. And so to not have the capacity to do what’s called ‘normal’ for everyone else is a problem for a lot of folks.”

While some experts argue that the pandemic has, in a sense, reduced risk factors for youth substance use by keeping young adults at home and away from their peers, it has also placed extra pressure on relatives to pay attention to signs of possible use. Furthermore, the Addiction Center points out that substance use can “damage family dynamics, erode trust and weaken communication.” Inevitably, family members take on “roles” — from working as a caregiver to becoming the family scapegoat — to compensate for those problems. 

Not only has the pandemic led to a spike in substance use, it’s also significantly affected the services that those in recovery have received. Most clinics and treatment centers have had to shift their resources online, thereby removing the in-person interaction that some patients — mostly those who are not tech-savvy or have limited access to the internet — might sorely need. The move has especially hurt those who are accustomed to the 12-step programs that commonly take place in live group settings. 

“The way that our fellowship works is that we sit in a room together and we talk to one another face to face,” Reagan Reed, executive director of the New York Intergroup Association of Alcoholics Anonymous, explained to The New Yorker in a March interview. “The meetings are the cornerstone and foundation of Alcoholics Anonymous, so removing them is going to have a really big impact on people’s ability to remain sober.”

Yet, at the same time, digital platforms like Loosid, a self-proclaimed “full-service sober app,” have been able to expand their reach and introduce new users to a wider network of healthcare providers and, even, potential partners. 

“Since the shelter-in-place happened, we had, in the first four-week period, a 1,970 percent increase in messages in the groups in hotlines,” Loosid’s CEO MJ Gottlieb told In The Know, while noting that most of the app’s highly engaged users are between the ages of 21 and 41. “We had a 620 percent increase in dating messages, which I, at first, thought was odd. But then I realized that people are not only missing connections, they’re also missing intimacy.”

Still, holes in services — chiefly those tailored to those in their teens and early 20s — remain. Because the pandemic has forced high schools and colleges to move their curricula (including recovery programs) online, some groups like Philadelphia-based community center Unity Recovery are still figuring out how to effectively serve those who are still coming of age and require a physical form of camaraderie.

“[We’re] trying a lot of different things, but I think [the lack of social interaction] is one of the big gaps that we still have for young adults that are in recovery,” Robert Ashford, the center’s executive director, said. “It makes the problem that much worse, like they’re going through an identity formation that’s troubled. It’s hard even in person when things are normal. I think it’s only greatly kind of exaggerated now, and, to be honest, I haven’t seen or found somebody that’s doing it really well.”

If you or someone you know is struggling with substance use disorder, consider the following resources and organizations:

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