Pandemic could make addictions worse, health experts fear

Israel reports surge in online gambling and anti-anxiety medication use, US shows increase in alcohol sales.

An attendant demonstrates an online baccarat game on a smartphone at the Global Gaming Expo (G2E) Asia in Macau, China (photo credit: BOBBY YIP/ REUTERS)
An attendant demonstrates an online baccarat game on a smartphone at the Global Gaming Expo (G2E) Asia in Macau, China
(photo credit: BOBBY YIP/ REUTERS)
From alcohol consumption and substance abuse to online gambling and overeating, the COVID-19 crisis could fuel addictive tendencies and lead those with existing problems to deteriorate.
Dr. Ilan Tal, medical director and a senior psychiatrist at the Tel Aviv-based Dr. Tal Center for Psychiatry and Mental Health, told The Media Line that many people are more anxious and stressed than usual, putting them at greater risk of developing addictions.
“We try to regulate [negative] feelings by doing [certain] things,” Tal explained. “If we are used to doing that by drinking alcohol, eating, gambling, or by playing on the computer, now those behaviors will increase because our stress is higher than usual.”
According to Tal, in Israel, there has been a “steep increase” in online gambling but with regards to alcohol consumption, it is still too early to tell exactly what impact the outbreak has had.
Last month, Israeli firm Optimove reported a 225% surge over pre-coronavirus figures in the number of people who began to play poker online for the first time.
“We do know from patients that are still coming in and that have drinking problems that they are drinking more,” he noted. “Domestic violence has also been rising.”
In fact, Israel’s Ministry of Labor, Social Affairs and Social Services on Wednesday revealed that calls to its domestic abuse hotline have soared in the second half of April. During the first month of lockdown – from March 15 to April 15 – an average of eight people called the hotline on a daily basis. Now the number has reached 33 calls per day on average. For this reason, the ministry is launching a text messaging hotline and on Sunday will also open a new shelter aimed at accommodating female survivors of domestic violence.
Along with online gambling, sales of benzodiazepines, which are used to treat anxiety, have also risen in Israel.
“I know that in some pharmacies in Israel, some of these medications are already sold out,” Tal revealed. “It might be because people are using more medications to calm down, but I also assume that some people try to regulate their [feelings] with these [medications] and then they become more addictive.”
For those who may be struggling to cope with addictions during this period, Tal recommends decreasing negative habits “very gradually” and trying to maintain them at a stable level. He also stresses that it is important for family and friends of someone who is using to refrain from using accusatory or overly negative language.
“Each gain is something that you should praise yourself about,” he related. “When you fall down or do something that you did not intend to do then focus on not blaming yourself. ... It has to be something that you can really do and not a goal that you can’t achieve. You want to be at least partly successful.”
While social distancing and lockdowns can exacerbate feelings of loneliness and anxiety, for those who have already undergone treatment and reached sobriety before the outbreak began there might be a silver lining.
“[People with substance use issues] have a lot more time to focus on themselves and really get serious about the work,” Eric Levitz, Director of AZ House, a free Jerusalem-based rehab center for men, told The Media Line. “They don’t have to worry about their jobs and different social triggers because they [have been] left with a lot of time.”
Nevertheless, he added, “the issue is for people that are trying to get clean and who have not successfully started: The ones that are days away from their last use or just stopped right now.”
Levitz underlined that lockdowns make it more difficult for those who need help or who are already on the road to recovery to access fellowships and other 12-step programs. To address this problem, AZ House has set up special coronavirus hotlines, Zoom meetings, and is also offering free educational videos. They have also made staff members available to those in need around the clock.
“I think that most of the people who are new might be getting worse but I don’t think [the pandemic] is causing a spike in addiction,” Levitz noted. “Money just ran out for a lot of people. You can’t go out in the streets. Begging for money is one source of income for addicts and alcoholics; robbing people, conning them and manipulating people.
“Everyone is watching their pocket and staying at home,” he continued. “It got a lot harder to be a drug addict with nothing and no money; so a lot of people probably switched to alcohol.”

US Alcohol Sales Rise
While the impact of the coronavirus on drug and alcohol consumption in Israel remains to be seen, reports in the United States are already showcasing a drastic increase in alcohol sales.
According to Nielsen, the sale of off-trade spirits rose 27.4% in the week ending on April 18 when compared to the same period last year. Overall, off-trade alcohol sales went up 15.9% during that week. In the same report, and based on a survey of more than 10,000 drinkers, Nielsen revealed that 17% of those polled admitted to stocking up on more alcoholic beverages than in previous periods, while 41% said they were not stocking up.
Furthermore, from March to April 18, total alcohol sales in the US rose by 24.4% over the previous year, with spirits and wines making up the majority of sales.
Despite these figures, Dr. George F. Koob director of the National Institute on Alcohol Abuse and Alcoholism told The Media Line that at the moment there is “limited data” regarding changes in alcohol consumption.
“We know from previous disasters, including 9/11 and hurricane Katrina, that per capita alcohol consumption tends to increase during such events, so we suspect alcohol use is higher than before the virus spread,” Koob said. “It is not yet clear how many people are drinking more versus stockpiling for the emergency.”
Among the factors leading to increased alcohol consumption, Koob lists negative feelings such as anxiety, low mood and irritability.
“Alcohol consumption tends to increase in times of duress and uncertainty as people struggle to cope,” he explained. “More people drink and those who drink do so more heavily, during and after such events.”
Those struggling with depression, anxiety, post-traumatic stress disorder and other psychiatric conditions are more than twice as likely as others to develop alcohol disorders, he said, which is why it is important for them to try tele-therapy or to join an online mutual support group. The NIAAA website lists several options for remote help.
“It is important that these folks receive the support they need to help them navigate through this difficult situation without turning to alcohol,” Koob noted. “This is also a very risky time for people currently in recovery from an alcohol use disorder. Stress is a common trigger for relapse.”
Maintaining adequate sleep schedules, exercising, proper nutrition and positive interactions with family and peers are all good ways to cope with the stress of the pandemic, he advised.
As in Israel, reports show more and more Americans are using prescription anti-anxiety medications. A report published earlier this month by Express Scripts, a US-based pharmacy benefit management organization, showed a 34% rise in prescriptions for such medications between mid-February to mid-March.
“This is a challenging time for everyone,” Koob stressed, adding that while online interactions may not provide the same satisfaction as face-to-face meetings, they are nevertheless an important way to maintain contact with people during times of social distancing.
“We humans are social animals and feeling disconnected socially can worsen symptoms of anxiety or depression and lead to an escalation of alcohol and other substance use,” he concluded.
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