COVID-19 and Substance Abuse

Beer bottle on dark tableAccording to the National Survey of Drug Use and Health, most adults use or have used at least one drug. More than 87% of adults over the age of 26 report using alcohol during their lives, with 51.2% using illegal drugs at least once. This puts a large number of people at risk of substance misuse, particularly amid the increased stress of a national pandemic like COVID-19.

People experiencing substance abuse issues may be facing unique challenges during COVID-19, such as not being able to easily access care. Regardless of your access to care, a number of strategies can help you stay safe while coping with addiction during a pandemic.

Risks for People With Substance Use Issues During COVID-19

The COVID-19 pandemic can present unique risks and challenges for people who are in recovery or currently misusing drugs and/or alcohol. Risks may include:

  • The temptation to use again or increase use: People who abuse drugs or alcohol often do so to cope with anxiety, depression, and other mental health issues, or to escape from boring, traumatic, or stressful circumstances. A global pandemic can trigger a wide range of emotional reactions. For people in recovery, the temptation to return to their addiction may be overwhelming. People with active drug or alcohol abuse issues may escalate their pattern of misuse.
  • Reduced access to healthcare. As COVID-19 impacts more people, healthcare resources may grow strained. Hospital emergency rooms may be full, subjecting patients to long waits or inadequate care. The comprehensive evaluation and support people with serious addictions need may become harder to access in some places. This may also mean that going to rehab or getting access to detox is limited at this time.
  • Exposure risks: Even when healthcare systems are not full, seeking care may increase the risk of being exposed to COVID-19. Seeking healthcare usually requires close contact with others, some of whom may be sick. Physiological cravings or symptoms of withdrawal may also induce some with substance abuse issues to leave the house despite stay-at-home recommendations in order to access alcohol or drugs, which may also increase their exposure risk.
  • Weakened immune system: Addiction to certain drugs may weaken the immune system. For example, some evidence suggests that opioids—the leading cause of drug overdose in the United States—may weaken the immune system. The painful physiological side effects of withdrawing from these and other drugs may elevate the risk of serious COVID-19 complications, especially in people who have other underlying medical conditions.

Withdrawal as a Health Issue

For people who abuse legal drugs, an overtaxed health system may limit access to those drugs. This can trigger serious physical symptoms of withdrawal. Concerns about dangerous detox symptoms have led some states to label liquor stores as essential businesses.

The realities of withdrawal, particularly during a pandemic, demonstrate that addiction is more than just a mental health issue. It has serious physical consequences. Suddenly withdrawing from the substances can cause a wide range of symptoms, ranging from chills and agitation to hallucinations and aggression.

People with addictions should talk to their health providers about the risks and benefits of withdrawing from drugs during a pandemic. While sobriety is a healthier long-term option, sudden withdrawal without access to medical care may be dangerous.

Managing Stress

Mental health diagnoses and substance abuse are closely related. People with substance use disorders are more likely to have co-occurring mental health issues. Likewise, mental health diagnoses such as depression and anxiety increase the risk of abusing substances.

The COVID-19 pandemic has exposed millions of people to isolation, parenting stress, relationship challenges, and financial insecurity. Most people are worried about getting sick or about protecting loved ones from the virus. When a person’s stress overwhelms their coping skills, they are more likely to abuse substances, to relapse, or to increase their reliance on substances they already use.

Healthy strategies to help manage stress during the pandemic:

  • Connect to loved ones while maintaining safe social distances. Try scheduling a daily video call with a friend or family member.
  • Look for virtual addiction support groups. Many 12-step and other peer support programs have transitioned to an online model.
  • Maintain a regular, consistent schedule as much as possible. A lack of structure can make the pandemic feel more overwhelming, increasing the urge to abuse substances.
  • Practice self-care. Identify strategies that help you manage stress and depression. For many people, exercise, hobbies, and time with loved ones can ease psychological pain.
  • Ask for help. Tell loved ones if you are struggling.
  • Partner with another person to offer mutual support and accountability. You might schedule daily video calls with a sponsor or trusted friend.

Tips for Staying Safe

Whether you’re in recovery, actively struggling with addiction, or worried that your abuse of substances is edging near addiction, a few strategies may help lower your risk during the COVID-19 pandemic:

  • Ask a healthcare provider about the risks and benefits of quitting drugs or alcohol now. For some people, the safest option may be to delay sobriety until the pandemic is over.
  • If you plan to continue using, discuss harm reduction strategies with a health provider.
  • Consider telehealth options for non-emergency care needs. You may be able to participate in 12-step groups via video chat, meet with your therapist on a telemental health platform, or ask your doctor questions about withdrawal online.
  • Stay home to the greatest extent possible. If you must leave the house for medical care or any other reason, practice frequent hand washing and avoid close physical contact with others. If you are sick, call your doctor or other health provider before going in.
  • Shelter in place with someone you love and trust. Isolation can increase cravings, and will limit your access to help if you overdose or have another drug-related emergency.

Addiction is a serious health condition, not a personal or moral failing. Most people with substance abuse issues need extensive support to get and stay clean. The right therapist can help you deal with the stress of a global pandemic, while managing drug and alcohol cravings. Therapy can also help you communicate with loved ones about your addiction and reduce the harmful effects of substance abuse on your relationships. To find a compassionate, knowledgeable addiction counselor, click here.


  1. Eisenstein, T. K. (2019). The role of opioid receptors in immune system function. Frontiers in Immunology, 10. Retrieved from
  2. Langås, A.-M., Malt, U. F., & Opjordsmoen, S. (2011). Comorbid mental disorders in substance users from a single catchment area – a clinical study. BMC Psychiatry, 11(1). Retrieved from
  3. National survey of drug use and health. (n.d.). Retrieved from

© Copyright 2020 All rights reserved. Permission to publish granted by Zawn Villines

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