This is a “pandemic within a pandemic,” according to addiction expert Tim Ryan, who’s watched the coronavirus outbreak exacerbate the preexistent opioid and mental health crises with devastating effect. Ryan, the star of A&E’s 2017 “Dope Man” special, is the founder of “A Man In Recovery Foundation,” which partners with Rehab.com. A former heroin addict, his mission is to assist others struggling with substance abuse.
In a Friday interview, Ryan explained how the stresses of isolation and financial trouble brought on by the pandemic are worsening addiction, both by pushing new users to abuse substances and making it more difficult for recovering addicts to stay sober. Rehab facilities are struggling to cope with the challenges of a viral outbreak, according to Ryan, who also said alcohol and fentanyl abuse seem to be especially prevalent as the nation stays home.
“What’s happening is people need purpose, they need connection, they need fellowship,” he told me. “Now they’re all alone.”
Ryan also shared compelling advice for concerned loved ones and anyone personally struggling to stay sober during this painful and unusual time. A transcript of our conversation, lightly edited for clarity, is below.
Emily Jashinsky: How are we seeing the impacts of quarantine on substance abuse? What have you noticed?
Tim Ryan: What people don’t understand—maybe they do because it was always in the news—we had a pandemic with the opiates and mental health prior to COVID. So what we really have now is a pandemic within a pandemic. And relapses are through the roof, overdoses are through the roof, calls to the mental health hotline are up 800 percent.
Whether someone was newly sober, three months, six months, nine months, a year, they need purpose and connection. They need their fellowship. And take the person that’s coming up on 90 days sober. They can’t go to a 12-step based meeting, they can’t get a 90-day coin. So a lot of people—on top of the instability of the market, the financial crisis—they might have lost a job, they’re waiting on PPP funds. People are full of anxiety and panic and this epidemic is getting much, much worse.
EJ: Have you experienced that the pandemic is pushing people towards addiction who haven’t struggled with it before?
TR: It’s pushing people towards it, because what’s happening is, take the husband or wife or the twenty-some-year-old that would get home from work, maybe have a few drinks. Well, now they’re isolating at home, working through Zoom, starting to drink at three o’clock, starting to drink at one, starting to drink at ten in the morning. People are self-medicating due to the quarantine. And they’re drinking more, and abusing more, and relapses are through the roof right now.
EJ: What is it about the circumstances of being isolated in a home or in an apartment that can push people towards substance abuse?
TR: So what’s happening is people need purpose, they need connection, they need fellowship. Now they’re all alone. Even the people that are crossing that line now, they don’t realize. And what happens is people aren’t saying anything. You know, you see people, “Hey, it’s a Friday night drinking party. Let’s have a Zoom drinking party.” And people are embracing this. I mean, alcohol sales are up 250 percent.
But what else it’s fueling is domestic violence, child abuse, neglect, suicide, because people are in so much panic they don’t know how to put up their hand and ask for help if they’re crossing that line. Their family members need to be cognizant of it and reach out for help.
EJ: What can people look out for, especially if they’re maybe not able to go check-in in person? What signs can people look out for to know whether they should be concerned about a loved one?
TR: So if they’re isolating, if they’re not showering, if they’re sleeping half the morning away, if they don’t have any routine. Then obviously, if they drank alcohol, if they’re drinking more and drinking earlier in the day. If they’re getting prescriptions for anti-anxiety medication, Valium, Xanax. Those are up to 28 percent.
I just talked to another family yesterday. The mother called for us to do an intervention with her 31-year-old son who was drinking and doing a lot of cocaine. But then she says, “Well, my husband
is 30 years sober but he’s taken 60 Vicodin every two weeks. I said, “Your husband isn’t sober. Your husband’s a full-blown opiate addict.” I said, “he’s taking 60 Vicodin every two weeks.” And she said, “Well, he had an injury a year ago, but he’s fine.” I said “No, I probably need to put your husband and your son into treatment.”
It’s easier for people to self-medicate but you got to be aware of the signs. What happens is people don’t know what to do, because a lot of people think treatment centers aren’t open. They don’t realize that treatment centers are open.
That’s why we’re partnered with rehab.com because literally, anybody can go to rehab.com, fill out a 30-second questionnaire: Is this for you, or a loved one? Alcoholism, drugs, mental health? Do you have Medicare, Medicaid, insurance, cash pay, or no insurance? And instantly it will give you at least three resources that you can call and get into treatment. People don’t know what’s available.
EJ: How are rehab facilities coping with keeping their patients safe and bringing new people in who maybe haven’t had perfect isolation records the past couple of weeks? How are the facilities handling it?
TR: You have basically three types of facilities. You have the ones that take indigent people, you have the state-funded facilities, and then you have the facilities that take in-network or network insurance, the for profit centers. Those centers were able to get ahead of the curve, get proper COVID testing in place. They’re testing clients, they’re doing much more thorough biopsychosocial assessment, they’re having to test to people prior to walking into the center.
But God forbid someone’s in and they show signs, they have a full detox or a wing that they can isolate the people in for two weeks. But a lot of the state-funded programs or free programs just don’t have the financial backing.
I can tell you of two in the Chicago area that have had to shut their doors. A bunch of the staff members got sick, they’re not in the financial positions to hire new people right now, so they’re not taking any clients. Another one of the big providers that takes state insurance and no insurance had four deaths within their facility. So a lot of people that don’t have resources are having a much harder time trying to get into treatment,
EJ: So not only is this existing epidemic already compounded by the circumstances of people having to isolate and quarantine but on top of that, it’s compounded by the issue of rehab centers struggling financially to care for them.
TR: Right and then here’s the thing, a lot of people don’t know what’s available out there. Rehab.com, we have 35,000 licensed providers, so you can go by state, you can search, mental health, trauma, substance abuse and find what fits your needs. But that’s where people need to take the initiative to make the phone calls and do their due diligence.
I had a family last night, the lady messages me at midnight and says, “I brought my daughter to this program, she’s standing in the lobby in downtown Chicago.” I said, “Ma’am, I told you, you have to call first, do a phone assessment, and make sure they have a bed available, you can’t just drive there and walk in.” She’s like, “Oh I forgot about that.” She drove two-and-a-half hours. And she’s like, “What do I do?” I said you could possibly take your daughter to one of these hospitals where you’re gonna have to wait till tomorrow morning and hope to get a bed. That’s what’s happened.
We have people that want help, and they can’t get it. And a lot of people are losing insurance and losing their jobs and can’t afford to get into treatment now.
EJ: Are people having a harder time getting certain drugs?
TR: No. Drugs are everywhere. Drug dealers will deliver. That’s one thing that doesn’t stop, and what they need to understand is drugs have been around forever, they’re not going away. And I think a lot of the cartels have looked at this as an opportunity to get more drugs across the border.
There’s a ton of fentanyl, heroin, crystal methamphetamine, and prescription pills. They’re everywhere, but you can also get on the dark web, you can order it off the internet. Drug dealers will deliver to your house, but most people are accidental drug dealers at home because I can walk in the neighbor’s house and go in their bathroom and they’ve got a bottle of Xanax or they’ve got a bottle Oxycontin. A lot of people have it sitting right in their cabinet, and they don’t have it in a lock box.
EJ: Have you noticed that there’s one particular substance that’s causing more problems than usual right now or is it just the same stuff?
TR: Alcohol is really through the roof because it’s legal, and fentanyl, because fentanyl can be mixed in with pills and people think they’re buying a bar of Xanax—well, it’s crushed fentanyl or mixed with fentanyl. It’ll kill you. Take Naperville, DuPage County [Ill.]. In the past three weeks they’ve had 20 overdose deaths in three weeks. Three weeks. The coroner, Mr. Jorgensen, is overwhelmed.
Then you’re having to deal with the COVID deaths. In the past week alone we’ve probably received upwards of 300 phone calls with people looking for help. That’s to my personal cell phone. You take rehab.com—our website traffic is up 382 percent in the past 30 days with people looking for treatment for either substance abuse or mental health.
Now you look at the paramedics all the first responders, the hospital workers. These people are experiencing so much trauma and PTSD that a lot of these people are going to need help once this is all over. And a lot of our veterans—these things, the isolation, they can’t go to their weekly groups—it’s bringing up their PTSD and there’s a high level of relapse not just with veterans but with people across the globe.
I talked to another friend of mine in Indiana who’s got about a 100-bed treatment center and I said, “How are things going?” He said, “I’ve had to deal with three AMA’s today.” That’s where people are trying to check out against medical advice because they’re they’re fearful of COVID.
EJ: What is it about being able to meet in person at a support group that can’t be replicated virtually?
TR: You know, I’m seven-and-a-half years sober. My wife Jennifer is 14-years-plus sober. We work together, we speak together, we do interventions. We have a solid foundation. And we’re doing Zoom meetings, and we’re speaking on them. But there’s something different from walking in and as I call it, being able to be with your tribe, the people that have watched you through this journey from day one, and been there.
Yeah, we can pick up the phone and FaceTime and call, but when you’re able to walk into a meeting and there’s 200 people there, it’s a difference versus having to do it through Zoom. And, yes, it works, but I know people now in Florida, in California, and some of the areas that are getting warmer now, they’re having meetings in their backyard, having 30 or 40 people and setting up chairs six feet apart. Twelve-step-based meetings, Christian-based meetings, these should be should be essential.
EJ: I’m curious because we saw all of these trends starting to worsen before the virus hit. It’s showing up in data, there’s an epidemic of loneliness and isolation. How do those things work together with the opioid epidemic and substance abuse?
TR: What people have to understand is most people that struggle with alcoholism or drug addiction have an underlying mental health issue. About 75 percent of the people have mental health issues. And when I say mental health, it could be depression, it could be panic, it could be anxiety, it could be bipolar and borderline personality. But, those are all forms of mental health.
Then you have the underlining trauma, which can be emotional loss, mental, spiritual, physical, or sexual. And if people aren’t having to have all these worked on, they’re getting deeper in depression, they’re getting more anxious. And what do you do? Addicts are creatures of habit, we numb the pain. So we start self medicating, just to try to get through the day.
EJ: How can people prevent it if they’re in quarantine and they feel this start to become an issue or they’re worried that will become an issue? What steps can they take?
TR: The greatest advice I can give anyone is, “You’re only as sick as your secrets.” So it’s okay to have that first thought or that second thought. But if you’re thinking of self-harming, or using, or drinking, pick up the phone and tell on yourself. Reach out. There’s online telehealth therapy, there’s people in recovery, there’s 800-numbers. If you need treatment, go to rehab.com and look for options. But ask for help. Put your hand up and ask for help.
But also the family members, loved ones, and friends. We’re all in this together, you, me, everybody. We’re all feeling this in some way, shape, or form and we’re trying to adapt to the new normal, whatever that is. But take the time to check in on your friends: “Are you doing okay? And don’t tell me you’re great.” Because I always said I was great. Get people to be honest, and if they’re struggling, let’s find them the help we need to.