An Addiction Specialist Shares How to Manage Substance Use Urges During a Pandemic Winter

Feb 24, 2021
By Sarah Church, Ph.D.

To understand more about how the winter (and pandemic) can be so difficult for those who struggle with substance use or are in recovery, here are a few things you should know.

Why is the winter hard in general for those who struggle with substance use? There are a lot of factors that come into play that make winter hard for those who struggle with alcohol and substance use disorders (SUDs). During colder months, we’re less social, spending more time inside and we’re not exposed to the sunlight that our bodies need. This year, the typical effects of the winter months are aggravated by the pandemic. People aren’t getting out and having the positive social contacts they are used to. For the most part, people are staying home. For some that is isolating, and for others who are living in close quarters with family members, this may lead to conflict.

Additionally, some people are affected by seasonal affective disorder (SAD). When we are not exposed to enough sunlight, our moods can dip. So, if you have struggled with alcohol or drug use and are also experiencing low mood, add either isolation or conflictual relationships to the mix and you have a recipe for relapse. It’s really not surprising that some people in recovery eventually turn to alcohol or substances to try to lift their mood.

How is the pandemic affecting these typical winter issues?

The change to working from home during the pandemic has amplified the challenges that winter months normally pose for people in recovery. Regular routines are disrupted, and people often don’t leave the home for days on end, sometimes finding themselves waking up and working through the entire day. People can then lose the cadence of self-care that had been folded into their daily routine — the ritual of working out in the morning, having breakfast and taking medications, getting dressed and ready for work, going to a mutual support meeting, having a brisk walk to work, grabbing a coffee, these all dissolve into the monotony of one day sliding into another.

How can people who struggle with substance use cope with the extra stressors of winter and the pandemic?

Find a way to get some exercise every day and get your heart rate up. Whether it is doing yoga on YouTube, doing a bootcamp on a workout app, riding a stationary bike, even just doing pushups, squats and sit ups — exercising is critical to reduce cravings and maintaining your mood.

Maintain healthy routines and habits, especially when it comes to participating in treatment and recovery support and taking your medications. One thing that is easier now than ever is that most doctors and therapists have virtual appointments. And attending a mutual support group has never been easier as they are all online. You can attend most of your appointments right from your couch!

How can loved ones support those who struggle with substance use?

When it comes to supporting your loved one who struggles with alcohol or a substance use disorder, start by trying to think of fun activities to do together. Maybe it is listening to a podcast or maybe there is a show that you can look forward to watching every week together. You can cook something new together or take a walk after dinner every night or challenge one another to an online word game or a video game. The goal is to fill your lives with activities that are more reinforcing than alcohol or drug use.

In addition, offer to be somebody who will listen nonjudgmentally. Let your loved one know that you are there if they ever want to talk, even if they want to talk about wanting to use. It can be hard to hear that your loved one still thinks about using. But this is completely normal and to be expected, and it is important that they have a place to talk it through. Just because they are thinking about using, doesn’t mean that they will relapse, it just means that the thoughts are coming up. Having someone who calmly talks them through it is invaluable. You may want to be straightforward and say something simple like, “If you have cravings, you can talk to me about it.”

**What should you do if your loved one slips and uses alcohol or drugs? **

If your loved one slips, the best thing to do is to help them get back on track as soon as possible and don’t beat them up about it. There is a phenomenon called the abstinence violation effect that we want to avoid. The idea is that if they violate their abstinence by using, they feel so ashamed and helpless that they spiral into a place of self-doubt and shame in which they decide to give up entirely on recovery and slide into a full relapse.

One way to understand the abstinence violation effect is to think of dieting. Imagine you are on a diet, and you go into the break room at work and there is a birthday party celebration going on. You struggle for a minute but end up eating a big piece of cake. You might feel angry at yourself. You had vowed not to eat sweets, so you say to yourself, “I completely messed up, I’ll never lose weight!” When your colleagues go back to their offices, you say to yourself, “I’ve already blown it, no use even trying anymore.” And you end up eating the rest of that cake.

Instead, you can acknowledge the slip with a mindset of, “OK, I ate one slice, but I can’t let that get me down. Let me get back on track now.” This is the same with SUDs, if you have a lapse, you can use it as a learning opportunity to understand what happened and try to use that knowledge to prevent a slip in the future.

When you have slipped, this is a time to lean on your resources and your support system to help you as you continue in your recovery.

What do you most want those who are struggling with substance use to hear right now?

You are not alone. There are a lot of people who are struggling right now. People are feeling anxious, and they are feeling down. If you’ve struggled with SUD in the past and are having thoughts about using, that’s not unusual, but it is a clue that you need to boost your support systems for awhile. Think about what has been helpful in the past. Are you doing those things, or have they fallen by the wayside? Maybe it’s time to reach out to someone you trust to talk.

Treatment really works.

There is significant evidence behind therapies and medications that have been developed for SUD. You have choices! There are many ways to address your drinking or drug use. Some people are more comfortable with abstinence and mutual support groups, while others are more comfortable seeking medical and psychological treatment. Unfortunately, there is no cure for substance use disorders. They are chronic medical disorders much like hypertension and diabetes that need ongoing support and medical care. Right now, there is so much stress and anxiety due to the pandemic and these issues are exacerbated by the winter. Treat yourself with compassion if you are struggling and seek assistance.

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