Telling my counsellor about the leftover bottle of Jack Daniels whiskey that’s been sitting in my kitchen since the Christmas before I stopped using – and my ever-increasing desire to drink it – felt petty in the face of a global pandemic.
Being relegated by social distancing measures to telehealth therapy on the computer in my bedroom, I was too worried that my wife might hear me admit my weakness anyway. Besides, having struggled with drugs and alcohol for most of my adult life, I know how these things go.
My therapist would ask me if I have a plan. I did – I planned to drink.
Three weeks ago, my sobriety felt like a foregone conclusion as it had, for the most part, for the three years since that last bag of designer speed I bought online during the Easter weekend of 2017. Each Monday over the last 36 months at 10 o’clock, I’d attend individual therapy sessions at the neighbourhood community behavioural health centre here in Philadelphia and discuss the various traumas that fuelled my drug use.
Once a month, I’d trade a clean urine sample for a script of Suboxone, an opioid replacement therapy made up of buprenorphine and naloxone that, with a reported effectiveness of over 50%, makes it a frontline tool in the current overdose crisis. Unfortunately, it’s not used nearly enough, as medication-assisted therapy ― the umbrella term under which Suboxone falls ― is considered by many, wrongly, to be trading one drug for another. For myself, however, it’s a lifesaving drug that gives me the freedom to work on those traumas.
My routine was built on conversation, social contact, and even a few handshakes and high-fives. I hadn’t beaten my demons, but they weren’t keeping me awake all night, either.
But in the six feet we’ve kept from others since the start of this crisis, those demons have found room to breathe. The coronavirus, and the social distancing measures necessary to keep it at bay, have threatened my sobriety, along with many others like me. Separated from my traditional social support structures, I feel alone, isolated, and anxious.
And I can’t stop thinking about that leftover bottle of Jack Daniels.
“Sobriety is fragile, and much like the soft fabric of society, it can come undone under the weight of disease or trauma.”
Sobriety is fragile, and much like the soft fabric of society, it can come undone under the weight of disease or trauma. Sometimes, it takes much less for things to fall apart.
A year-and-a-half ago, I was a-year-and-a-half into my sobriety when I almost lost it for no reason at all. I started to hide money from my wife, was agitated with my kids, and became more socially distant. My plan was simple – I was going to buy drugs and numb the pain.
But first, I went to my weekly appointment with my counsellor. We talked about literature and basketball and the stupid things Donald Trump did that week. And I told her about my plan.
People who can afford fancy rehabs with equine therapy and $100-per-hour therapists who are always on call have the privilege of adjusting their medications on an as-needed basis. Those of us on Medicaid, however, have to funnel through the system. Although I would be unable to see my doctor for another three weeks, contact with my therapist at an in-person appointment saved my life.
I promised to put my plan on hold and shook her hand in agreement. Covid-19 has changed that dynamic, for me, and so many others who struggle with addiction.
In some ways, the coronavirus pandemic has exposed the fault lines in the treatment-industrial complex, bringing to the forefront the stigmas and biases inherent in the system. Over the past few weeks, the government bureaucracy that strangles addiction treatment, including the Department of Health and Human Services and the Drug Enforcement Administration, has lowered the barriers to entry. They’ve made telehealth more accessible, allowing the system to connect with more people who need help, and suspended the laws around buprenorphine —the lifesaving opioid addiction medication — allowing patients to receive a prescription without having to see a physician in person.
Many people have rightly questioned why this hadn’t been done earlier, especially in the face of another pandemic that’s taken hundreds of thousands of lives over the past few years ― the overdose crisis.
Conversely, COVID-19 is forcing a multitude of vulnerable people to face their addictions head-on without the built-in support systems they would otherwise have in a pandemic-free world. Many states, including the commonwealth of Pennsylvania, where I live, have closed down all liquor stores in response to the virus, an act which runs the risk of sending thousands of people with alcohol use disorder into immediate withdrawal. Delirium tremens, or DTs, can occur, resulting in shaking, irregular heartbeat, high body temperature, and death.
Many doctors still require buprenorphine patients, along with other opioid-dependent people, to come into the office for their monthly scripts, despite new coronavirus guidelines from the government bureaucracy. In some instances, people struggling with drugs and alcohol have to choose between breaking quarantine and maintaining their sobriety. Worse still, there have been reports of patients on methadone, another opioid replacement therapy that requires once-a-day office visits, crowded into long lines to wait for their daily dose.
And telehealth, too, builds as many barriers as it breaks down. As one friend who’s also a psychologist told me recently, she’s seen fewer patients since the start of this crisis. People with unstable living situations don’t have the freedom to speak freely in their homes, she said. Sometimes a counselling appointment is their only refuge.
“My home life is far from unstable, and in many ways, I’m luckier than most, but in the face of a global pandemic, my demons started touching my face.”
My home life is far from unstable, and in many ways, I’m luckier than most. But in the face of a global pandemic, my demons started touching my face.
Three weeks ago, I was three years into my sobriety, and everything felt like it was going alright. My wife and I were debating whether to send our kids to school, as the school district had yet to close down at that time. In the heat of our disagreement, I began to feel socially distant. It’s silly and stupid, and precisely the type of thing that might trigger a relapse.
By the following week, my counsellor had canceled our appointment. The schools had officially closed, and she had to stay home to care for her kid. We couldn’t talk about anything – not literature or basketball, or whether I had developed a plan.
I started to feel ashamed of myself.
As the week went on, the pressure of our new homebound life grew. My wife and I had to figure out how to home school our kids and convince her aging parents not to leave the house. As a freelance writer, I dealt with increasing rejection in a marketplace that now only wanted stories about the growing global pandemic. There was no one to call to adjust my meds.
Even my Suboxone doctor added to my anxiety, as contrary to new federal regulations, I learned that I would have to break my quarantine and visit his office to receive my next script. To treat my addiction, I have to provide a urine sample in a public restroom at a doctor’s office during a global pandemic to prove that I deserve my medication.
At the height of my drug use, I was a horrible father and a terrible husband. I lied and cheated and stole and almost broke my family’s world. Sure, I have trauma or, depending on your school of thought, suffer from a disease, but I’m not about to risk letting my wife think that will all happen again by inadvertently announcing it on a telehealth appointment.
COVID-19 and the social distancing measures that it has forced have fast changed the world. Like sobriety itself, it can all fall apart for those unprepared. For 20 years I filled the space between the people I pushed away with a bottle, used the pills I took as a mask, and quarantined myself within lines of cocaine and speed. I didn’t ask for help because I was afraid of what I would find within myself.
Now that I’m being asked to retreat back inward, I’m worried that I won’t be able to break out once this is over. Right now, all I have is today. And today I am not going to drink or use drugs, even in the face of a global pandemic.
But man, I’m thinking about that bottle of Jack Daniels Honey Whiskey that’s been sitting in my kitchen.
Brandon A. Dorfman is a freelance journalist. This article first appeared on HuffPost US Personal.
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