LJ* began treatment for his addiction to sex and drugs in 2017, with an eight-week stint in a residential drug treatment program in Georgia. Prior to a trial return visit back home to Ann Arbor, LJ was given his phone back. "The minute I got my phone, I found a way to get drugs," he says. LJ missed his flight back to Michigan, and he was later admitted to a psychiatric hospital. After several stays in hospitals, treatment programs, and transitional housing, he was finally ready to continue his recovery at home. All in all, he had been gone about eight months.

In the years since, LJ was doing well with his recovery. He regularly attended support group meetings and volunteered to drive other men to and from meetings. And he had regular therapy sessions with Wendy Yallop, a social worker with U-M Addiction Treatment Services (UMATS), and Richard Boggs, a certified sex addiction therapist at Kenneth Adams & Associates. He had been working with Yallop since the beginning of his recovery journey, when she helped him get into the Georgia facility. LJ began his therapy with Boggs when he returned to Michigan.

Then came COVID-19, and LJ's therapy and meetings went online. "For a lot of people who have been in recovery for drug and alcohol problems, the onset of COVID-19 was really unsettling," says Mark Ilgen, Ph.D., professor of psychiatry and director of UMATS. "There are people who felt less stable in their recovery and some who relapsed," he says. "Their whole support system changed overnight." For people who were used to relying on in-person support groups, Ilgen says the initial switch to virtual meetings may have had a negative effect on their recovery.

LJ attended virtual meetings at the beginning of the pandemic, but he didn't find the same sense of connection he found with in-person meetings. "When you go to a meeting, you sit around a table and you get to know people," he says. "With the Zoom meetings, at first I was like, 'I'm going to be on this. I'm going to make this work for me.'" But as time went on, he struggled to stay engaged. "I was drifting from it. I wasn't sharing. I was just sitting there. I'd click down the screen and start shopping on Amazon."

LJ also suffered from the loss of his service work driving other men to and from support group meetings. "You're in the car, and you're talking about recovery or your struggles. It's kind of the meeting before the meeting and the meeting after the meeting." It was also LJ's way to give back to the community that helped him so much through the initial stages of his recovery. "When I went to rehab, all the people were giving to me — the counselors, the other patients," he says. "Service work is giving back to anyone in addiction."  

On top of these losses, LJ was also disappointed at having to cancel a summer trip to Italy with his partner. The couple also missed out on Detroit Symphony Orchestra concerts and a chance to see the musical "Dear Evan Hansen." Having something to look forward to had been an important part of LJ's recovery.

In April, "I started looking at things on my computer that I shouldn't be looking at. I started lying again," he says. The dishonesty was a symptom of his addiction rearing its head again. "Lying is one thing addicts do really well. We want to show, 'I'm fine. I'm OK. And I'm able to handle all these things by myself.'" But LJ was not fine. In June, he relapsed.

LJ was not alone in his struggles. Drug and alcohol use has been on the rise since the beginning of the pandemic. "Like everything else, COVID-19 has upended the ways in which people use substances and also the problems that they experience related to substances," says Ilgen. He cites the recent finding that opioid-related overdose deaths have increased substantially since the onset of COVID-19. "That probably reflects two different things," says Ilgen, "one being the increase in use and two, the fact that people are using alone. They might have fewer people around to rescue them, and their isolation may be, in and of itself, part of the problem."

Reinventing Recovery

LJ has been able to get sober again since June, but the work he's done to get there looks very different from previous phases of his recovery. He says Yallop has helped him "reinvent recovery" so that it makes sense in the age of COVID-19.

"As we all settle into the reality of COVID-19 lasting months on end … people are figuring out how to better rely on other resources," such as online meetings, says Ilgen. "Those may become more effective as people establish a new normal."

That has been true for LJ, who is now leading an online support group meeting on Wednesdays. He has certain rules and rituals that help him stay focused and connected, so that he can get some of the same benefits as in-person meetings. "I take my phone out of the room and put on meditation music in the background."

Part of LJ's new normal also includes an in-person meeting, which he hosts on Saturdays in his backyard. The group is about a half dozen people who stay socially distanced the whole time. In anticipation of winter, LJ has created an "impromptu fire pit" to keep the group warm.

LJ also volunteers two days a week at the Humane Society. "When you're doing that service work, you get out of your head. You're not thinking, 'Am I going to do drugs today?'"

Along with finding new ways to give back and stay connected, LJ, with help from Yallop and a couple of his friends in recovery, has come up with a list of strategies any addict can use to reinvent their recovery during the pandemic. Some of the strategies include listening to meditation music, finding safe ways to meet with others outdoors and socially distanced, practicing mindfulness and gratitude, reciting positive affirmations, travelling virtually (by watching travel shows or documentaries), getting activity outdoors, and connecting with nature.

Another strategy that has helped LJ is getting a marker board to keep track of his daily schedule. The marker board idea is one that Yallop had been suggesting for a while, but LJ's recovery reinvention motivated him finally to give it a try. He's also found activities to look forward to. He and his partner went to a drive-in movie, and they have plans to do an online meetup with friends who live in Toledo. "We're all going to have our dinners in front of us. We're going to have a zoom dinner."

With the help of his partner, his friends in recovery, and Yallop, LJ is taking good care of himself and staying sober. LJ is a health care professional, and he wants anyone in addiction, but particularly health care professionals, to know, "You don't have to be alone. You can get help." LJ recommends the Health Professional Recovery Program (HPRP), which helps monitor his recovery plan, making sure he attends meetings and therapy sessions and gets regular drug screenings. UMATS also offers specialized treatment programs for health care professionals, with an added emphasis on the challenges faced by treatment providers.

Although the pandemic has made addiction recovery harder for a lot of people, there may be a few silver linings. Ilgen says some addiction-related problems may have even improved during COVID-19. For example, driving while impaired likely decreased when people stopped going out to bars and restaurants. And although some patients have struggled with relapses, Ilgen says the pandemic has motivated other patients to "rise to the occasion and really invest in their recovery."

LJ is the rare person who is in both camps. Like LJ, some people in recovery have even worked to reach out to others who are in need of support. "As many examples of this being a negative, we have countless examples of people stepping up for themselves and loved ones, as well as for others," says Ilgen.

For anyone struggling with substance use, the University of Michigan Addiction Center offers many online resources, including links to online meetings, 24/7 crisis helplines, and more.

*Name has been changed