Essential Workers at Increased Risk for Addiction Due to Pandemic Fallout

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Contributor: Staff at Timberline Knolls Residential Treatment Center

Aside from the potential effects of the coronavirus itself, the COVID-19 pandemic has led to a spike in the use of substances such as alcohol and opioids. Alcohol sales were up 350% in September 2020 compared with the same time a year earlier, and many of the people most at risk for abusing alcohol were the roughly 15 million Americans who already suffered from alcohol use disorder [1].

The Centers for Disease Control and Prevention (CDC) found that 13% of Americans reported starting or increasing substance use as a way of coping with pandemic-related stress [2]. The American Medical Association said in December that 40 U.S. states saw an increase in opioid-related mortality [3].

There’s one broad, important subset of the population that has been at increased risk for addiction during the pandemic. It’s those who put themselves in the most danger to care for others as COVID-19 has ravaged America.

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Why Essential Workers Are at Greater Risk

Healthcare workers and others on the front lines during the pandemic have faced a higher risk for infection as they have treated cases of COVID-19. Many nurses, doctors, and long-term care specialists spent at least some time over the past year isolating themselves from their own families to avoid bringing their increased risk home.

But as the trauma of seeing so many impossible situations plays out — family members saying goodbye to infected loved ones via Zoom or deciding which patients should be placed on a facility’s dwindling number of ventilators, to name a couple — these essential workers have also been at a greater risk for substance abuse due to higher rates of stress than the general population.

Researchers Dean McKay and Gordon J.G. Asmundson recently developed a tool called the COVID Stress Scales, which categorizes stressors from the pandemic into five areas [4]:

  • Danger and contamination fear
  • Social and economic stress
  • Traumatic stress symptoms
  • Checking and reassurance-seeking behavior
  • Xenophobia

These five factors form what this research team has dubbed COVID Stress Syndrome, a way to measure potential increased substance use and abuse risk. The factors that affect the general population can be compounded in essential workers, putting them at especially high risk for addiction.

One previous study on substance use in healthcare professionals estimated that 10%-15% of healthcare professionals would misuse drugs or alcohol at some point during their career [5]. That number is on the rise during the pandemic, according to addiction specialist Dr. Michael McCormick, the medical director of the Healthcare Professional Unit at Caron Treatment Center.

“We really began to see it probably in April or May, and it’s continued since then, and it’s actually recently been much worse over the last three months,” McCormick told NewsNation Now in February [6]. “So, it affects them in a number of ways. One is, of course, increased substance use, whether it’s alcohol or drugs, but it’s also affecting them from anxiety, a depression standpoint.”

The Factors Most Likely to Affect Essential Workers

Each of the five factors in the COVID Stress Scales can impact healthcare workers and others on the front lines in terms of stress level and corresponding substance use, but a few, in particular, stand out as potential stumbling blocks in their line of work.

First Responders, Essential Workers and Ambulance at HospitalEconomic stress, for instance, has been shown to increase the risk for alcohol use in healthcare workers, especially women and those who have a lower level of education [7]. Other findings have cited a lack of education leading to higher drug use among healthcare workers, while social stress has long been shown to increase substance use risk in this professional population [8].

Some findings speculate on potential long-term concerns. Previous pandemics have induced significant traumatic reactions in healthcare workers. One 2020 study cites evidence that many medical and nonmedical healthcare workers will develop posttraumatic stress disorder (PTSD) because of their pandemic-related experiences.

Arguably the most troubling factor in the COVID Stress Scales is the last one. McKay and Asmundson believe that healthcare and essential workers are more likely to be the targets of discrimination, as front-line employees come disproportionately from underrepresented groups. That has occasionally led to the general population conflating these groups with both their ethnic or racial status and infection risk.

Any sort of stigmatization is troubling, and, broadly, stigma has a history of leading to an increased risk for alcohol and drug use [9]. Essential workers are no exception.

How to Get Help If You’re Struggling

Anyone who has spent time caring for a sick parent or child understands the mental, emotional, and physical tolls it can take.

For these front-line workers, giving every ounce of energy and compassion to their cause despite often not knowing what would come next during this pandemic was a nearly impossible challenge. Putting the best interests of so many other vulnerable populations first can lead our essential workers to push aside their own needs until it’s too late.

It doesn’t need to be that way. Substance use disorder treatment is available, and it can help. It can be difficult for healthcare workers to disclose their own struggles, but opening up to those around you is often the first step to pursuing the professional intervention you need.

Addiction can impact anyone, and given all our healthcare workers have had to endure over the past year, they are more vulnerable than anyone. With the proper treatment, though, it’s possible for them to achieve successful, long-term recovery and continue to make a difference in the lives of others.


References:

[1] Mann, B. (2020, Sept. 11). Hangover from alcohol boom could last long after pandemic ends. NPR Morning Edition. Retrieved from: https://www.npr.org/2020/09/11/908773533/hangover-from-alcohol-boom-could-last-long-after-pandemic-ends.

[2] Czeisler, M.; Lane, R.; Petrosky, E.; Wiley, J.; Christensen, A.; Njai, R.; Weaver, M.; Robbins, R.; Facer-Childs, E.; Barger, L.; Czeisler, C.; Howard, M.; and Rajaratnam, S. (2020, Aug. 14). Mental health, substance use, and suicidal ideation during the COVID-19 pandemic — United States, June 24–30, 2020. Centers for Disease Control and Prevention. MMWR Morbidity and Mortality Weekly Report 2020;69:1049–1057. Retrieved from: http://dx.doi.org/10.15585/mmwr.mm6932a1.

[3] American Medical Association. (2021). Issue brief: Reports of increases in opioid- and other drug-related overdose and other concerns during COVID pandemic. Retrieved from: https://www.ama-assn.org/system/files/2020-12/issue-brief-increases-in-opioid-related-overdose.pdf.

[4] McKay, D. and Asmundson, G. (2020). Substance use and abuse associated with the behavioral immune system during COVID-19: The special case of healthcare workers and essential workers. Addictive behaviors, 110, 106522. Retrieved from: https://doi.org/10.1016/j.addbeh.2020.106522.

[5] Baldisseri, M. (2007). Impaired healthcare professional. Critical Care Medicine. 35(2 Suppl):S106-16. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/17242598/.

[6] Bolton, F. (2021, Feb. 3). Studies show pandemic increases risk of stress, substance abuse in medical field. NewsNation Now. Retrieved from: https://www.newsnationnow.com/health/coronavirus/studies-show-pandemic-increases-risk-of-stress-substance-abuse-in-medical-field/.

[7] Saridi, M.; Karra, A.; Kourakos, M.; and Souliotis, K. (2016). Assessment of alcohol use in health professionals during the economic crisis. British Journal of Nursing. 25(7), 396–405. Retrieved from: https://doi.org/10.12968/bjon.2016.25.7.396.

[8] Bennett, J. and O’Donovan, D. (2001). Substance misuse by doctors, nurses and other healthcare workers. Current Opinion in Psychiatry. 14:195–199. Retrieved from: https://journals.lww.com/co-psychiatry/Abstract/2001/05000/Substance_misuse_by_doctors,_nurses_and_other.6.aspx.

[9] Room, R. (2005). Stigma, social inequality and alcohol and drug use. Drug and Alcohol Review. 2009;24:143–155. Retrieved from: https://doi.org/10.1080/09595230500102434.


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Timberline Knolls BannerAt Timberline Knolls Residential Treatment Center, located outside of Chicago, Illinois, we provide specialized care for women and girls who are living with mental health conditions such as substance use disorders and eating disorders. Our private facility offers female-only treatment programs for eating disorders, addiction, and a range of mental health conditions. We work closely with each person to develop treatment goals to maximize strengths while focusing on individual needs. Our treatment team understands that each woman has unique needs and that she must play a role in her journey to wellness.


The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on April 5, 2021
Reviewed by Jacquelyn Ekern, MS, LPC on April 5, 2021
Published on AddictionHope.com

About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.