Marta (26 years old) was caught by the onset of the COVID pandemic in her second year of rehabilitation from her cocaine addiction. He attended two weekly group therapy sessions at the Proyecto Hombre organization which, from one day to the next, were held on Skype. “I was in the final phase of the treatment and at one of the levels in which the sentimental issue is more touched upon. To stop seeing your colleagues and therapists live and shutting myself up at home with my family was complicated,” he explains.
Drug addicts during the state of alarm: “How do I explain to the police that if I don’t go shopping I am going to get sick?”
For this young woman, the change “was rare” and at first she did not dare to speak and participate in the meetings. on-line. “It was like starting over, it’s not the same as being face to face.” Marta emphasizes that the pandemic did not catch her in a stage of consumption, and although she has suffered anxiety during these months – “she had many thoughts, memories …” – that made her need individual therapy, she has not suffered any new relapse in her addiction . “It was complicated, but in my case, I hadn’t been drinking for a while, it wasn’t that much risk,” he says. Two months ago they have recovered the face-to-face sessions, with new measures such as distance and masks, and the young woman hopes to finish her therapy in the first quarter of 2021.
Other colleagues have not come out so well. One of the characteristics that affect drug addicts is that a high percentage suffer from mental health problems, as Jesús Tamayo, president of Proyecto Hombre in Córdoba, recalls. This pandemic it is affecting with virulence to those who suffer psychological or psychiatric pathologies. “There have been psychotic outbreaks and we have had to call the health services. And some of those who have experienced anxiety attacks have taken to the streets for drugs, “he says. This has caused some relapses in consumption, although it is still too early to have more precise data on what has happened in this regard. In any case, according to Tamayo, most of the relapses have been redirected when the centers were reopened, despite the fact that certain restrictions are maintained.
During confinement, the therapies in this organization and in other similar organizations such as the Red Cross began to be carried out online, but not everyone had access to a computer and a Wi-Fi network to connect. When people, in addition to the addiction pathology, drag other difficulties, such as being on the street or in situations of economic vulnerability, everything gets complicated.
Now they are receiving a wave of new income, mostly for residential resources. The reason the therapists allude to is that by staying at home locked up with their family for two months, many drug addicts have exposed all their difficulties and conflicts in a clearer way and hidden addictions have come to light.
“When a person goes to a treatment center they feel like they are hitting rock bottom and in a moment of desperation they have to make decisions. It can also be due to external pressure, from his job or from his family environment ”, emphasizes the head of Proyecto Hombre. People who had not yet reached that point have been stuck in their family nucleus all day, without the spaces in which they maintained their addiction with less difficulties. “There have been more tensions and an acceleration in the process.” This has meant that, by their own decision or due to family pressure, some dependents have now decided to try to detoxify, he describes. In addition, these months hospital admissions have slowed down. detoxification support floors, which would motivate that there is now an accumulation of demand.
Even with incomplete knowledge of how the pandemic has affected drug use, recently the delegate of the National Plan on Drugs, Joan Ramón Villalbí shared his impression that there has been and is a greater demand for access to treatment by dependents that has collided with the precariousness of work in the centers due to the pandemic (sick staff, teleworking, etc.), a reality not completely overcome.
More acute phases of addiction
What is clear is that confinement and restrictions due to COVID have affected drug addicts differently depending on what phase of their pathology they are in. Thus, as Juan Jesús Hernández, head of the Health Plan and the Addiction Intervention Program of the Spanish Red Cross, explains, those who still had a serious addiction have suffered more problematic withdrawal syndromes, while those who were in a process of monitoring their pathology without having been able to leave these substances has also had a worse evolution, as they have fewer consultations and are not in person. People in advanced stages, with greater motivation to change, as is the case with Marta, have generally suffered less from the consequences of COVID in their pathology.
During the months of confinement, “it was shown once again that there are first-rate and second-rate addicts: those who needed alcohol and tobacco during confinement regularly obtained their dose. But if you were addicted to an illegal substance, there were many difficulties in getting it, due to mobility and access to vendors, ”says Hernández.
Explain to the police that it was necessary to go outside to buy drugs or to go to a venipuncture center it was not always an easy task. In those months, drug prices rose, substances were more adulterated and it was more difficult to get money to purchase them. Among other reasons, the travel stoppage due to the pandemic had affected international drug trafficking, which produced a change in consumption patterns.
Once the months of hard confinement are over, the situation has improved somewhat for this group. In the centers managed by the Red Cross, treatment has also been given again, Free, confidential care and assistance for adults with any type of addiction without the need for a health card. In them you can find professionals from the psychological, social, medical and nursing areas, and pick up medication or methadone. Although the situation is still not as before. “They are like health centers, that is, the reality is that none have returned to normal. Assistance by phone is prioritized when possible, and the collection of medication as far apart in time and appointments to avoid crowds ”, he emphasizes.
Few infections even in the most extreme situations
The organizations consulted for this article agree that they have been surprised by the feeling of low prevalence of the disease in the group of drug addicts. One of the reasons that are considered is the isolation in which many of these people live, often victims of social rejection, which would condemn them to a previously unwanted distance. The way in which the pandemic has affected them has more to do with the closures, the isolation, the new difficulties in “finding life” on the street.
This is what Aura Roig Forteza, director of Metzineres, says, a “comprehensive harm reduction program” that offers “sheltered environments for women who use drugs while surviving violence”, based in Barcelona. “The precariousness of the women we accompany has gone to much more. Many work with tourists, begging on the street, with sex work, and the underground economy on which they depended has been greatly diminished ”.
The COVID epidemic has greatly affected these women in this indirect way, both through confinement and the reduction or even closure of social services. However, initially it was difficult for a population affected by multiple factors to give importance to the pandemic, to begin with because they do not usually have much access to current information. “In the early days they didn’t understand very well what was happening,” says Roig.
At the Metzineres premises, in the Barcelona neighborhood of El Raval, between thirty and forty women a day come to seek shelter in a safe place. “They have a kind of resting place, since many work at night.” There they can leave their belongings in lockers, be treated in the infirmary if they need it and enter with their dogs, which is something that most shelters of this type have forbidden. But often women who live on the streets feel more protected if they have an animal to accompany them.
The association assures that it prefers to do activism rather than welfare: “We dedicate ourselves a lot to basic services: food, self-care workshops, mutual support, solidarity, feeling of belonging …”. During the confinement, as theirs was considered an essential service, the premises remained open, and even extended their hours to Saturdays and Sundays, although budget problems later made them close this second day.
“They already came from very precarious realities that have now worsened, with more situations of violence, for example in the so-called drug stores or consumer floors,” he says. On the other hand, many of these women, especially the older ones, are survivors of another epidemic, that of HIV. “His companions and companions died, they became ill and no one was moved so much by those deaths, due to a virus as well. This makes them feel rejected again ”.
It is early to have a sharper, data-based photograph of how COVID-19 has affected and is now affecting drug addicts, but one certainty is that like any other chronic patient with pathologies other than coronavirus, their reality has also changed. complicated, much more the greater their situation of vulnerability, precariousness and loneliness. “There is not a big difference in how an addicted person has been affected – reflects Dr. Hernández – deep down we speak of a chronic disease.” This may have prompted some to try to get past the consumption phase as soon as possible.