♪♪ >> Fear, isolation, stress.

These are just a few of the things we've felt as a result of the COVID-19 pandemic.

So how did we cope?

Well, some people that didn't use substances before the pandemic, started.

Some looked for an escape by increasing their use.

And for others who were already entrenched in a substance-use disorder, the pandemic may have had deadly consequences.

>> It's tragic.

Addiction, if left untreated, especially opioid-use disorder, it's really a terminal diagnosis.

During the pandemic, there was a 30% increase in opioid overdose deaths.

>> Connection is vital, and how we stay connected was tested.

And we had to get creative and pivot.

>> All, pretty much, 12-step meetings were canceled, you know, within like a week to two-week period.

You know, so it left this hole.

A number of people that I know.

That I think that if it wasn't for the pandemic, they may have held on.

>> Today, health care is about empowering people to take control of their health, whether creating a fitness routine, choosing the right procedures and medications, or adhering to treatment for a chronic condition.

Capital Blue Cross -- Dedicated to underwriting "Transforming Health" for the good health of the community.

♪♪ WellSpan Health -- Helping patients reach their health goals through a coordinated system of physicians, hospitals, and convenient health-care services in communities across central Pennsylvania.

Learn more at wellspan.org.

WellSpan Health -- For the journey that is life.

Support also comes from viewers like you.

♪♪ ♪♪ >> Hello, and welcome to "Transforming Health: Substance Use and a Pandemic."

I'm Keira McGuire.

Over the next half hour, we'll take a look at current trends in terms of substance use, how we got here, and how we might get back on track.

>> This pandemic has had multifactorial stressors on us, right?

So there's the stress of the unknown.

At the beginning there as fear, anxiety.

There was folks who were scared of engaging in health-care systems.

We had lockdowns.

>> You know, I think that when people are faced with a lot of adversity, it's certainly an opportunity for resilience, you know, and people to actually rise to the occasion.

But when it's sustained over time like this in the pandemic, it's really complicated and hard to sort out, and people will often revert to drinking, you know, using marijuana, using any kind of drug that they have available just to get an escape.

So, far and away in this country, the most common substance misused is alcohol.

Certainly in the pandemic we've seen a lot of increases in all demographics in alcohol use.

The National Survey on Drug Use and Health found that there was increases in the people that were drinking across all age groups.

It's not just my patients.

It's people overall.

Lots of new users of alcohol have been identified in the years since the pandemic began, and more heavy drinking has been identified.

Heavy drinking is defined as greater than five drinks for greater than five days out of every month.

So a drink is a shot of liquor, a five-ounce glass of wine, or a 12-ounce beer.

So any combination of five of those over five days out of every month.

And so that's a big concern.

Women are drinking a lot more.

Women have really borne the brunt of challenges during this pandemic, between childcare and work.

There's got to be an escape valve somewhere.

♪♪ It's certainly explainable why women in particular or people that have been heavily impacted by the pandemic should decide to drink more, but it is scary to anticipate the health consequences that will come from it.

>> Poor sleep, poor concentration, missed days of work.

Associated with higher risk of traffic motor-vehicle accidents.

Inattention to details.

Interpersonal conflict with loved ones.

But then there's also the potential harm to the body itself.

>> For men, if you have more than three drinks in one sitting a night, it can put you at risk for pickling your liver, so cirrhosis of the liver.

And if you're a women, if you have more than two drinks every night that will put you at risk for cirrhosis of the liver.

So these are real problems.

Sustained drinking is not good for the body, and it can lead to a whole host of health consequences.

♪♪ ♪♪ Once we get past alcohol, marijuana is a huge drug of choice in the United States.

And then really it falls of a cliff.

Much fewer people use stimulants such as cocaine, methamphetamines, and opioids such as heroin or oxycodone or fentanyl, which has been the leading cause of death.

And so you may wonder, "Why do opioids get such outsized attention?"

because, you know, it's far less frequent than alcohol or marijuana use.

And that has to do with the lethality of it.

You know, just one use of the wrong opioid, and you can overdose and die.

And during the pandemic, there was a 30% increase in opioid overdose deaths.

So that is so shocking and so concerning that that's why we talk about it a lot.

♪♪ In the mid-'90s, there was a lot of publicity around the idea that the United States was undertreating pain.

So physicians, prescribers, were incentivized to treat a lot of folks with opioids.

So this is what was going on in medical offices, and suddenly this becomes a huge public health crisis.

It really hit a fever pitch around 2015, 2016.

♪♪ ♪♪ And we started to see a decline in the overdose deaths before the pandemic.

So it was going down.

Especially in Pennsylvania.

That was the fourth-hardest-hit state in the country with opioid overdoses.

We started to see declines in the rates of death, which was really promising.

And then the pandemic happened, and everything was off the table.

♪♪ A lot of people in recovery relapsed.

These were people that had jobs, that the jobs may have gone away.

They had homes, they may have become homeless.

There was a just huge economic crisis that affected a lot of people that were doing really well.

So we saw a lot of relapses.

And then, you know, for other people who may have been functional or sort of hanging on by a thread, started using more heavily as well.

A lot of patients lost their insurances, so a lot of folks were cut out of treatment, couldn't afford treatment, and they dropped out.

So a lot of recovery programs are done in groups.

With the pandemic, a lot of these groups have moved online, a lot of these groups stopped existing.

>> Many folks describe the social support being one of the most, if not the most, important aspect of their recovery.

Many folks will describe that one of the most important things to them is never missing a group, for example, going to a group every day.

>> But what happens when people don't feel like others know -- can know them or really know what they experience on a daily basis, is they start feeling really lonely.

And if they're not working, if they're at home alone, if they're just there lost in their thoughts, especially when they can be their own worst enemy, it is a challenge to stay sober.

♪♪ >> Hi, my name is Danny Albert.

I'm a person in long-term recovery, and what that means to me is I haven't had a drink or drug since April 30, 2017.

The first time I had a substance was at a young age.

I'd say maybe 11.

My substance, for me, was an escape from life.

My substance use went from partying on the weekends to needing a substance every day.

I went to Millersville University for a year and a half, but when I got to the school, I was like, you know, I partied it away.

I couldn't manage both things, right?

I couldn't manage my substance use and my academics, and I failed out of school.

I felt like a failure.

I felt the shame and guilt.

About that time is when prescription pain medication became my substance of choice -- opioids -- and that's all I wanted.

That was my only focus -- How am I gonna get prescription pain medication?

It was this cycle of self-hatred, right?

Like, I did not like the person I was.

And it was this cycle of running away from who I was, and that's what a substance did for me.

It took me away from the person I had become.

From there I met my daughter's mom.

I had a kid on the way, and I wasn't ready.

I couldn't take care of myself.

How was I gonna take care of a kid?

And my depression was greater and the spiral was worse and worse, and my opioid use went to heroin use, um, to mask the pain.

After she was born, I was working a job and trying to manage a full-time substance use.

Ultimately, her mom moved out with her.

Then my substance use got worse.

The first treatment facility, went to that facility because of other people.

Like, they wanted me to go, and I wanted them to be happy with me.

So that was the catalyst for me to go into my first treatment facility.

So, going into my second treatment facility, I was willing to do whatever it took.

And I got a journal, and I wrote, "Just try to not use drugs or alcohol."

Like, just try, right?

'Cause I didn't think I could do it.

I didn't think it was possible.

And the more I sat in there and I talked to people around me and I heard from their experiences, and it was individuals that had been to multiple treatment facilities.

And I started listening to the wisdom that they had and the pain that they caused and the brokenness that they felt and how they worked on those things.

And then I had a phone conversation with my daughter, who said, "Daddy, I just don't want you to be sick anymore."

And that's how it started, right?

Like, it started with this passion for my daughter.

I started writing down who I wanted to be and what that looked like, and I started writing down goals.

30-day goal, 60-day goal, 90-day goal.

I went on to start an organization called Hero in the Fight, created to break the stigma of addiction and raise awareness on the impact it has on individuals, families, and in our communities.

You know, recovery has brought my world to life after years of just existing, right?

I have my daughter in my life.

I get to see the world through her eyes.

You know, she just had her 10th birthday.

Today I'm the general manager at the Harrisburg Melting Pot.

♪♪ During the pandemic, as I was processing things myself, I made a decision that every day I was gonna call three different people on my contacts list, and I would scroll through and just pick random three different people, right, to kind of stay connected.

I personally got on Zoom meetings, and I realized how hard it was for me, and I live with someone that's in recovery, and I get to see them every day, and I get to talk to them, and it's still hard for me.

Connection is vital, and how we stay connected was tested.

And we had to get creative and pivot.

So this morning -- what I did with this pandemic and my routine has been with COVID-19 is I've been trying to have more structure to my day.

So I wake up, first thing I do, open my eyes, thank God for another day, and I start to meditate.

I'm just really mindful and present of the moment.

At noon I have a Zoom meeting with a 12-step fellowship.

What I'm trying to do is what helps me is staying connected.

You know, one thing that's been a struggle is the fact that we don't go to meetings and we can't see people one-on-one.

And this way we can visually see other individuals in recovery on the same mission as us, as myself, just trying to get another day of recovery.

I think isolation and not having coping skills led to more substance use for individuals.

The strongest people are those that speak up about what they're going through.

That's strength.

It's not weakness.

That's what's important.

If you're going through it, a situation, and you don't see any hope and you feel hopeless, talk to at least one person.

It doesn't need to be your parents.

It doesn't need to be a family member.

It doesn't even need to be a friend.

There are resources.

But at least talk to one person.

Zach Whipperman is a person in long-term recovery, someone that I look up to, and when I'm going through life situations I reach out to him for advice.

>> Hi, my name is Zach Whipperman, and I'm a person in long-term recovery.

So I realized as a child, you know, probably in middle school, high school, just feeling like something was missing.

Just not being comfortable overall, not being comfortable in my skin, anxiety.

I remember the first time I used a substance, and I remember feeling different.

I didn't feel as uncomfortable in my skin.

Started using marijuana, graduated to using, like, some prescription pills.

Definitely found some things that I liked.

And then it graduated from there -- prescription pills, a lot of prescription pain medicine.

I remember the first time I did opiates, right, like a prescription pain medication.

And I'll probably never forget it.

Like, I remember that feeling, and I remember thinking in my head, like, if I can feel like this for the rest of my life, everything will be okay.

I remember I went to work one day, and I felt -- I just didn't feel right.

I felt like I was getting sick.

And actually someone that I worked with, they had said, you know, "You've kept messing around with that stuff.

Now you're addicted."

And then my mindset changed to, you know, now I can never feel sick again, right?

So now my desire to use every day went like -- multiplied by 10.

When I started using, it was fun.

Then it became fun with problems.

And then at the end it became just problems.

Legal issues.

You know, probation kind of came into my life.

And that is really what forced, like, the first treatment.

From there, like the next year of my life had consisted of being incarcerated twice, going to three rehabs, and living in three different, like, sober homes, recovery homes, and me just continuing to not allow myself to be really involved in the recovery process to the extent that I needed to be.

I was incarcerated for the second time, and I remember sitting, you know, in jail and just thinking, like, "How did I get here?"

You know, I had this, like, I guess you could call it like a moment of clarity, you know -- spiritual awakening, maybe some people would call it -- where I just sat there and I said, "I have to do something different."

So I left jail and went to the third treatment center I was in, did 30 days there.

Took recommendations, suggestions, went to a recovery home for a minimum of six months, decided to stay longer.

I was there longer.

And, you know, I've been clean ever since.

That was 2012.

Two children.

Two boys.

Own a house.

I'm a homeowner.

I live in Hummelstown.

You know, dog.

I've been afforded the opportunity to work in addiction treatment.

You know, it gives me an opportunity to give back.

A lot of younger -- males, especially, I can relate with them, they can relate with me, and I think it gives them hope.

I'm the person that I needed 10 years ago.

There's some recovery literature that says, "One addict helping another is without parallel."

And I always think about that, and that's really what it is, right?

To be there, to experience it, to be able to help someone else, give the hope.

♪♪ Then when the pandemic hit, and you say, well, you got to stay in your house -- you know, a big part of, like, the disease of addiction is isolation, right?

So a lot of people, before they come to recovery, they're isolating, they're using by themselves, they're using in their homes, and then they use recovery to kind of break out of that.

Well, now, you know, you essentially have to stay at home, right?

So it brings up these past thoughts and actions.

All, pretty much, 12-step meetings were canceled in like a week to two-week period.

You know, so it left his hole.

The people using, that number's increased.

The people overdosing, that number's increased, which, ultimately, the people that need treatment, right, that could benefit from recovery, that number has increased.

But also there's been a number of people that maybe were new or maybe were struggling that I think that if it wasn't for the pandemic, they may have held on, they may still be clean.

I remember, like, being okay myself, because at this point I had, I don't know, coming up on almost, I guess, eight years clean, just shy of eight years clean at the time.

So I felt okay.

I had a good foundation.

And I remember thinking, like, "What about the people early in recovery that don't have this?

Like, they don't have a support group like this.

What are they doing?"

>> Hi, good morning.

My name is Saige.

I'm in recovery.

My sobriety date is March 11, 2020.

But, you know, that's not my original sobriety date.

Recently I had three years sober, but I drank again about three weeks ago.

It's 8:00 a.m., and I have to get up.

I'm gonna make some tea.

And hopefully go on a run and do some yoga now that everyone's quarantined.

I've been trying to take care of myself, so...

I went to one meeting with people, and then meetings started shutting down.

So in the beginning it was really overwhelming.

I wasn't really sure how I was going to do this.

I did panic a little bit.

I had a couple days of just, like, what am I going to do?

And I was told to do a couple of things -- to attend a meeting, or try to attend a meeting, every day, you know; to have some source of higher power, whatever my concept is, and to really pray to that higher power; and to call three women that I know that are in recovery and stay connected with them.

I think it is really hard, though, being new in sobriety and having to go through this, because you're getting sober on Zoom, you know?

You're talking to people through a laptop, or...

It's isolation, and isolation is not easy.

That's something I did when I was drinking, you know?

June 11, 2020, I'll have three months of sobriety.

This is not my first sobriety date, but hopefully it is my last.

This is a process.

It's one day at a time.

And I'm learning that, that I have to ask for help and that I have to be honest, especially in moments when I feel uncomfortable.

>> The number of people that I have known that have lost their life to the disease of addiction is countless.

You know, I'd say, you know, directly, probably 25 to 50.

Indirectly, you know, hundreds.

The toughest part to think about is the fact that the first few, like the first couple years, were really tough, and then it got to the point where, like, I'm just numb, right?

Like, I hear about someone else, and it's just -- you know, I'm numb to it.

You know, that's the result of drug addiction.

So, you know, very high spike, and I think it definitely -- you know, the cause is the pandemic.

>> Before the pandemic, the numbers were getting better, right?

There was more money and more presence and more talk about the recovery side of things.

And when you have a stop to a lot of life the way it was, and barriers and loss of funding, and individuals who thrive on connection now being isolated, that's what leads to the higher numbers.

>> When this all began like in 2000, the overdose deaths were less than 4,000 people, and now it's over 100,000 people -- a year.

>> I think, unfortunately, we did lose some ground in the advances we were making in the treatment of substance-use disorders as a whole during the pandemic.

>> We used to see things about, like, the opioid epidemic, you know, things about drugs and alcohol.

We used to see things on the news about that like once a week.

And then COVID happened, and it just all went away.

Now there is definitely some ground to be made up, and I hope this is the year to do it.

Most meetings have opened back up.

I think that there's definitely some people that were here a couple years ago that aren't anymore.

Maybe they got comfortable not going to meetings.

You know, they just kind of disappeared -- you know, which is always concerning 'cause you don't know, like, is that person -- did that person go back to using or drinking?

You know, no one's heard of them.

It's kind of an unknown.

>> You don't have to be alone in the way you feel, in the things you think.

There are people that have been where you are, and they're here to help you.

There are resources available.

You never have to be alone.

>> It's never too late, you know, to get into recovery.

You know, you're never too far gone.

>> If you or someone you know is concerned about substance use, call 1-800-662-HELP.

I'd like to thank all of our guests for sharing their knowledge and experiences so openly.

Please join us next time as we continue to share stories and transform health.

I'm Keira McGuire.

Thanks for watching.

>> Today, health care is about empowering people to take control of their health, whether creating a fitness routine, choosing the right procedures and medications, or adhering to treatment for a chronic condition.

Capital Blue Cross -- Dedicated to underwriting "Transforming Health" for the good health of the community.

♪♪ WellSpan Health -- Helping patients reach their health goals through a coordinated system of physicians, hospitals, and convenient health-care services in communities across central Pennsylvania.

Learn more at wellspan.org.

WellSpan Health -- For the journey that is life.

Support also comes from viewers like you.

♪♪ ♪♪