In response to the growing pandemic of coronavirus disease 2019 (COVID-19) in the country, the Philippine government, through Proclamation 922, signed by President Rodrigo Duterte on March 8, 2020, placed the entire Philippines under state of public health emergency. The government imposed an enhanced community quarantine (ECQ) in Luzon and other provinces, which was effectively a total lockdown, restricting the movement of the population except for necessity, work, and health circumstances.
Additional lockdown restrictions mandated the temporary closure of non-essential shops and businesses. Worldwide, most governments opted for a nationwide lockdown strategy or community quarantine, closing all non-essential services, including liquor and tobacco shops, and instructing citizens to ‘self-quarantine’ themselves inside their houses.
Does the lockdown present an opportunity to quit drinking and smoking, or to detoxify? How does the lockdown hit some populations with substance use disorders (SUDs)? How do these people cope with the non-availability of their “wanted items” during this time? How has the lockdown affected and impacted the drinking, smoking, and drug use of people and what consequences it has had on these public health issues?
Experts say that non-availability of alcohol, cigarettes, tobacco, vapes, and drugs during this time of community quarantine is likely to adversely affect the mental health of people who are binge-alcoholics or smokers or drug users. Accordingly, people who are heavily dependent on alcohol or smoking, often face a range of cognitive and physical symptoms when they abruptly stop consuming. Smokers and alcoholics may face withdrawal symptoms as COVID-19 lockdown continues. Withdrawal syndrome is the combination of physical and mental effects that a person experiences after they stop using or reduce their intake of a substance such as alcohol and prescription or recreational drugs.
Withdrawal symptoms can range from mild to serious. Some of the symptoms include anxiety, depression, irritability, mood swings, throbbing headache, nausea, sweating, shaky hands, stomach cramps, confusion, insomnia, and hallucinations, after one suddenly quits drinking and smoking. The intensity and length of these withdrawal symptoms can vary widely, depending on the nicotine, alcohol or drug addiction and the biological make-up of the person. But the psychological symptoms can last for longer.
Compared to alcoholics and smokers, some experts say that under the lockdown period, problems for drug addicts could even be three-fold. First, there is a high risk of drug addicts mixing substances they can get their hands on during the shutdown or try and administer them through a different route than usual to get the high that they are used to and this could cost them their life. Secondly, these drugs are anyway expensive because they are not legal and have to be sold clandestinely.
The lockdown is likely to push up the prices further and so an addict may try criminal means to get that additional money. Thirdly, for those addicts who fail to get the drugs, there will be severe withdrawal and since treatment facilities may not be easily accessible, the user will suffer complications which again can, in some cases, cause death or push one to commit suicide.
In this scenario, people finding it difficult to cope with withdrawal cannot access hospitals easily, because most of the hospitals have been dedicated to COVID-19 patients. For addicts of banned substances, it is even more difficult because their withdrawal symptoms are more severe compared to alcoholics and smokers, and the treatment too is complicated. Addiction psychiatrists believe that going may get tough for “severe addicts” of alcohol, illicit drugs and psychotropic substances and also for those presently under rehabilitation.
Moreover, experts warn of a potential surge in the number of people relapsing in the community, as the pressures from lockdown could ruin those in stable recovery from drugs and alcohol. The links between traumatic stress and drug use are well-established. People respond in the usual ways, such as painkillers, alcohol and recreational drugs to cope with anxiety and stress.
While there is no doubt that fighting the coronavirus pandemic must be top priority, experts say that the lockdown’s effect on addicts should be given due attention so that issues concerning them get addressed too in due course. Most existing facilities are located in the metros or big cities while addiction rates are much higher in villages and smaller towns where there are no facilities to treat addicts.