LAS VEGAS — Many in quarantine are tempted to stay in bed, watch television, binge on junk food, search for new ways to be occupied and, most important, avoid interacting with others.
That routine can damage those grappling with addiction, who say that social interaction and staying busy are keys to helping them stay clean.
"We come from lifestyles before where all we did was get high, sit on the couch and watch TV," said Breann McCulloch, a Las Vegas-area resident who has been sober for almost five and a half years. "Now you tell us to go back to the very thing that almost killed us."
McCulloch told the Las Vegas Sun the pandemic reminds her of some of her darkest days struggling with opiate and heroin addiction. The things that helped her then — mentorship, community service, eating out and activities involving close person-to-person contact — have been severely limited for the past several weeks.
The opposite of the isolating aspects of addiction isn't recovery, after all — it's human connection, she said.
Still, McCulloch said she's been developing coping mechanisms over the past several years. Like much of the rest of the world, she fills her days with online video meetings and tries to stay busy and maintain a normalized schedule with her husband and four children: waking up, drinking coffee, meditation, exercise.
She also mentors other women like herself who are in recovery, albeit from a distance.
She knows if she doesn't keep up with these rituals, she'll fall into a familiar place from which she's worked so hard to stay away.
"I can't imagine trying to get sober in a time like this," she said. "There aren't as many freedoms available right now as I had when I was getting sober."
Sober living facilities like CrossRoads of Southern Nevada remained open during the statewide shutdown of nonessential business. Still, because of virus concerns, residents were hesitant to leave home quarantine for a treatment center, or any medical provider, CEO Dave Marlon said.
CrossRoads, near University Medical Center, is open 24/7 and admits anyone in need of medical detox or addiction counseling. Over the preceding weeks, CrossRoads saw a significant uptick in admissions to its 182-bed facility, although numbers are still down, Marlon said.
CrossRoads founder Jeff Iverson said he's seen a few clients relapse since the shutdown order.
"It's unfortunate but we don't shoot our wounded," said Iverson, who remembered struggling with methamphetamine addiction more than a decade ago. "We welcome them back with open arms and we never give up on our fellows."
Marlon said increased consumption of alcohol is a contributing factor in relapse cases. By the end of March, sales of alcoholic beverages in the U.S. spiked 55%, according to market research firm Nielsen.
"With people out of work, I think they've been drinking more," Marlon said. "I saw big lines at the dispensaries like I've never seen before. I think people with more time on their hands, if they had a substance abuse (problem) and they were keeping it at bay by having to work a lot, this pandemic exacerbates both mental health and substance use disorders."
Liquor sales remained an option in most states during shutdown orders, and Marlon said that actually helps those with acute alcoholism avoid severe withdrawal symptoms.
"If we did stop all access, it would have potentially made the problems more acute for some of those people," he said. "Sadly, for the chronic alcoholics, if they stop without having treatment, up to a third of them could have seizures. So it is something that needs to be addressed medically and clinically."
Marlon isn't certain when it will be safe to conduct in-person support group meetings at the facility. Instead, CrossRoads has enhanced its staff and technology to serve those battling addiction remotely.
While trained in telemedicine prior to the pandemic, Marlon said he only saw it used for those who were incarcerated or in rural parts of the state. Now he's starting to fully embrace this method of mental health care.
"I have a Sunday evening group session with peers," said Marlon, who is also in recovery. "We talk now regularly and I'm expecting to continue this. To me, instead of having to drive to a meeting, doing this from a laptop is something that will last post-pandemic."
While a helpful tool, McCulloch said telemedicine has limits, especially for women or mothers who may not be able to receive adequate treatment while at home with children.
"A lot of women I work with get to bubbling breaking points where they need an outlet," she said. "They need to be with other women. They need to be with other adults. They need a break."
For some in recovery, self-care is leaving the house, even if for an hourlong support group meeting, she added.
While there have been a few ups and downs over the past few weeks, McCulloch said she remains strong by telling herself the current conditions are only temporary.
"Hopelessness on any level — pandemic or not — feels permanent," she said. "But it's not. Pretty soon, we will be able to meet again and spend time together."