Covid-19 has put many in recovery from substance use disorder at risk of relapse. The American Medical Association notes that opioid overdose rates may increase and access to treatment complicated by the pandemic. Social distancing and stay-at-home orders have disrupted the support systems many rely on.

Following are five common triggers for relapse and how to work against them.

Pandemic Boredom and the Risk of Relapse

Our normal social and recreational outlets are not available to us. It’s not safe or prudent to meet up with friends the ways we have in the past. Those who work from home may feel inordinately tied to the house. Now that new hobbies have been tried, the house cleaned from top to bottom and every show on Netflix binged watched, what do we do with ourselves? If boredom sets in, relapse could follow.

The most common suggestion for dealing with boredom is to be of service to others. What can you do from your home or in a safe way to improve your mental health and help someone else while you’re at it? Can you raise money for a favorite charity, deliver food to the food bank, or walk an elderly neighbor’s dog? Is it time to find an online 12-step group and regularly attend their virtual meetings? Occupying yourself with useful tasks that build feelings of self-worth is an important way to stave off boredom.

COVID Fear as a Relapse Trigger

Many people are afraid. Will I or someone I love get the coronavirus? If I do and get very sick, will I find room at the local hospital? Can I afford to get sick and rack up huge medical bills? Will I lose my job? How will I keep food on the table? These are only some of the frightening situations facing millions of Americans right now.

12-step programs suggest meeting fear with faith. How do we do that? It’s a question of discernment. There are some things you can change, in which case, it’s prudent to take action. There are some things you cannot change, in which case, you can lean into your courage to face whatever is immutable. In either case, ruminating on what may or may not happen only feeds fear. Being mindful of what is actually happening now, and acting on what you can do something about, will diminish your fear.

Staying Sober During Disconnection

Social isolation is real. We are not physically connecting with people we care about as we have in the past. This physical distance can lead to emotional disconnection. Many people feel lonely and are isolated and alone.

While it may feel like the hardest thing to do, it’s important to pick up the phone and call, Facetime, Zoom, Skype, or otherwise reach out to those we care about. Let them know you are struggling and ask how they are doing. We are all in this situation together. By connecting through technology, we are able to share ourselves in ways that build, rather than diminish bonds.

Another way to feel connected is to interact with animals. Pets in particular provide a source of unconditional love and can be a bright spot in bleak times.

Uncertainty and Sobriety

The stress of not knowing what is going to happen with our health or jobs, the kids’ school, and all the rest is incredible. Will our job or business make it? Will we have unemployment insurance to rely upon? Will someone we know take ill? How do we coordinate virtual education for our children? When will I be able to access a vaccine? At what point will life ever be “back to normal?” These are very real stressors. There are many uncertainties.

Meditation is an excellent way to address uncertainty. Meditation practice has us get into the now, to feel our bodies and be present. A regular meditation practice reduces stress and improves health, notably lowering blood pressure. Meditation can also release endorphins, and increase serotonin, dopamine, and melatonin levels, creating a sense of calm.

There are excellent, free, or low-cost online meditation groups as well as a number of apps that can help you develop a meditation practice.

Lack of a Support System During the Pandemic

It may be the case that you simply don’t have people around you who understand what you are going through. If your family is not in recovery or most of your associates used drugs or alcohol with you, you may lack the support you need to thrive. Good people who can listen to you when you have a problem are an important aspect of recovery.

The quickest way to develop a support system is to attend virtual 12-step meetings, or similar types of mutual aid groups. The success of these groups is based in large part on like-minded people assisting one another. These are people who are in recovery and understand the need for support.

To find a 12-step group, simply do an online search. Whether you want Alcoholics Anonymous, Recovery Dharma, SMART Recovery, Al-Anon or Nar-Anon (for the family members of alcoholics or addicts), finding help is as easy as calling the local information number. The local number for your area is likely manned by a volunteer who will happily tell you about support activities in your area, and give you access to virtual links and passwords for online activities.