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I walked out of rehab and into a pandemic

Isolation is not the best thing for the newly sober.

After more than 15 years of chasing oblivion in a bottle, I knew it had to end. So I checked myself into rehab on February 21. The plan was to dry out for 30 days, get out of rehab, find an Alcoholics Anonymous group, connect with a sponsor, and hopefully end the vicious cycle of drinking, regret, depression, and more drinking.

But come March 22, when my 30 days were up, I found the world to be vastly different from what it had been when I had entered rehab — empty streets, bare shelves at the grocery store, and people more afraid of others than usual. All I had learned of the terms “shelter in place” and “social distancing” while in a rehab center in California’s Santa Cruz Mountains was from the local daily newspaper and short calls from a payphone to my loved ones on the outside. But I had no idea what I was in for.

Once discharged, I realized how the beginning of my sobriety would go: no hugs from friends and family, no AA meetings in church basements, no dinners at my favorite restaurants. These things I had clung onto as bright spots as I faced my life after rehab were now gone. Then there were the classic triggers that cause people to relapse — isolation and economic insecurity, which have been now amplified to levels most of us have not seen in our lifetimes.

“This is the worst possible time to get into recovery, there is not a doubt about it,” Dr. Paul Earley, president of the American Society of Addiction Medicine, told me over the phone.

There are around 20 million people with substance addiction disorders in the US, according to federal data. Combined with the 14,500 addiction treatment centers in the country limiting and changing operations due to the coronavirus pandemic, there are likely thousands newly cut off from the support they seek.

The pandemic has created unique challenges for many groups of people, and painfully exacerbated existing disparities. But for those of us fighting addiction, it’s especially scary. The collapse of the normal support structures has made building new patterns, habits, and community exceedingly difficult.

“I was trying to think of how this could be worse, maybe a war situation,” Earley said. “But the isolation and loneliness people are facing now is about as bad as it could get.”

Fresh out of rehab, I was ignorantly confident in myself. But after three weeks of isolation, I found myself parked outside a liquor store for 30 minutes, debating whether or not I should enter. I eventually did.

Looking toward sobriety

I’m 36 years old, and after years of being a full-time journalist, I’m now a grad student who spends summers working in Bristol Bay, Alaska, to earn money for tuition by fishing salmon. I still pay my monthly bills through freelance journalism and contract writing gigs, and I’ve always been a productive drunk, but boozing every night has made two jobs and grad school all very difficult to sustain. Hangovers bled the night into the day and have often made unaware bosses and editors perplexed with the inconsistent quality of my work and my failure to meet deadlines. My romantic relationships fell apart over and over again.

After years of failing to meet my professional expectations, a string of failed relationships, and a history of substance misuse on both sides of my family, I started cognitive behavioral therapy with a psychologist to begin to address my problems. One thing became painfully clear earlier this year: I couldn’t make the positive changes I needed while continuing my relationship with alcohol. So, I put my life on hold and sought help finding the tools I needed to fully address my drinking and shortcomings.

the author Nick Rahaim Courtesy of Nick Rahaim

Recovery is difficult and all too often bound toward failure. As someone new to sobriety, I’m in no position to talk with any authority on how to be successful. But as someone working toward a new way of living, I know how hard it is to stay away from addictions in the midst of the public health crisis we now face.

Alcoholics Anonymous meetings were a big part of my plan to be a part of a larger community during this newly sober stage of my life. Like most of life these days, AA and other 12-step meetings — of which there are an estimated 66,345 groups and 1,361,838 members across the nation — connect on Zoom. Local AA groups, including those in my hometown of Monterey, California, have adapted to quickly move normally scheduled meetings online. Facebook groups and webpages have popped up to allow people to join meetings happening across the globe at any time.

I tune in a few times a week on my laptop from my studio apartment. Most who attend the online meetings seem elated to see the familiar faces of their allies in recovery. While they are all welcoming to a newcomer like myself, and I have felt comfortable sharing that I am fresh out of rehab, it’s still hard for me to connect with them on a personal level as a new face on a computer screen.

There is something missing from the in-person meetings, where I’m told that connections that bleed into after-meeting conversations build the early bonds of establishing a support network. And this is not only an excuse for why my attendance is well short of the recommended 90 meetings in 90 days for people new to sobriety, and why I’m not even close to finding a sponsor to help guide me through the 12-step and early sobriety.

Earley, who himself has 36 years of sobriety, agrees that making first connections with one’s potential support community remotely is a difficult endeavor. Video conferencing tools are best suited for people who have an established rapport with each other, he said.

“Access to therapy and support networks is the glaring problem right now,” Earley said. “Everyone needs human closeness, especially for those in early recovery, and that is lacking in a video conference. It’s inherently more difficult for people to connect and feel safe.”

Nikki Soda, the membership development officer for the National Association of Addiction Treatment Providers, sees similar challenges in getting people plugged into support networks after rehab.

“You don’t get all the tools needed for recovery by interacting through a computer, you build a foundation through the conversations before and after meetings — those parking lot conversations when you speak with someone one-on-one,” Soda said.

While Covid-19 is a more immediate public health concern than addiction, alcohol misuse alone affects 15 million people in the US and leads to 88,000 annual deaths, according to federal data. And that’s not even counting the other public health crisis that hasn’t gone away during the pandemic: the 2 million Americans with opioid addiction, leading to nearly 47,000 overdose deaths in 2018, according to the most recent federal data. Relapse, especially for people who use opioids, can easily lead to death, but those with addiction are more at risk for contracting and dying from Covid-19 because they are also more likely to be homeless, incarcerated, or have other physical ailments, according to the National Institute on Drug Abuse.

Earley and Soda have both seen the majority of intensive outpatient facilities move to virtual treatment. Access to services has tightened even as treatment providers try to do their best in a difficult situation. People have to unlearn habits and change attachments, they said. Yet sheltering in place often isolates those with addiction in triggering environments.

The struggle is not over

In the parking lot at the liquor store, I gave into my urges, walked in, and bought a six-pack of beer and a pint of Seagram 7 whiskey — the brand my dad drinks daily. It wasn’t planned. The walls of the small apartment I live in by myself felt like they were closing in on me. While I had a few social distance outings with friends, not being able to see anyone regularly was making me start to crack.

This isn’t the way the initial draft of this article ended, but I’ve stayed sober in the days since. Building routines has always been difficult for me, but doing so while trying to stay sober feels like improv jazz — sometimes harmonious, sometimes dissonant. I tune into AA meetings over Zoom, I talk to my therapist by teleconference, and I’ve tried to establish a daily mindful meditation practice as a way to fight against my self-destructive impulses.

But my situation is still precarious. People with addiction are already more likely than not to relapse, let alone during a pandemic where we’re forced to physically separate. Some of the people I became closest with in rehab have already fallen into a full relapse. What scares me the most is my rehab friends and acquaintances with opioid addictions — they are reentering society only to find isolation, and the comfort of their next dose could be fatal.

These aren’t easy times for any of us, and for those looking for sobriety in these uncertain times, Earley has some advice: “I want people to have hope that if the struggles seem greater than normal, this is not a normal time, so it’s not the time to be hard on yourself.”

There are many like me who decided to change their lives at a time when the world itself was undergoing rapid change. It’s a struggle, but on the flip side, the timing couldn’t be better — sheltering in place would be a terrible circumstance to be in active addiction. I feel much better going through it sober than drunk, and that alone gives me hope.

Nick Rahaim is a writer based in Monterey, California. Check out his website and find him on Twitter at @nrahaim.

Correction: This essay has been changed to reflect that addiction treatment centers will likely limit and change operations, not necessarily close, due to the pandemic.

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