A crisis within a crisis: Addicts at risk as drug support groups close

Coronavirus is forcing support groups for millions of addicts around the world to shut, leaving many to struggle alone at a time of isolation and anxiety and heightening their risk of relapse.

The usual hugs and handshakes are banned, while many groups that once gathered in person and in private now meet outdoors or online, where those without fast internet or smartphones are struggling to access them.

About 283 million people around the world suffer from alcohol-use disorders and 3 million a year die from alcohol abuse, the World Health Organization estimates. Some 35 million people have drug-use disorders.

Alcoholics Anonymous (AA), one of the largest networks of support groups to help people quit drinking, says it is in 180 countries, with a membership estimated at more than 2 million.

Like other 12-step programs, AA is decentralized, meaning individual groups are autonomous and decide whether to hold meetings, go online or suspend completely.

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Keith Humphreys, a Stanford University psychiatry professor, said the risk of relapse was higher when people were alone and inactive.

"If I go to the meeting, my health's at risk, but if I don't go to the meeting, my health's at risk for a different reason," he said.

British addiction support organizations said face-to-face meetings were being shuttered and online services ramping up, though a small number of in-person events were still on for services such as needle exchanges.

Some U.S. and Canadian groups were still meeting, the General Service of Alcoholics Anonymous said, while others had moved online or created contact lists for keeping in touch.

In Mexico City, AA attendees wore masks and did not touch, while in the Kenyan capital Nairobi, some groups shut and others met in public parks standing one meter apart.

"It's a crisis within a crisis," said Matthew Thomas, a communications consultant for the British charity Action on Addiction and a recovering addict.

He knew of two people who had relapsed in recent days after struggling without in-person groups.

"Addiction is disease of isolation," he said. "Community is one of the ways that people can recover from addiction, and that community has been really seriously compromised."

NO HAND-HOLDING

AA is better than therapy for stopping drinking and helps people lower healthcare costs, according to a review of 27 studies Humphreys and two other academics published this month.

"They can go that same day, they don't have to fill in any forms, they don't need any health insurance and it doesn't cost any money," he said.

In Mexico, many meetings are still open but with antibacterial gel at the entrance, masks and each person serving their own coffee, said Javier, a 27-year-old AA member.

He said his group, which ranges from teenagers to the elderly, is taking the coronavirus seriously, but is also worried, particularly about a student member whose classes have been canceled.

"That worries us, what will happen to him, if he'll drink... it also hurts his family," he said.

In Nairobi, countless Alcoholics Anonymous groups have been forced to disband. While some have managed to switch to video conferencing, most attendees do not have smart phones or cannot afford the high internet costs.

"The meetings were really important for us. They made us feel welcomed and loved, so it's been very difficult since they stopped," said one male AA member in Kenya who did not want to be named.

Though getting connected can be tough, and many dislike the less personal online meetings, the switch has also brought unexpected benefits for some.

John, part of the Narcotics Anonymous public information outreach team in Britain, said he was often the only person to turn up to the group he set up when he moved to a rural area.

Yet while the online groups that have now been set up are thriving, John - whose name has been changed at his request - said he was looking forward to returning to church halls.

"I don't think there's any substitute for face-to-face meetings really."