Every year on Thanksgiving, Laney would drive through neighborhoods, glancing into windows to see families gather. Homeless, addicted to heroin, and estranged from her own family, she’d end up parked outside a casino, cold and alone in the dark.
“One year, my sister packed me a plate of Thanksgiving leftovers, and I ate it in my car,” recalls Laney, 37, an Ideal Option patient in Washington state. “I felt sad and lonely. It was a horrible day to get through.”
Christmas was no better. She’d hope a relative might send a card with money she could use to buy drugs.
Fast forward three years: Laney plans to spend Christmas with her boyfriend, their baby daughter, and her boyfriend’s family.
“I’m excited to get a tree for the first time and start creating memories with my own little family,” Laney says. “The holidays feel warm and welcoming now.”
At the same time, Laney feels the weight of the pandemic: She lost her job as a restaurant server, and while excited to be living with her boyfriend and daughter, has felt isolated from the friends she made during her 18 months in a sober-living house.
“Sometimes the pandemic makes me feel like I’m almost back in using mode: not seeing anyone, not being out in public. It took me a long time to feel comfortable back in society, and now, because of the virus, I can’t.”
Laney takes Suboxone®, attends 12-step meetings, and feels solid in her recovery. But for someone new to treatment, she knows, dealing with the pandemic on top of the holidays could prove overwhelming.
“You could tell yourself: ‘Shoot, I’m living the life anyway — I’m already not going out in public. So, I might as well be using.’”
Even when there’s no virus on the rampage, the holidays can be plenty stressful for folks in recovery from substance use disorder (SUD). Add COVID-19 to the mix, and 2020’s holiday season may be daunting.
“The combination of isolation and financial struggle is a real set-up for a return to use over the holidays,” says Dan Goulette, an Ideal Option addiction medicine provider. “Many patients have burned bridges with family and don’t have a supportive environment to help them deal with stress.”
If you’re new to recovery or thinking about treatment, know this: Like Laney and so many other Ideal Option patients, you can build new bridges and find other avenues for support. Here are seven strategies to keep in mind as you navigate recovery in a holiday season like no other.
Tip #1: Avoid people who use
“Don’t jeopardize your future by putting yourself in a situation that will trigger you,” says Dolores Van Bourgondien, an Ideal Option addiction medicine provider in Alaska. “The holidays are a time when people let loose. Guard your recovery.”
If the people you used with are family members, have that tough conversation. Tell them: “Hey, I’m in recovery, and this is really important to me. I can’t be there if you’re using.”
To steer clear of the friends you used with, you may need to change your phone number. Those folks may push you to use again. After all, misery loves company.
“It’s difficult to move on to new places and new friends and to break ties with family members,” says Dolores. “It takes a lot of self-discipline. But you have to put yourself and your sobriety first. That’s not selfish; that’s self-preservation.
Tip #2: Stick with the folks who are rooting for you
If you’re feeling isolated and vulnerable, schedule extra visits with your Ideal Option provider. “Instead of visiting every three weeks, come in and see us more often for a check-in,” says Dolores.
If you participate in a 12-step program, find a sponsor and commit to calling your sponsor regularly.
If you feel uncomfortable around your family, well-meaning as they may be, pass on this year’s holiday gathering. That’s a lesson Laney learned her first Thanksgiving in recovery. COVID-19 may be a blessing in this sense as the CDC is pleading with people to make sure they celebrate the holidays safely to reduce the risk of infection.
“You feel like everyone’s looking at you,” she recalls. “You have to put on this façade that you’re feeling normal, but inside you’re shaking. It’s better to be around people who truly understand what you’re going through.”
So, for Christmas that year, Laney attended an NA function with her sober-living roommates. “I wasn’t feeling comfortable in my own skin yet. I just wanted to stay with my little recovery family.”
Two years later, Laney still cherishes those friends and knows those bonds are important to her recovery. Because of the pandemic, she has had to make an extra effort to stay in touch with them.
“We have group chats, and a couple of the girls will stop by my house and stay hi,” says Laney. “I try to make it to a meeting every two weeks. I know if I keep doing everything I was doing before the pandemic, I’ll be OK. I’ve got a good foundation.”
Tip #3: Expect your emotions to run high, and understand why
Anxiety, grief, regret, guilt, anger, shame — for folks in recovery, the holidays are particularly fraught with emotion, and cravings to use may follow.
“Often, people in recovery are breaking ties with family or reuniting, and those are ongoing difficult processes that the holidays magnifies,” says Jane Sveen, an Ideal Option addiction medicine provider in North Dakota.
The high rate of overdose deaths during the pandemic is taking a toll too, Jane says.
“My patients will tell me, ‘I lost two close friends’ or ‘I have three family members who’ve died in the last month’ or ‘I have a funeral this week.’ The trauma of that is so difficult to deal with that they may feel they want to use.”
What’s more, early in recovery, the brain can’t yet handle the onslaught of emotion.
“The area of the brain that modulates our stress response is overactive in folks with a history of substance use disorder,” explains Dan. “So, if they face an acute stressor, that can throw them into a cascade of cravings.”
That’s what Laney felt during her first holiday season in recovery. “Everything was so fresh and new. One minute I’m happy to be sober, and then I’m crying and angry. I was trying to find my footing and function as a normal person.”
Dan says many patients are blindsided by the flood of emotion and cravings. “They don’t understand what’s going on. They’ll say: ‘I’m sick of using, I’ve lost my job, I’ve lost everything, and I don’t know why I still want to use.’ When I explain why the brain is driving this behavior, sometimes they’ll come to tears.”
If you have underlying mental health issues, such as depression, anxiety, PTSD, or unresolved trauma, it’s important to get treatment in addition to treatment for substance use disorder.
Journaling can help too. “Journaling is a way to get to our thoughts and anxieties,” Dan says. “It helps to identify triggers and anything that’s causing stress, so you can think more critically.”
And while you needn’t push yourself to visit unwelcoming family, Dolores notes that sometimes, even the attempt to connect can ease feelings of guilt and regret.
“I tell patients, ‘Pick up the phone and call your mother. She may not answer, but you’ll feel better that you put forth the effort.’”
Tip # 4: Take your Suboxone® or other medications that help with your substance use disorder
At no time is medication-assisted treatment more critical than the holidays. Medication such as Suboxone® fills the brain’s opioid receptors, blunting cravings and the misery of withdrawal.
A dose lasts 24 hours, so to keep those receptors filled, the medication must be taken daily. Otherwise, the compulsion to use will come on strong. “The brain is programmed to avoid withdrawal at all costs,” notes Dan.
Laney knows that well. She completed seven inpatient treatment programs in 10 years, only to relapse each time. It wasn’t until she was offered Suboxone® at Ideal Option that she was able to sustain recovery.
Once, while visiting her mom, she briefly considered stealing her mom’s pain pills.
“But Suboxone® took away that thinking,” she says. “I told myself: If you take it, you’re not going to get high, so there’s no point. Without Suboxone®, knowing the pills were there would have driven me crazy.”
Tip #5: Do what makes you happy
When you’re in active addiction, your brain is constantly flooded with dopamine, a chemical involved in the brain’s pleasure and reward system.
When you’re in recovery, that flood has receded — along with the misery it brought — and you may be left feeling down.
“Make a list of activities that bring you fulfillment and joy,” advises Dan. “If you’re feeling triggered, immediately look at your list and jump into one of those activities. That will give a natural dopamine release.”
Even in a pandemic, there’s no shortage of ways to enjoy yourself around the holidays. Go for a bike ride or a walk in the woods. Toss around a football with your kids or grandkids, or take them sledding. Attend a church service on Zoom. Listen to music or bust out your guitar.
Tip #6: Develop a daily routine
“When my patients lose structure in their life, they start to feel more chaotic, and that introduces stressors that can result in a return to use,” says Dan. “When you have structure in your life, you’re exerting control, and that can be really powerful.”
If you’re not working, developing a routine takes more effort, but it’s important for staving off boredom. Focus on building healthy habits, such as daily exercise and nutritious eating.
Go for a morning walk, set aside a time to journal or meditate, learn a new skill with a free online course, and try new recipes.
Tip #7: Know that the holidays will get easier
That first year in recovery, Laney muddled through, relieved to be sober but feeling awkward, anxious, overwhelmed. Not yet working, she worried about money for gas, food, electricity, and other things.
A year later, employed as a server, she felt stable enough to spend Christmas with her boyfriend’s family. “Instead of showing up dirty and grimy, like we used to, we actually helped decorate the tree and brought Christmas cookies. That was a new thing. It felt good — not forced. I felt a lot more solid than the first year.”
This year is better still. She even quit smoking. Emotionally, she’s on an even keel. She has her own place to live. She’s a mom.
“On Halloween, we carved pumpkins, and we’re starting our own little traditions. Suddenly, the holidays feel new, fresh, and fun.”
If you feel like you need extra support during this holiday season, please reach out to us. Visit www.idealoption.com or call 1-877-522-1275. We can help!