On March 19, 2020, a Public Health Order from the California state government directed all Californians to stay home except “to go to an essential job or to shop for essential needs.” Labeled “essential businesses,” Santa Clara County’s 10 BevMo! liquor stores stayed open on March 19 and never closed.

In fact, BevMo! employees say that their stores now have more customers than since before the start of the COVID-19 pandemic. BevMo! has also added an alcohol-delivery option at all of its locations.

Jason J., a Whole Foods manager in Silicon Valley who requested anonymity due to Amazon’s strict communication protocols, says alcohol sales across the board are up at least double digits in the months of March through June compared to last year.

The pandemic “has been good for the industry,” he says. “Spirit sales have been astounding. In a given week, we’re doing 40 percent over last year.”

The numbers are similar nationwide. Off-premise sales of spirits have soared 32 percent, while wine sales have increased 26 percent and beer sales are up 17 percent over the same period in 2019, according to Wine Business.

The surge in alcohol sales locally during quarantine shouldn’t come as a surprise since bars have been closed in the Bay Area. Take-home cocktails have been the hot item everywhere, especially at Whole Foods. In particular, a product called On the Rocks has been “flying off the shelves they’re selling so fast.”

Prior to the pandemic, Jason says the Whole Foods store he works at had “token representation” of take-home cocktails. Not any longer. “It used to be a convenience item more than anything,” he says. “But with bars being closed, people are flocking to our stores to get any kind of cocktail. We’ve stocked a lot more take-home cocktails because they’re selling so fast. Once bars were closed up, we had directives to make sure our shelves were full and prepared. And almost immediately sales picked up.”

Bitter sparkling sodas—which are soda water with bitters in it—have also been a huge hit, as customers can take them home and add any spirit to their liking.

“It’s kind of like a base cocktail, and it’s been pretty popular,” Jason says. “We’ve started carrying more of those in the last two months.”

Under the Influence

Since the pandemic upended everyone’s way of life in March, many Silicon Valley residents have developed a new relationship to substance abuse.

Meanwhile, many of the programs that treat people for substance-use disorders have been constrained by public health measures that require social distancing and quarantines to slow the spread of COVID-19.

Angelito Kemp, program manager for the Fremont office of Center Point, a government-supported referral center that places people into substance use programs, says public health orders have forced him to turn many clients away.

“The program is taking less clients because of COVID, because they want to social distance,” Kemp says. “We have what we call a ‘pending services list’...  We’ve had it as long as 95 clients who need to get into a program.”

Center Point tests clients for COVID-19 and brings them into the general population if the test is negative, but if the client tests positive, they are not allowed in. Kemp emphasizes that COVID-19 has in no way stopped substance abuse, but has in fact hindered programs in place for helping addicts, including homeless people, who make up a substantial amount of Center Point’s patients.

The Bay Area’s homeless population has grown quickly in recent years, and suffers significantly from substance abuse. Now, with many recovery services going online, the South Bay population of unsheltered residents is blocked from the regular in-person meetings they previously relied on.

“This has affected the homeless population’s ability to stay sober and off alcohol,” says James Raggio of East Bay Intergroup, which supports AA fellowships throughout the region. “Because we’ve had a certain percentage of our members who are homeless who would come to in-person meetings that don’t have access to technology and who are not able to attend Zoom meetings … I’m certain it has affected their sobriety.”

Another Bay Area recovery program is Options Recovery Services, an agency with outpatient treatment services as well as housing for people in recovery. Justin Philips, an operations officer for the nonprofit, confirms that many Options clients are homeless.

He adds that they expect the homeless population to increase soon, “With people that have pre-existing health conditions, mental health conditions, addiction and so on. That is going to create a critical situation for them. Then you have people that are obviously impacted by not having stable employment or losing their jobs or not being able to afford their rent or their mortgage or what have you.”

Philips points out that homelessness is entwined with substance abuse. “With the current nature of COVID and all the stress that comes along with that—it reactivates trauma, it creates a sense of instability and un-safety,” he says. “People go to what works for them. Unfortunately, for millions of people, alcohol is what works for them, nicotine is what works for them, methamphetamine is what works for them; and that reignites a vicious cycle of dependence that is deadly and leads to more and more and more problems.”

Although it may seem like the world shut down on March 19, drug dealing never faltered and access to addictive substances did not stop.

“If you ask just about any addict, they’ll say, if they need a drug, they’re going to find it,” says Edward G., who works for the NorCal Region of Narcotics Anonymous, a 12-step fellowship and sister program to AA; and as per the group’s foundation of anonymity, his last name is not included in this article. “Addicts will go to any length to get what they think they need,” he says. “I think that the business still carried on. It’s an illicit business, is it not? So why would they be hindered by any public order?”

NA has not seen any significant decrease in relapses or lack of access to narcotics from COVID-19, and Edward compares the virus to the disease of addiction in its ruthlessness.

Sobering Up

Michael G. checked himself into Harmony Place Drug Rehab Center in Woodland Hills on June 6. A cocaine addict, Michael G.—whose real name is not being used, per the center’s rules—was carried out of his home on a stretcher two days prior, after collapsing to the floor. “My body went numb,” he says. “Honestly, I thought I was having a heart attack and was going to die. I hadn’t slept or eaten for two days.”

The coronavirus pandemic has affected every sector of life in the United States, which has the most disease-related infections and deaths in the world—and the runner-up isn’t even close. The virus has made recovery centers like Harmony Place—which also has a facility in Monterey—adjust and evolve so their clients can continue to receive the best care possible in hopes of getting clean.

The last three months of quarantine have been particularly difficult for people like Michael G., who are either battling substance abuse issues or in the process of recovery.

“During the pandemic, there’s been a lot more free time because you weren’t able to go anywhere,” he says. “So I was either home doing drugs or out of the house acquiring drugs. It definitely impacted my [two year] addiction to cocaine.”

Harmony Place founder Jeff Schwartz says he’s researched the numbers and found that liquor and drug sales have shot up dramatically since the pandemic hit. “The increase in alcohol consumption is incredible,” he says. “We’ve seen an 80 percent increase in alcohol sales … [and] a 100 percent increase in marijuana sales. The increase in the abuse of drugs and alcohol has been rampant. People are stressed out, having panic attacks, a lot of major depressive disorders and PTSD. In order to shut that down, people use alcohol, marijuana, pain medications, heroin, methadone and fentanyl. People are looking for an escape from having to deal with the reality of what’s going on right now.”

Busier Than Ever

Harmony Place has been inundated with increased phone calls, and Schwartz says the same thing is occurring at other recovery centers. “I’ve been a licensed therapist for 30 years and have been running a treatment center for 20 years, and I’ve never seen the facilities in my line of work as busy as it has been,” he says.

Due to state and county public health orders—and for safety reasons as Harmony Health has up to 50 new clients a day checking in from different areas of California—the center has transferred many of its services to telehealth since the pandemic began.

Psychiatrists and internal medicine doctors fill out their assessments and psychiatric evaluations online and see all of their patients using platforms like Zoom. Most if not all of the 12-step programs such as Alcoholics Anonymous and Narcotics Anonymous are holding their meetings virtually, and that has been the most glaring downfall for people who are in the process of recovering from substance-abuse issues.

“It’s really difficult to bring 12 clients in a room, have them watch a 65-inch TV screen and keep their attention,” Schwartz says. “Twelve-step meetings like AA and NA are all about camaraderie and connecting with one another, and it’s hard to get that personal connection over a TV screen. I’d say that’s been the biggest problem for everyone, is not being able to physically connect in the 12-step meetings.”

Schwartz went on to add that groups like AA and NA are free of charge—unlike private therapy sessions—removing any financial barriers from the clients. Just as important, the 12-step meetings provide accountability and community, critical factors in helping prevent a person from relapsing.

“If you don’t have a support group, then you’re going to have trouble,” Schwartz says. “Trying to do 12-step programs online, we’re losing people because they get bored and don’t feel the camaraderie. They start going out on their own and before you know it, they’re back on the phone having relapsed again.”

It’s been a little over three weeks since Michael G. checked into Harmony Health, and he is seemingly on his way to successfully beating his addiction. His cravings for cocaine have reduced dramatically, and he’s been able to finally have open and deep conversations about his addiction, taking accountability in the process.

Michael G. was effusive in his praise for the center, noting its safety measures and overall competency of the entire staff, from the nurses to the doctors.

“Jeff and his staff have helped me out a lot,” he says. “It’s been life-saving.”

Michael G. talks regularly to his family members, friends and fiancé, who stuck by his side throughout this process.

“My fiancé and family members have been extremely supportive and have even taken the initiative of walking in step with me on this journey,” he says. “They’re reading materials and wanting to understand where I’m coming from so that it will help me continue on this path. Now that I’m no longer trying to protect my addiction and the truth is out, I feel light as a feather and free as a bird.”

The Toll of Addiction

According to the National Institute on Alcohol Abuse and Alcoholism, around 88,000 people die in the United States each year from alcohol-related causes alone, and, according to the U.S. Centers for Disease Control and Prevention, around 46,900 people died from opioid-related causes just in 2018.

“As many Americans that have died from COVID, we lost that many Americans last year from substance abuse and alcohol, if not more, and I still think there’s a huge stigma attached,” says Josh Zeises, founder of the Facebook group Quarantine Conference: Mental Health & Substance Abuse, and chief marketing officer of Enlightened Solutions drug and alcohol addiction treatment center in New Jersey. “People don’t want to admit it, they don’t want to admit they have a problem, they don’t want to admit that their family members are suffering.”

Zeises founded the Facebook group on March 20 and used it to host a digital conference on substance abuse with hundreds of attendees from all around the world. He worries that without in-person services, addicts are struggling. “People that have found themselves addicted or relapsed or into a drinking habit are going to have a very difficult time [going back to work] without the help of a detox center,” he says.

In order to ensure that as many clients as possible retained access to their services, Options created a new process of admission.

“We bring people in, we check their temperature, we look for warning signs, we do a medical screening, we have an on-site medical doctor,” Zeises says. “She’s doing it through telehealth now, but every person is screened.”

Newcomers from the outside community enter a quarantine house where they can wait for a few weeks until they get a COVID-19 test and remain separate from general population housing. Philips has seen the number of clients at Options increase.

“Our doors remain open no matter what, so we view ourselves as an essential service,” he says. “People are suffering and dying from addiction every day, and we thought it was critical to remain open during that time.”

“As a result,” he adds, “we’ve actually seen more parts of the system refer to us, and we’ve seen an increase in our numbers overall because of that availability. There are a lot of agencies that were worried about how to provide services safely. We ultimately transitioned completely to telehealth so people are able to access our services.”

Telehealth is defined by MayoClinic as “the use of digital information and communication technologies, such as computers and mobile devices, to access health care services remotely and manage your health care.” Since the start of COVID-19, telehealth has expanded rapidly due to the Coronavirus Aid, Relief, and Economic Security Act (or CARES Act), which was signed into law at the end of March. The CARES Act expanded telehealth services in Medicare, and waived the requirement that medical services must include in-person meetings with a medical professional.

One recovery service that made the decision not to move online was Intervention Works, a California-based company that facilitates interventions between substance abusers and their loved ones. Intervention Works focuses on the emotional connection between people, and their process seemed impossible to replicate in a virtual environment.

Interventions Works therapists Cassia Bloom and Shawn Smith believe that substance abuse, particularly alcoholism, has increased in quarantine, even though Intervention Works has interacted with fewer clients. Bloom says that she has noticed a self-medicating trend in clients who are experiencing depression and anxiety in quarantine.

“I think that locking people in their houses for three months has led to a lot of things happening right now, substance abuse being one of them,” she says.

“Cabin fever and isolation is a big piece of it,” Smith says. “We know that isolation and substance abuse kind of go hand in hand.”

Luckily, ordinary 12-step meetings translate more successfully to a digital setting.

“We’ve had some people who have joined our meetings that are more curious, because it’s easier to go to a Zoom meeting and be anonymous than it is to walk in a door,” says Raggio about East Bay Intergroup. “So, because of that we’ve had people come and join meetings with less inhibition.”

Although they scrambled to set up online meetings and even dealt with “Zoom bombing,” his organization is one of many that intend to make online resources a permanent feature. Another organization that will take this step is Narcotics Anonymous.

Edward says, “Exponentially, our fellowship grew in terms of people meeting and getting to know each other in a way that we never could before, so it was a very positive fallout.”

Both programs still intend to bring back in-person meetings whenever possible.

Because, as Raggio notes in a recent interview, “AA is completely about connection and helping one alcoholic work with another, and part of that connection in the past has definitely been more face to face and in-person.”

Options will keep online recovery services as well as in-person services in a COVID-19-free future, because some Options clients have found online meetings less stressful.

“As opposed to having 12 people in a circle and one person is trying to speak in front of 12 people, it kind of lessens the stage fright in a telehealth type of venue because the people aren’t directly physically in front of you,” Raggio says. “From the facilitator’s standpoint, they’re starting to see a lot more honesty and information sharing in their groups by people that didn’t traditionally do that in an in-person setting. The social pressure is kind of lessened with telehealth, and we’re looking at that as a real benefit.”

Staying at home affects people’s sobriety in a variety of ways. Larry V. Moore Jr. has been sober for five-and-a-half years, but at a difficult time in quarantine, he commented on social media that he was considering drinking again.

“With all of this stuff happening, it really did come to the point where I thought ‘Gosh how nice would it be to just go out to the liquor store, buy a bottle of Jameson, come home and just get completely tore up when the kids were at their mom’s house,’” he says.

Moore lives in Florida, and since March, he has not seen his brother, sister-in-law, niece, mother or father in person because his family is concerned for the niece’s health.

Moore’s dog died recently, and with the absence of his family and beloved pet, he found himself struggling. “I’m stuck at home and you can’t go anywhere and you can’t do anything; you’re alone and the whole world is kind of collapsing and it’s just kind of an implosion,” he laments.

Moore says that maintaining sobriety requires filling one’s time with engaging activities that do not involve substances.

Luckily, he has found a special way to keep himself occupied: a rabbit.

“Now that we’ve got the bunny in our life, it’s kind of filled the void of the loss of my 13-year-old best friend [dog] and so, quarantine or not, I’m not having an urge right now, because to be honest I don’t have the time to sit around and think ‘I really could use a drink,’ he says. “Instead I’m sitting around and thinking, ‘Gosh I can train [the rabbit] to jump through hoops and to fetch,’ and I read about rabbits … I know that sounds silly but that’s exactly what I’ve done. And it’s just taken my mind off of, not just losing the animal that I loved so much, but being so down.”

Unfortunately, not everyone has been able to achieve sobriety.

“A lot of people who were living a clean and sober lifestyle—either early in recovery or further into recovery—were able to maintain it for the first few weeks, were able to maintain their sobriety, but everybody has a breaking point,” Bloom says. “So I think during the middle of the quarantine, a lot of people hit a lot of breaking points. So you have your people who were already using going into the crisis and the people who were sober who relapsed during the crisis.”

An anonymous source says that when quarantine first started, she became less reliant on her addiction to prescription stimulants, but has been drinking and smoking marijuana more often. “I haven’t seen memes about doing meth because you’re bored, but you see memes about getting drunk because there’s nothing else to do,” she says. “Drinking is probably the worst thing that I do for my health. I use Adderall less … but the thing that has been getting worse is the drinking.”

She attributes this to boredom, and says the lack of stimulation people experience when staying at home is a much stronger cause of stress than it gets credit for.

Substance abuse is not deterred by anything, including a pandemic. COVID-19 has resulted in a lack of in-person services, and stress to addicts.

As Edward says, “It [addiction] doesn’t care if you’re red. It doesn’t care if you’re blue. It doesn’t care if you’re Black. It doesn’t care if you’re straight. It doesn’t care if you’re LGBTQ, gender non-conforming, whatever it is. It does not care. It is the exact parallel of the COVID-19 virus. It does not care.”

RECOVERY RESOURCES 

Greater San Jose Area of Narcotics Anonymous sjna.org

Peninsula Area Narcotics Anonymous peninsulana.org/meetings

Santa Clara County Fellowship of Alcoholics Anonymous aasanjose.org

Intervention Works 831.332.0047