The entire world population is experiencing trauma as a result of COVID-19. The pandemic has been changing several aspects of our lives for over a year now. The negative effects of COVID-19 are felt on our finances, our social activities, and our physical and mental health. This collective trauma affects each of us, but even more so those of us who suffer from addiction, mental illness, or concurrent disorders.
While it can be tempting to postpone treatment, these health problems must especially be addressed and treated during the pandemic. “Public health sanitary measures such as physical distancing, quarantine, and confinement can exacerbate loneliness, mental health disturbances, withdrawal symptoms, and psychological trauma”.  Adaptive and flexible solutions such as outpatient programs and online counselling can help to support those who are struggling during this time of physical distancing and uncertainty.
Why Continue or Begin Treatment During COVID-19?
The risks associated with mental illness and addiction can quickly become greater than those associated with COVID-19.
- Alcohol or drug addiction: Excessive alcohol consumption often leads to physical dependence. It can cause depression in addition to weakening the immune system, therefore increasing risk of contracting a virus or relapsing.
- Mental health disorder: A person with a mental illness is at risk of exposure to unique triggers related to COVID-19 that worsen their condition, such as fear, anxiety, and anger.
Treating A Drug or Alcohol Addiction During the Pandemic
Current global circumstances surrounding COVID-19 may create situations that may jeopardize your recovery:
- Coping with the pandemic may cause you to consume alcohol or psychoactive substances in large quantities to relieve negative emotions. This is called self-medication, where one may self-diagnose and take substances as a coping mechanism without consulting a healthcare professional. Self-medication presents several risks, such as unwanted side effects, improperly adjusted dosage, and even overdose. If a person self-medicates and is genetically susceptible to substance abuse, they risk developing an addiction or relapsing into a pre-existing one.
- Stopping alcohol or drug intake suddenly—whether by choice or by lack of access—and without medical consultation can have serious consequences. Alcohol withdrawal symptoms vary, but can be fatal for some heavy drinkers. Withdrawal from other substances may cause discomfort or stress, provoking one to seek out new or more substances, which could lead to a lethal overdose.
- Social isolation is an identified trigger for addiction and relapse. A person in recovery relies on meetings with their therapist and support groups. However, social distancing complicates access to these essential resources. In this context, virtual drug treatment can help you avoid relapse. Even if you are not in the same room, you no longer have to feel alone. Professionals and peers can come to you to support you, even with physical distancing measures in place.
Feelings of boredom and loneliness created or amplified by the pandemic are strong triggers. Telehealth allows you to begin your treatment at home without delay. For example, EHN Online is our virtual intensive outpatient program, designed to treat drug or alcohol addiction or mental health disorders. This treatment allows you to talk to a therapist via teleconsultation and participate in vital online support groups.
Existing treatment options have needed to adapt in order to continue providing effective service throughout the COVID-19 pandemic. Evan Newton, therapist at Bellwood Health Services, explains that preparing for life after treatment has also changed for people undergoing inpatient treatment: “To respect physical distancing without undermining social life, we offer support groups that are now online and accessible every day, at any time of the day, anywhere in the world”.
Treating a Mental Health Disorder During COVID-19
The results of an online screening test developed by Mental Health America show that anxiety and depression disorders have increased dramatically since the start of the pandemic. Between April and September 2020, 70% of respondents with moderate to severe anxiety or depression disorder said one of the top three contributing factors to their mental health issues was loneliness or isolation. 
Negative emotions in response to the current crisis are normal. Online therapeutic programs exist to help you regain control of your life while respecting health measures. You can speak to a therapist and interact with people who are experiencing struggles like yours through online support groups.
EHN Online offers a virtual intensive outpatient treatment programs that include individual counselling, group therapy sessions, and 10 months of aftercare. This virtual program also provides access to our wellness app to help ensure that you have access to all the resources you need to help meet your mental health or addiction goals.
Choosing Telehealth to Treat a Substance Abuse or Mental Health Disorder During a Pandemic
Public health measures have complicated access to health care. In-person consultations are limited, and some people avoid going to their doctor out of fear of contracting COVID-19. Telehealth makes it possible to overcome these challenges and offer care despite the restrictions put in place to keep communities safe.
Telehealth or telemedicine includes several forms such as teleconsultation, tele-expertise, telesurveillance, teleassistance and telepsychiatry. The Federation of Medical Authorities of Canada has defined it as a “medical service provided remotely via information and communication technology”, available by email, phone, video conference, text message, live chat, mobile application, or a web platform. 
As one of many examples, telehealth allows your doctor to send your prescription directly to the pharmacist, who then has your medications delivered to your home. You can also take advantage of a videoconference consultation with your therapist or undergo treatment for a substance use, mental health, or concurrent disorder.
The Main Advantages of Virtual Treatment
Utilizing virtual treatment solutions to address and recover from mental health and addiction has several advantages. This includes better access to care, flexibility, and greater accessibility.
1. Access care during a pandemic
Telemedicine allows you to start or continue your treatment remotely while respecting public health measures. The World Health Organization supports that telehealth services enable access and continuity of medical care while reducing the potential for community spread of the virus. 
2. Flexibility that facilitates effective treatment
Health professionals can offer consultations and support groups outside of normal hours. As an added bonus, you don’t have to travel to your appointment, get stuck in traffic, hire a babysitter, or miss hours of work.
The Journal of Substance Abuse Treatment explains that this new flexibility and simplicity seems to have a positive impact on the retention rate, increasing the number of people who complete a treatment.
3. Greater accessibility for remote areas
Remote areas are often underserved when it comes to treatment for addiction and mental illness. Virtual solutions are reducing the issue of physical distance between patients and healthcare professionals, so that everyone can access the care they require.
4. Video conferencing experience
Not being able to meet in-person with a therapist or group is often considered one of the biggest disadvantages of telehealth. However, advances and increased accessibility of video conferencing continue to overcome this disadvantage: video conferencing allows clients and therapists to still communicate face-to-face. While in-person therapy, when possible, is valuable, virtual therapy has its own unique positive features. In fact, Michèle Bernard, therapist at Clinique Nouveau Départ, explains that “the distance created by videoconferencing often pushes people to open up more easily”.
What do I Need for Virtual Treatment?
Most modern home devices are sufficient to get you started in online treatment. Here are the basics of what you would need:
- You are able to access a video conferencing platform such as Zoom
- You own a computer or device with access to a high-speed Internet connection, a camera, and a microphone
- You have a private space to share personal information securely
Begin or Continue Treatment with EHN Canada
In today’s environment, we offer both inpatient treatment at our facilities across the country and a virtual intensive outpatient program. Before starting treatment, our team of specialists will contact you to make a telephone assessment of your condition. Screening questions allow us to assess your situation to provide you with the treatment that is truly right for you.
Here are some questions you might be asked:
- How much alcohol or drugs do you use? How often?
- Are you able to reduce or stop your consumption as needed?
- Do you feel the need to consume more and more alcohol or drugs to achieve the same effects?
- Are alcohol or drugs having a negative impact at work or in other areas of your life?
- Do you suffer from other types of addictions?
- Have you done therapy in the past?
For residential or inpatient treatment, we continue to welcome people with addictions and mental disorders ranging from moderate to severe. We have adapted our internal protocols to the current context. Our prevention and control measures go beyond public health recommendations to ensure a safe environment for everyone.
- New arrivals must isolate themselves and take a screening test before joining the group
- Visitors and outpatients cannot come to the clinic
- Individual meetings with therapists and group meetings take place in person in a safe environment
- Regulated requirements at all times include mask wearing, physical distancing, and proper sanitization of hands and high-touch locations
EHN Online: Intensive Virtual Care from Home
Is This Type of Treatment Suitable for Me?
As with anything, mental health resources are not a one-size-fits-all solution. Finding suitable treatment depends on the severity of the disorder you have. However, people with mild to moderate symptoms of drug or alcohol dependence can benefit greatly from our online treatment at home via video conferencing.
People with mild to moderate symptoms are usually able to:
- To carry out daily activities
- Continue to assume most responsibilities at work
- Better control their cravings for alcohol or drugs
- Despite these positive actions, negative effects of substance use or behaviour changes are or are starting to become evident
Additionally, an EHN Online intensive outpatient program may be right for you if:
- You feel as though you need more structured treatment than your current online therapy, group therapy, or medication
- Or you need a treatment that is less structured than an inpatient rehabilitation program
Our Intensive Outpatient Substance Addiction Program is now offered by video conference. This has been adapted to be accessible and safe during the pandemic.
To find the best fit for you, one of our specialists will do an evaluation by phone to determine the level of severity of your disorder and offer you a treatment adapted to your needs. For more information, call us anytime at 1-866-860-8302.
How Does Virtual Treatment Work?
Here is what to expect from the EHN Online program that is designed to treat alcohol and drug addictions:
Phase 1: Two Months of Intensive Therapy
Four evenings of virtual group therapy and one individual consultation per week by videoconference.
- Group Therapy: discussion guided by a facilitator based on themes such as emotions and self-regulation, mindfulness, the pleasure of a life without substances, interpersonal relationships and family, and relapse prevention
- Individual Counselling: Private session with your therapist utilizing evidence-based approaches, primarily Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT). CBT and DBT help identify and effectively change how your thoughts, attitudes and beliefs relate to the behavioural reactions that negatively affect your mental health or addiction.
Phase 2: Ten months of Aftercare
One group meeting per week by videoconference.
- Connect with people who are currently in treatment and others who are recovering through group meetings. These guided discussions allow you to feel less alone and to feel heard by people who are or have been through similar situations.
Throughout your time in our intensive outpatient therapy program, you will have access to our outpatient app, Wagon. This will help you to track daily progress, accomplish your goals, and better communicate with your counsellor to achieve and follow your personalized recovery plan.
Each evening, you will answer a few questions about feelings, triggers, and more to help you and your counsellor determine your patterns and create coping strategies to manage difficult times. Additionally, you can turn to your SOS section whenever you feel like you require immediate support.
Peer Support Through Video Conferencing
The Mental Health Commission of Canada (MHCC) describes peer support as “a supportive relationship between people who have a lived experience in common.” The MHCC explains that supportive peers “are valued for their authenticity because they can relate to the challenge and have found their way to recovery”. 
As Evan Newton points out,” This is a fundamental part of recovery. People with substance abuse disorder or mental illness are strongly encouraged to participate in these focus groups during and after their treatment”. EHN Online offers support groups for a variety of needs, including socialization and stabilization to help participants connect with others regardless of their recovery status. This form of transitional support helps the group members to identify their next steps and share their experiences with others.
As a result of COVID-19, these support groups are now available online. The structure remains the same: a facilitator guides the discussions around a theme and people with similar experiences share their stories. “There are several theories that explain the nature and effectiveness of peer support. At its core, peer support alleviates the feelings of isolation and shame in those who are afflicted” [Translation]. 
EHN Online supports patients in identifying and joining groups that will aid their recovery and help them maintain positive connections and habits that were formed during treatment.
How Can Virtual Therapy Help Me?
Studies cited by Frontiers in Psychiatry have shown that “telehealth, particularly live video interaction with therapists, has significant positive effects on the mental health of patients”.  A report from the Canadian Agency for Drugs and Technologies in Health (CADTH) demonstrates that patients who undergo therapy to treat drug addiction through telemedicine are as likely to complete it as they do with in-person treatment. 
While virtual healthcare is a relatively new practice, research suggests that teletherapy is a viable alternative or a useful addition to in-person cognitive- behavioral therapy (CBT) for alcohol and drug addictions.  It is expected that as research and solutions continue to grow, the benefits of virtual counselling and care will grow in parallel.
Telehealth After COVID-19
The pandemic is pushing health professionals and the scientific community to rethink their methods of offering treatment. Frontiers in Psychiatry specifies that we must “identify and integrate evidence-based information technology and digital tools […] to have addiction care services which are resilient in the face of future systemic shocks”. 
Emily Pfender, a behavioral technician and doctoral student in health communication with a specialization in mental health, believes that “by increasing the use of telehealth and investigating best practices for its use […] we can provide preventative measures after the COVID-19 pandemic subsides, more effective care to patients during future pandemics and global crises, and reduce mental health care disparities”. 
Further research is required to confirm the long-term benefits and effects of telehealth, but this newer solution shows great promise.
Telemedicine is a solution that allows you to treat an addiction or mental health disorder during COVID-19.
EHN Canada Can Help You
Speak to one of our specialists to begin your journey with our intensive outpatient program. If you would like to learn more about the addiction and mental health treatment programs provided by EHN Canada, enroll yourself in one of our programs, or refer someone else, please call us at 1-866-860-8302 for virtual outpatient support, available wherever you are.
Our phone lines are open 24/7—so you can call us anytime.
,  &  Jemberie WB, Stewart Williams J, Eriksson M, Grönlund AS, Ng N, Blom Nilsson M, et al. Substance use disorders and COVID-19: Multi-faceted problems which require multi-pronged solutions. Front Psychiatry [Internet]. 2020; 11: 714. https://dx.doi.org/10.3389/fpsyt.2020.00714
 MHA. nd “Covid-19 and Mental Health: A Growing Crisis.” Mental Health America. https://mhanational.org/sites/default/files/Spotlight%202021%20-%20COVID-19%20and%20Mental%20Health.pdf.
 Bruneau, J., Rehm, J., Wild, TC, Wood, E., Sako, A., Swansburg, J. and Lam, A. Telemedicine for the treatment of substance use disorders: A practical guide national. Montreal, Quebec: Canadian Substance Abuse Research Initiative. Version 1. May 2020 p. 13.
 World Health Organization. Telemedicine: Opportunities and Developments in Member States: Report on the Second Global Survey on eHealth 2009 (Global Observatory for eHealth Series, Volume 2). 2010. https://www.who.int/goe/publications/goe_telemedicine_2010.pdf
 Mental Health Commission of Canada. Guidelines for the Practice and Training of Peer Support [Internet]. mentalhealthcommission.ca. https://www.mentalhealthcommission.ca/sites/default/files/peer_support_guidelines.pdf.pdf
 Elliott L. The lived experience takes the lead in a peer support project [Internet]. mentalhealthcommission.ca. https://www.mentalhealthcommission.ca/sites/default/files/PS_Lived_Experience_Article_FRE_2.pdf
 Ho C, Argáez C. Telehealth-delivered opioid agonist therapy for the treatment of adults with opioid use disorder: Review of clinical effectiveness, cost-effectiveness, and guidelines. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2019.
 CADTH. Telehealth: Summary of Evidence [Internet]. 2016. p. 10. https://cadth.ca/sites/default/files/pdf/telehealth_bundle.pdf
 Pfender E. Mental health and COVID-19: Implications for the future of telehealth. J Patient Exp. 2020; 7 (4): 433–5.
American Psychiatric Association, American Psychological Association et al. nd “A Unified Vision for Transforming Mental Health and Substance Use Care.” Wellbeingtrust.Org. https://wellbeingtrust.org//www/wp-content/uploads/2020/10/Unified-Vision-v8-10_28_2020.pdf.
Anderssen, Erin. 2020. “Half of Canadians Have Too Few Local Psychiatrists, or None at All. How Can We Mend the Mental-Health Gap? The Globe and Mail, January 18, 2020. https://www.theglobeandmail.com/canada/article-half-of-canadians-have-too-few-local-psychiatrists-or-none-at-all/.
Bruneau, J., Rehm, J., Wild, TC, Wood, E., Sako, A., Swansburg, J. and Lam, A. Telemedicine for the treatment of substance use disorders: A practical guide national. Montreal, Quebec: Canadian Substance Abuse Research Initiative. May 15, 2020. 52 p. Version 1.
CADTH. 2016. “Telehealth: Summary of Evidence.” Cadth.ca. 2016. https://cadth.ca/sites/default/files/pdf/telehealth_bundle.pdf.
“COVID-19 and the Opioid Crisis: When a Pandemic and an Epidemic Collide.” Nd Aamc.Org. https://www.aamc.org/news-insights/covid-19-and-opioid-crisis-when-pandemic-and-epidemic-collide.
“COVID-19 Information and Resources – Families for Addiction Recovery.” Nd Farcanada.Org. https://www.farcanada.org/covid-19/.
Galewitz, Phil. 2020. “Coronavirus Crisis Spurs Access to Online Treatment for Opioid Addiction. ” April 20, 2020. https://www.npr.org/sections/health-shots/2020/04/20/837120101/coronavirus-crisis-spurs-access-to-online-treatment-for-opioid-addiction.
Grinspoon, Peter. 2020. “A Tale of Two Epidemics: When COVID-19 and Opioid Addiction Collide. ” Health.Harvard.Edu. April 20, 2020. https://www.health.harvard.edu/blog/a-tale-of-two-epidemics-when-covid-19-and-opioid-addiction-collide-2020042019569.
Harvard Health Publishing. 2019. “Alcohol Withdrawal: What Is It?.” Health.Harvard.Edu. April 2019. https://www.health.harvard.edu/a_to_z/alcohol-withdrawal-a-to-z
Jemberie, Wossenseged Birhane, Jennifer Stewart Williams, Malin Eriksson, Ann-Sofie Grönlund, Nawi Ng, Marcus Blom Nilsson, Mojgan Padyab, et al. 2020. “Substance Use Disorders and COVID-19: Multi-Faceted Problems Which Require Multi-Pronged Solutions.” Frontiers in Psychiatry 11: 714. https://doi.org/10.3389/fpsyt.2020.00714.
Lin, Lewei Allison, Anne C. Fernandez, and Erin E. Bonar. 2020. “Telehealth for Substance-Using Populations in the Age of Coronavirus Disease 2019: Recommendations to Enhance Adoption: Recommendations to Enhance Adoption. “JAMA Psychiatry (. Chicago, Ill) 77 (12): 1209. https://doi.org/10.1001/jamapsychiatry.2020.1698.
MHA. nd “Covid-19 and Mental Health: A Growing Crisis.” Mental Health America. https://mhanational.org/sites/default/files/Spotlight%202021%20-%20COVID-19%20and%20Mental%20Health.pdf.
Montastruc, Jean-Louis, Emmanuelle Bondon-Guitton, Delphine Abadie, Isabelle Lacroix, Aurélia Berreni, Grégory Pugnet, Geneviève Durrieu, et al. 2016. “Pharmacovigilance, Risks and Adverse Effects of Self-Medication. ” Therapie 71 (2): 257-62. https://doi.org/10.1016/j.therap.2016.02.012.
Mota, Pedro. 2020. “Avoiding a New Epidemic during a Pandemic: The Importance of Assessing the Risk of Substance Use Disorders in the COVID-19 Era.” Psychiatry Research 290 (113142): 113142. https://doi.org/10.1016/j.psychres.2020.113142.
Pfender, Emily. 2020. “Mental Health and COVID-19: Implications for the Future of Telehealth. Journal of Patient Experience 7 (4): 433–35.
Rocksheng, Zhong. 2020. “COVID-19 and the Future of Telepsychiatry.” Psychology Today, August 18, 2020. https://www.psychologytoday.com/blog/trends-in-telemedicine/202008/covid-19-and-the-future-telepsychiatry.
Health Canada. 2020. “COVID-19 and Substance Use: A Toolkit For Service Providers and People Who Use Drugs”. canada.ca. December 1, 2020. https://www.canada.ca/fr/sante-canada/services/dependance-aux-drogues/trousse-outils-consommation-substances-covid-19.html.
Health Canada. 2020. “Supporting people who use substances during the COVID-19 pandemic. “Canada.ca. September 1, 2020. https://www.canada.ca/fr/sante-canada/services/dependance-aux-drogues/aide-personnes-qui-utilent-substances-covid-19.html.
Santilli, Mara. 2020. “Will COVID-19 Change the Way We Treat Opioid Use Disorders?” Refinery29. September 23, 2020. https://www.refinery29.com/en-us/2020/09/10040231/opioid-use-treatment-telemedicine-covid.
Shainna, Ali. 2020. “Telemental Health during the Coronavirus Pandemic.” Psychology Today, 7 April 2020. https://www.psychologytoday.com/blog/modern-mentality/202004/telemental-health-during-the-coronavirus-pandemic.
Wikipedia contributors. 2021. “World Population.” Wikipedia, The Free Encyclopedia. February 28, 2021. https://en.wikipedia.org/w/index.php?title=World_population&oldid=1009453542.
“World.” 2020. Prb.Org. June 18, 2020. https://interactives.prb.org/2020-wpds/.
World Health Organization. 2009. “Telemedicine: Opportunities and Developments in Member States: Report on the Second Global Survey on EHealth Global Observatory for EHealth Series.” Https://www.who.int/goe/publications/goe_telemedicine_2010.pdf.
“World Population: 2020 Overview.” Nd Yale.Edu. https://yaleglobal.yale.edu/content/world-population-2020-overview