by Elena Vidrascu, MSc

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Preventing America’s Next Drug Epidemic: A Multidisciplinary Approach is a series designed to introduce the many facets of substance abuse, and how integrating the work of multiple partners may be the best approach towards prevention and treatment.

As of March 24th, the number of active cases of COVID-19 (coronavirus) in the United States reached 55,236. My graduate school advisor made a spreadsheet tracking the active number of cases in the US and how this compares to Italy’s trajectory of the spread. In the graph below, the blue line represents Italy and the orange line the US. I’ve filled in the numbers for the past couple of days, and as of yesterday we can see that the actual number of cases in the US is on par with the predicted exponential curve. By the end of today, the number of cases is expected to reach 80,000. This is about a week faster than the rate of spread in Italy. Exponential curves aren’t perfect, but they do tell us one thing: it feels like nothing is happening until suddenly things explode. That explosion is what we are about to experience, and according to several news articles, some young people just don’t seem to care.

As one young 20-something person recently put it on Instagram, “Social distancing wasn’t working for us,” with a hashtag “coronavirus can’t stop us” and a photo of 8 young people apparently partying and drinking beer. What is it about the flood of news coverage headlines that isn’t reaching these young people? Or if the news is reaching them, why does it elicit such opposition? For millions of Americans, and people all over the world, this pandemic is eliciting fear and stress, exacerbating symptoms of mental illness in many, and yet in many others, nothing is triggered, as they seem to simply move on with daily life as if normal. As a young adult myself, this is extremely disturbing to witness.

In 2018, 57.8 million Americans were diagnosed as having a mental and/or substance use disorder. Out of the estimated population of 327,536,552 in December 2018, 57.8 million comes to about 18% of the population. About 1 in every 5 people is likely to be severely affected by the stress this pandemic has brought, with job insecurity, fear for loved ones, social isolation, and many additional factors challenging their mental health. Acute stress is known to exacerbate mental health problems, and this pandemic is nothing short of a stressor. If you take a moment to look at peoples’ Facebook posts at this time, it’s obvious that a common coping strategy is to indulge in alcohol. What many people likely don’t realize is that there is a bidirectional interaction between acute stress and alcohol consumption. Initially, alcohol may seem to help reduce distress, but it may actually prolong the tension produced by a stressful event. Many research studies with animals and humans have also demonstrated that stress increases cravings for drugs and alcohol, which suggests how this pandemic can quickly become a disaster for many people who are unable to cope in other ways and/or are trying to maintain their recovery.

Perhaps many young people are subconsciously dealing with this stress by continuing to party with their friends. Advising people to practice social distancing may itself be a stressor for those who are on the extreme right end of the introversion-extroversion scale. They can’t fathom being alone with themselves for an indefinite period of time. So when they hear that only older people are getting sick and dying, their response is to disregard social distancing recommendations and act as if they are immune of any viral infection even though more reports are showing there are instances where younger people have become ill and even died from COVID-19. Many recent studies, including an epidemiological study done with 2143 children in China, shows that children at all ages were susceptible to COVID-19, even if experiencing less severe clinical manifestations. The important thing to emphasize here is that although young people may be more likely to be asymptomatic, they can be contagious and spread the virus to vulnerable people at risk of dying. In the figure below we can see that although there’s a low number of deaths among individuals aged 20-44 in the US, the number of hospitalizations between February 12-March 16 is high, indicating that young people are getting infected and therefore can spread the infection to others. 

Even by reducing exposure to other people by 50%, the drop in spread of infection after 30 days is huge, as is illustrated in the figure below.

Although young people may be more likely to be asymptomatic, they can still be contagious and spread the virus to vulnerable people at risk of dying.

One thing is certain: the way we process stressful events is different for each of us.

To identify how stress might be impacting you during this COVID-19 outbreak, please check out the following CDC guidelines for coping with stress: https://www.cdc.gov/coronavirus/2019-ncov/prepare/managing-stress-anxiety.html

It might also be helpful to remember what others have said: we really are all in this together. Here are some tips to avoid substance misuse and reduce stress while practicing social distancing.

1. Mindfulness meditation. See my previous post here for an introduction to this.
2. Exercise. You can find many online resources with at-home exercises.
3. Nature. Being in nature can help promote alpha brain wave activity, which can help boost creativity and reduce depression. Try to go outside for a walk or even a hike.
4. Indirect Social Connection. We can’t get it directly, but that doesn’t mean we can’t get it at all! Netflix offers a chrome extension called Netflix Party, which only one person needs to download. Then, you can both watch a TV show episode or movie together, while Skyping!

Comment below with any additional ideas!

Read all columns in this series:

• Mindfulness and Dis-Ease: Managing Mental Wellness
• The Free Prescription Doctors Are Writing to Lower Anxiety and Stress
• Cannabinoid Hyperemesis Syndrome: Yes, Teens Smoking Marijuana Too Much Can Hurt You
• Sound Healing, Part 2: A Conversation with Alexander Tuttle
• Sound Healing for Treatment of Chronic Pain, Anxiety, Stress, and Drug Addiction, Part 1: An Introduction
• Screen Time and Content Might Increase Youth’s Risk to Future Substance Abuse, Part II
• Screen Time and Content Might Increase Youth’s Risk to Future Substance Abuse, Part I
• The Opioid Epidemic: Where Do the Numbers Stand and Where Can We Focus Our Efforts? A Video and Interview
• Could a Dose a Day of Meaningful Social Interactions Help Keep Drug Addiction Away?
• Mike Connors on Treating Youth & Young Adults Struggling with Substance Abuse and Addiction

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Elena Vidrascu, MSc, is currently pursuing a doctorate degree in Psychology & Neuroscience at UNC Chapel Hill. Her primary field of interest is substance and alcohol use disorder prevention, with goals to disseminate information to the public and to influence policy change to push for more integrative approaches towards prevention and treatment. In her spare time she enjoys playing tennis, hiking, doing puzzles, and cuddling with her kitten Maple.