Editorial Comment:  Isolation

Three of the articles reviewed emphasize COVID-19-related risk factors for addiction relapse.  Featured prominently are the lack of interpersonal connections, absence of intimacy, and unavailability of feedback; in a single word, isolation.

Articles have been appearing relating to the variety of psychological impacts of COVID-19 (e.g., V. Thakur & A. Jain, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177120/), but one needn’t seek far to uncover anew both literary and journalistic examples, not limited to: Daniel Defoe, Albert Camus, Giovanni Boccaccio, Marcus Aurelius, Michael Crichton, Steven King, Thucydides, Randy Shilts.  Those in the helping professions have long remarked the impact of addictions on relationships.  But less-frequently acknowledged is addiction as a disease of relationships. Creation and repair of interpersonal relationships are therapeutic in the management of addiction. The notion is not original to authorities in the field, and it is certainly intimated in the recovery community literature.   Isolation, or more insidiously just the feeling of isolation is a common denominator between the addictions and the affective disorders.  It can be mitigated by clear instructions to create, renew, and examine the connections in the life of the person with addiction; instructions which are well within our expected skills.

- Bill Haning, MD