Physical distancing is a new reality for all of us and even people without mental illness are struggling to adapt to this new way of life. It is critical that health and wellness professionals do not overlook South Africa’s growing addiction crisis in their workplace response to COVID-19, but instead build a comprehensive approach that will stem the increase in addictions and ensure access to treatment for employees who need help.
Coping mechanisms can become addictions
The medical profession now recognises a surprisingly wide range of addictive behaviours. Misuse of alcohol and drugs, either prescribed or illegal, are perhaps the most well-known, but gambling addiction is an increasing problem, while some people may also have problems with shopping, overeating, workaholism, Internet use, pornography, sexual relations, co-dependency and self-harm, among other issues. Some of these behaviours may start as coping mechanisms that progress into habitual patterns of behaviour that have the power to cause serious harm to the sufferer or those around them.
Increasing substance use and abuse over lockdown
For many people the coronavirus lockdown has been an unpleasant experience, bringing about negative emotions that range from boredom to loneliness and depression. Alcohol and drug abuse are activities to occupy a person’s time if they are lonely and bored. Moderate drinkers who have access to alcohol despite South Africa’s ban on alcohol sales may well have been drinking more; and even though only a percentage of people have the propensity for addiction, increased consumption can have a knock-on effect where people who are more prone to addiction can get caught up.
“Alcohol and drug abuse are activities to occupy a person’s time if they are lonely and bored. ”
People who have existing drug abuse issues and are isolating at home will not have had the distractions that normal life provides. They may well be tempted to increase their drug use as a way of filling this void, or coping with being cooped up in a stressful environment. Despite closed borders drug dealers have not stopped plying their trade, they have just become more coordinated and existing users may be at greater risk of overdosing or ingesting dangerous chemicals that are cut into impure drugs to maintain supply levels. All the while substance misuse support services and GPs have been curtailed from providing their usual level of support during the current crisis. 1
Substance dependency statistics published in 2014 show that consumption of drugs such as cannabis, cocaine, and Tik in South Africa were already twice the global average and second to none in Africa (UN World Drug Report, 2014). Commenting during Substance Abuse Awareness Week (22 – 28 June 2020) the South African National Council on Alcoholism and Drug Dependence (SANCA) expressed the sentiment that the prohibition of alcohol sales during the lockdown, has reinforced the notion that South Africans lack responsible alcohol use. SANCA says there was desperation evident from the making of home brew concoctions, illegal trade in alcohol and robberies at liquor stores.
All addictions can affect employee productivity
As with drug addiction, problems will arise when the urge to view pornography conflicts with an employee’s daily work responsibilities. The bottom line is that the employee who partakes in viewing pornography in working hours is no different than the employee who uses alcohol or drugs on the job. It is crucial that EAP providers view sexually addictive behaviour, in all of its forms, as an addictive disease that can be treated.
“global pornography consumption rates are up, in general, over the coronavirus lockdown.”
Increased use of pornography over lockdown
An article published by Psychology Today in March 2020 reports, “some research has found that when people are faced with the prospect of their own mortality this prompts sexual desire and behaviour as a coping mechanism”. The article finds that global pornography consumption rates are up, in general, over the coronavirus lockdown. For example, as reported by Pornhub (the world’s largest porn portal), global traffic on their site has steadily increased since March 2020 as the pandemic has spread and lockdowns have been instituted in major cities and countries around the world.
In 2017, South Africa made Pornhub’s top 20 most-frequent-users’ list for the first time. This means that for the first time South Africa exceeded all other countries on the African continent in the consumption of pornography on that site. Speaking during a webinar arranged by Business For South Africa, an organisation that coordinates a corporate response to the Covid19 crisis, Andrew Davies, a clinical psychologist and MD of Independent Counselling and Advisory Services (ICAS) Southern Africa, said: “There has been an increase in people seeking help for mental health and psychiatric disorders such as anxiety disorders, predominantly adjustment disorders, depression [and] addiction disorders. ICAS has seen a 28% increase in requests for help with pornography addiction.” Click here https://947.co.za/articles/2020/07/06/listen-increase-in-porn-addiction-anxiety-among-sa-workers-during-lockdown if you would like to listen to more.
“In 2017, South Africa made Pornhub’s top 20 most-frequent-users’ list for the first time.”
“There is a point at which pornographic material that was previously seen as gross now becomes “acceptable”.”
The pathway to porn addiction is characterised by repeated return to pornographic material. Once a consumer gets hooked, they will increasingly go back for more and once addicted, they cannot get rid of this dependency by themselves. With the passage of time, the addict will require rougher, more explicit, more deviant and aberrant sexual material to achieve the same high. There is a point at which pornographic material that was previously seen as gross now becomes “acceptable”. Over time what was taboo, repulsive or even illegal, is seen as acceptable. The person comes to believe that this type of antisocial, or deviant, sexual activity depicted is normal – even if the activity is contrary to their personal standards and moral beliefs. At this point there is an increase in the tendency for the consumer to act out the pornographic behaviours they have viewed. Merely looking no longer satisfies the addict. The fantasies may have to be acted out.
Recommended assessment for Internet pornography addiction
An assessment for suspected Internet pornography addiction may take three or more sessions with an individual who seeks help from an EAP for addiction to pornography and will benefit from including the following elements:
- Construction of a timeline of all relationships;
- Gathering of information on any sensitive parental attachment, sexual history and Internet pornography engagement as these can be useful in assessing the addictive patterns and attachment disturbances that have occurred;
- Listening to the presenting problem from the client’s point of view;
- Gathering a history of familial addiction issues;
- Exploring any history of trauma and being exposed to pornography at a young age;
- Observing any anxiety issues and OCD behaviour, which are often present
EAPs should also be aware that high rates of comorbid substance and other behavioural addictions may be present; therefore an assessment should be made for other addictions, since the occurrence of multiple addictions can greatly hinder treatment. If substance misuse, or other type of disorder, is present, it is recommended that these addictions be worked on concurrently with detox from any substances taking place before sex and pornography is addressed.