Various factors make winter a potentially high-risk season for people with substance use disorder (SUD). First, research shows that opioid overdoses increase in winter. More specifically, fatal overdoses can spike by up to 25% after extended periods of freezing or below-freezing temperatures due to various social, behavioral, and environmental factors.
However, opioids aren’t the only substance that becomes more likely to be consumed in winter. That’s because the cold and lack of sunlight cause a series of emotional and physical changes that make people more vulnerable to mental illness and physical aches, both of which are significant risk factors for SUD.
1. Seasonal Affective Disorder (SAD)
Seasonal Affective Disorder (SAD) is a type of major depressive disorder at the same time each year. People with this condition experience symptoms of depression in the same season every year, such as feelings of hopelessness, sleep problems, and unexplained weight changes.
While commonly related to winter, when the temperatures drop and there is less sunlight, SAD can also occur in other seasons. When SAD happens during spring and summer, it is called summer-pattern SAD and is less studied than winter-pattern.
When symptoms begin, some people may try to self-medicate with substances, a common gateway to addiction. Others may try to alleviate their lack of energy through stimulants or numb their negative emotions with alcohol or opioids.
2. Social Isolation
In addition to potentially contributing to mental illness, winter may also lead to less social interactions due to spending less time outdoors. Also, holidays can be isolating for people far from their families or who don’t have strong family connections.
While loneliness is expected in many life situations (moving out of a familiar environment, losing a loved one, etc.), there’s an undeniable link between sustained loneliness like the one some people feel in winter and substance abuse.
A lack of social connection and support can lead to unhealthy behaviors, and experts now recognize loneliness as a significant risk factor for several health conditions, including substance use disorder. It can also exacerbate co-occurring disorders like depression or anxiety, the most common mental illnesses that happen alongside substance abuse.
Furthermore, the cycle of loneliness and substance abuse perpetuates itself, with loneliness inciting substance abuse, in turn leading to further isolation.
3. Proneness to Opioid Use and Fatal Overdose Risks
Cold weather can cause body aches and pains due to changes in barometric pressure that expand and contract tendons, muscles, and scar tissue. This often leads to pain in joints affected by arthritis. Also, low temperatures can thicken the fluids inside joints, causing stiffness exacerbated by being physically inactive.
All these factors increase the risk of opioid use or relapse. Unfortunately, cold weather also increases the risk of fatal opioid overdoses, according to research. The study found a 25% increase in fatal opioid overdoses after periods of freezing temperatures.
The reasons aren’t obvious, but researchers suggest it could be a combination of factors. The main ones are opioids’ impact on respiratory function and body temperature regulation and behavioral changes during cold weather, like using opioids alone, which increases overdose risk.
This shows that a combination of social, behavioral, and environmental factors makes winter a potentially high-risk season for people who use opioids.
4. Holiday Stress
While we usually associate holidays with having a good time with loved ones, they can be stressful when managing family dynamics, budgeting for celebrations, etc. For people who actively experience substance abuse or are in recovery, these stressors can worsen their condition.
Holiday drinking, in particular, is widespread. As people face pressure to drink from peers and the mere presence of alcohol during social events, they may experience triggers and cravings.
Additionally, LGBTQ+ folks are more vulnerable to holiday stress and may resort to drinking to cope with depression, anxiety, and feelings of rejection for expressing their authentic selves.
A few ways to cope with holiday stress-induced alcohol consumption include:
- Bring your non-alcoholic beverages to a social event or focus only on non-alcoholic drinks.
- Connect with friends and family members who understand and support your sobriety goals.
- Exercise, sleep well, and focus on eating healthy during the holidays.
These strategies can help you manage the stresses of the holidays and the increased risks of substance abuse that come with stress.
5. Economic Hardships During Winter
Winter can be a financially difficult time due to the costs associated with home winterization, utility bills, holiday spending, potential injuries, car maintenance, winter wardrobes, property damage from ice and snow, and other expenses caused by the harsh weather. All these factors can strain your budget, leading to financial stress.
In addition to putting you in a difficult financial position, the potential economic hardships of winter can increase stress and anxiety, which are risk factors for substance abuse.
That’s because financial strain can lead to a low mood and a sense of hopelessness, making some people more likely to use substances as a coping mechanism, especially those with a history of substance abuse.
According to research, older men are particularly vulnerable to heavy drinking due to financial stress.
6. Vitamin D Deficiency
Vitamin D deficiency, or hypovitaminosis D, occurs when people have a below-normal vitamin D level. One of our primary sources of vitamin D is sunlight, so winter’s short days make us more likely to develop a deficiency.
Low vitamin D levels deteriorate our bone health and immune system, leading to a higher risk of experiencing common colds, bronchitis, pneumonia, and other diseases. Additionally, research shows that low vitamin D levels are associated with more intense symptoms of depression and anxiety, which is why mental health professionals should perform vitamin D screenings when treating these mental illnesses.
A study suggests that low vitamin D levels increase the effects and cravings of opioids, potentially increasing the risk of addiction. Another study suggests that people with severe substance use disorders often also have vitamin D deficiency. The study suggests serum vitamin D concentration may influence the severity of substance abuse.
The relationship between vitamin D, mental illness, and substance abuse is complex and needs more research. However, based on what we know, vitamin D helps our tissues and organs work correctly, so a deficiency may lead to being more vulnerable to mental illness, facing more challenges when recovering from substance abuse, and experiencing higher risks of relapse.
It’s important to remember that substance abuse can potentially co-occur with many physical and mental illnesses, including nutritional deficiencies. As a result, it’s essential to see the bigger picture while also recognizing that vitamin D deficiency during winter can increase substance use and abuse risks.
7. Indoor Winter Lifestyle
Due to the harsh weather conditions, winter often leads to a predominantly indoor lifestyle. As we’ve explored, winter can increase social isolation, contribute to seasonal affective disorder (SAD), and minimize vitamin D levels because we’re less exposed to the sun, especially in cloudy regions.
All these factors, when combined with being effectively trapped indoors due to the weather, can lead to an increased risk of experiencing mental illness and substance abuse, especially in people with a history of addiction.
But the indoor winter lifestyle may also introduce boredom into the mix. Although boredom may initially seem a trivial feeling that passes by, it’s a complex emotional state that psychologists don’t fully understand yet. Boredom can have serious consequences, as people who get bored easily face a higher risk of developing:
- Depression
- Anxiety
- Addiction
- Problematic gambling
- Eating disorders
- Hostility
- Anger
- Poor social skills
- Poor work and poor academic performance
Engaging in stimulating activities throughout winter can mitigate the risk of boredom contributing to a relapse.
Some examples include new hobbies, learning healthy coping mechanisms, planning outdoor activities when the weather allows it, maintaining social connections, volunteering, and ultimately giving these activities enough time to grow on you and start making a difference in your emotional state.
Seeking Help During the Winter
Winter is a challenging enough season for most people without the added burden of an SUD. Arranging holiday plans, the drop in temperature, and the shorter days resulting in less sunlight can affect your emotional well-being and increase the risks and effects of substance use.
You should be able to enjoy this time of the year as much as anyone else, so if you or a loved one experiences any of the seven factors discussed in this article, seek help for substance use.
SUDs are complex conditions, and we all benefit from support, whether from family and friends or the healthcare system. Taking the first steps may seem impossible, but they will lay the groundwork for your long-term recovery.
