Loving someone who is struggling with addiction can be scary and confusing, even during the best of times. During crises such as COVID-19, when America's opioid epidemic is deepening and people are isolated, it's easy to feel lost on how to help.

Opioid overdose rates are on the rise, with more than 40 states reporting increases in opioid-related deaths during the pandemic, according to the American Medical Association. In 2018, more than 67,000 people in the U.S. died of drug overdoses, Centers for Disease Control and Prevention figures show.

"The underlying factors that contribute to addiction are all amplified right now by COVID-19," says Dr. Itai Danovitch, an addiction psychiatrist who leads the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai. 

Anxiety and stress can be even more triggering for those with mental health conditions who turn to substances as a way to cope.

Read: Understanding the Opioid Crisis

Sheltering in place has made connecting harder. In turn, many people are cut off from their support systems, even those in recovery. Most 12-step meetings such as Alcoholics Anonymous and Narcotics Anonymous have closed their doors to avoid exposure and turned to online meetings. 

"When things are unstable, it is the people who are on fragile ground that are the most likely to bear the greatest impact," he says.

Dr. Danovitch stresses that tough circumstances don't have to mean overdose or relapse—and that people do recover from substance use disorders with the right support.

Read: Depression: Know the Signs

Because many people are working and studying from home, quarantine can actually be an opportunity to spot a problem, especially if you're already concerned.

Pay attention to whether your loved one's intake of alcohol or drugs is creeping up (if they're using more to achieve the same effect or more than they planned to), prioritizing alcohol or drugs, or hiding substances. Also watch for withdrawal symptoms, which can be as subtle as heightened anxiety. 

The National Institute on Drug Abuse notes someone misusing substances might:

• Sleep at odd hours
• Not take care of themselves (such as by skipping showers and tooth brushing)
• Be in a bad mood or have quick mood swings
• Be either lethargic/sad or overly energetic and talking quickly
• Change their food intake
• Lose interest in their favorite pastimes that don't revolve around substances
• Miss appointments and obligations
• Avoid family and friends
• Experience problems with work, school and relationships

If you don't know details about their use or they're already in recovery and you suspect a relapse, you also might notice these behavior patterns above.

Read: Disrupting Addiction

Everyone's struggling with loneliness to some degree right now. 

For people who don't live together, make sure you're touching base more often than you normally would, whether it's by phone, video call or in person while following proper physical—but not emotional—distancing during the pandemic. Let them know you're there for them and that you care.

Read: How to Support Elderly Friends and Family During COVID-19

Avoid shaming your loved one. Instead, offer unconditional love and treat the substance use disorder like any other medical condition, Dr. Danovitch urges. Your loved one might be afraid or embarrassed to talk about it with you. When appropriate, ask how you can best support them.

"It's important, particularly in addiction, that we are sensitive in the language we use, because there's so much stigma and we have a tendency to blame people as opposed to empathizing with them, supporting them and infusing them with a sense of hope that there is help available," he says.

If you know someone who uses opiates such as heroin, Dr. Danovitch recommends keeping the opioid overdose reversal drug naloxone on hand—a "lifesaving intervention," he says. 

Read: Talking to Your Kids About Drugs

You can't control other people's behavior, but you can point them in the right direction.

As a starting point, contact your primary care provider or health insurance provider, Dr. Danovitch suggests. There are also search options online and over the phone, such as the Substance Abuse and Mental Health Services Administration National Helpline, that can refer you to treatment options that take payment on a sliding scale or are covered by Medicaid. 

The treatment program you choose should be licensed and accredited by the appropriate agencies and offer evidence-based intervention, Dr. Danovitch says. That can include medication-assisted treatment, as well as cognitive behavioral therapy, motivational enhancement therapy and relapse prevention. 

Ask the programs what types of treatment are available. Staying persistent is key, he says. 

In the newsroom: Cedars-Sinai to Test New Opioid Abuse Treatment Method

People who struggle with addiction often have co-occurring mood and anxiety disorders, so getting to the bottom of those plays a part in long-term recovery, Dr. Danovitch says. Addressing the whole person and their support system is linked to better outcomes and long-term recovery.

Isolation is also higher stakes for people with addiction, he adds, but there are plenty of 12-step social support options that have regular virtual meetings and sponsorship.

Dr. Danovitch points out those groups aren't just for people who struggle with alcoholism and addiction. Al-Anon can be a vital resource for concerned family members who are trying to figure out how to help. 

"Addiction is common, it's treatable and it's a disease—it's not anyone's fault," he says. "And with treatment, people can achieve recovery, which is really an incredible thing."