For those with substance-abuse issues, or those in recovery, the COVID-19 pandemic is an added weight to an already heavy burden.

Almost all of Quebec's alcohol or drug treatment centres are closed to in-person meetings or new patients, and those who are currently in in-patient programs have to remain isolated.

For advocates helping people living with addiction, there is a real concern some will be left behind.

"The window of opportunity for help is usually pretty slim. When somebody calls for help, they usually want it right away," says Mike Weston, the director of Andy's House Treatment Centre in Montreal.

"If they are calling and we aren't able to admit them or help them, that opportunity may not present itself again."

Andy's House Treatment Centre director Mike Weston says they've had to adapt and move all their in-person meetings online. (CBC)

Along with a litany of new public health directives, the pandemic has brought economic turmoil as well. Job loss and isolation can be extremely hard for a recovering addict.

"Every day is a weekend for addicts now," said Robert, a member of Cocaine Anonymous in Montreal.

CBC News agreed to use a pseudonym.

"Their life is totally unmanageable. They're isolating. They're foreboding that something terrible is going to happen."

Robert says while government measures are meant to protect everybody from COVID-19, they turn "normal life" upside down. For those in recovery, that can mean turning to substances to help with the stress.

Anna, who has been sober for 13 years, says it will be especially hard for those just beginning their recovery process.

"I definitely have a concern for those people who are struggling right now due to isolation, anxiety, panic, fear," she said. Anna is also a pseudonym.

"A lot of people who drink or use often do that in isolation," she said. "So I would imagine that this time would be difficult for people."

Finding opportunity and optimism

But Weston says there is an opportunity in the pandemic, which lies in how centres adapt to the new reality.

Alcoholics Anonymous, as well as Cocaine Anonymous, have turned to online meetings to help their members during the pandemic.

Jean-François Mary, from Cactus Montréal, says the government should be concerned about the effects of withdrawal during the pandemic. (Sarah Leavitt/CBC)

"Normally, we would go to a physical meeting but now we are trying to offer the same service online," said Robert.

"There is a beauty to this: Now, I can go to meetings in London, England or Las Vegas, Nevada."

For many, AA is essential.

"I actually think, in some ways, this actually lowers the barrier for people to feel safe to come to meetings," Anna said.

"Sitting at home, pressing a button and seeing a group of people facing the same or similar issues is great."

The federal and provincial governments have both promised funding to key community organizations, including those who offer psychological support.

Users left with only one safe injection site

For those addicts who continue to use, options to do so safely are very limited. Cactus Montréal is the only safe injection site still open in Quebec.

"All the other [organizations] lack the equipment to remain open, so we concentrated all the resources in the biggest one, Cactus," said its executive director, Jean-François Mary.

For those addicts who continue to use, options to do so safely are very limited. Cactus Montréal, seen here in a file photo, is the only safe injection site still open in Quebec. (Paul Chiasson/The Canadian Press)

Mary says his clients are among the most marginalized people in Montreal.

"In times like this, social inequalities really pop up," he said, pointing to a lack of resources for those who use drugs.

"Say for those in isolation, what's the plan for their drug use? What's the plan for their withdrawal symptoms?"

The international drug trade has been hampered due to COVID-19 measures, Mary says, so prices are going up and people can't afford to buy anything.

"People who are withdrawing may be sent to the hospital and of course that's an added burden [to the health care system]," he said.

Last Thursday, the federal government approved a safe supply of drugs to Vancouver's Downtown Eastside residents.

"It's an important piece to ensure we can help support those people as best we can … to ensure that they're able to comply with our public health advice around isolation or quarantine," said B.C.'s chief medical health officer Dr. Bonnie Henry.

Mary says that kind of support, designed to help marginalized people follow public-health guidelines, needs to happen nationwide.

Where to find help