Steven admits he still gets cravings. He only recently weaned himself off of the Suboxone he was prescribed to treat his opioid addiction.

The 41-year-old from Milwaukee, who declined to provide his last name because of the stigma that comes with addiction, has been clean from heroin for six months and completely sober for three months.

But the coronavirus has presented new challenges that have disrupted his daily routine and contributed to mounting stress and anxiety.

“It’s difficult to get yourself out of this mindset of thinking the world is going to hell, and I might as well use to make myself feel good,” he said.

Steven and others recovering from substance use disorders are especially vulnerable to COVID-19, medical and treatment experts say. They may be unable to get necessary prescriptions and treatments vital to their recovery. They're already more at risk for homelessness, and if they get the disease that means they may be more likely to need hospitalization or be more prone to severe symptoms.

“We keep talking about elderly individuals or individuals with preexisting conditions. What we’re learning from scientists is that substance use disorder is itself an underlying condition" for the coronavirus, said Jessica Hulsey Nickel, founder of the Addiction Policy Forum.

Already she said she's receiving reports of relapses in the network. Offices used for 12-step meetings have been closed due to state-mandated stay-at-home orders.

Some people are hesitant to attend meetings online after they were hacked by "Zoombombers," threatening participants' anonymity and taunting their disease. Others have resorted to the less personal but more secure option of teleconferences.

Those who require medication to treat their addiction, such as Suboxone or methadone, find it harder to get their prescriptions in the inundated health care system, treatment experts say. And inpatient treatment centers struggle to cater to their patients while following social distancing guidelines.

Those who relapse, Nickel said, put themselves at risk for job and food insecurity, as well as homelessness. Members of the homeless community infected by COVID-19 are twice as likely to be hospitalized and two to three times as likely to die as the general population, according to a new data-driven analysis from researchers at the University of Pennsylvania, UCLA and Boston University.

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Substance users who contract the virus face greater dangers than the general population, experts say.

Just as people who have opioid use disorders are more likely to die of an overdose if they have a chronic respiratory disease, lung damage from COVID-19 could pose the same risk, said Dr. Nora Volkow, director of the National Institute on Drug Abuse.

Methamphetamines could also contribute to lung damage and pulmonary hypertension because they constrict the blood vessels.

“The same advice we’re giving to our cancer and diabetes patients needs to be relayed to those who have an opioid or meth disorder,” Nickel said.

Substance use disorders are also known to be strongly associated with smoking or vaping, which harm lung health and increase the risk that a person with COVID-19 develops severe illnesses.

A majority of people who battle with a substance use disorder continue to smoke cigarettes, even years into their recovery, said Dr. Jeffrey Samet, chief and chair of general internal medicine at Boston Medical Center and Boston University School of Medicine. "And we do know that COVID is more complicated among those with tobacco-use histories."

People who smoke were 2.4 times more likely to have severe symptoms from COVID-19 compared with those who didn't smoke, according to a study published in February by the New England Journal of Medicine.

And for those practicing social distancing or are alone because of stay-at-home orders, the risk of overdosing is increased with no one around to call emergency services or administer naloxone, commonly known by its brand name Narcan.

So how do we protect those who are not only at risk for contracting the virus, but also vulnerable to severe complications?

Steven says he helps himself by sticking to a routine, being active outside and taking his recovery one day at a time, similar to what he did before the outbreak.

Nickel says the Addiction Policy Forum is reaching out to patients to educate them about the virus. She recommends enlisting the help of family and friends, whether you're recovering from a substance use disorder or actively using.

"In general, there's so much stigma around addiction and the stigma that our patients face on a day-to-day basis is heartbreaking," Nickel said. "And right now in the middle of this crisis we need to make sure our patients get the most care."

Tips for those in recovery during the coronavirus pandemic

The Addiction Policy Forum recommends the following tips for those who are in recovery:

Seek recovery support online including your addiction health care provider, 12 step meetings and other key programs.

Stay connected to your health care and addiction provider to take and refill medications. Ask about virtual options appointments.

For people with an active substance use disorder:

Do not share supplies including injecting supplies, pipes, vapes, bongs, straws or glasses.

Despite social distancing requirements, do not use opioids alone especially if injecting fentanyl or heroin. If alone, call or video chat a friend.

Consider stocking up on naloxone to have on hand and ensure loved ones have access as well.

Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.