Whether due to health concerns or public health gathering limits, it's been more difficult for peer-support groups to meet in person to discuss their issues with substance use disorders.
Some people involved with those groups say the switch to virtual meetings has opened up some opportunities, but there are still concerns about the lack of in-person connection.
Gord Garner, vice-president of the Community Addictions Peer Support Association, says some people are reluctant to go virtual at a time when people find it hard to get support for substance use disorders.
"There's no doubt the in-person meeting reduction has had a negative impact on the health of the community," Garnet said.
"For peers, that's often their first experience with hope, that's often where they find their stabilization, it's often where they maintain their well-being."
Helping others also provides people in those groups a sense of purpose, structure and tools, which Garner compared to going to a gym.
"You can exercise by yourself, but you can't be with others by yourself," he said.
Major decline in attendees to in-person meetings
Ottawa's Alcoholics Anonymous Intergroup (AA) has seen a major decline in their in-person meetings from 161 per week before the pandemic to just 45 per week last month.
Joanne, who CBC has agreed not to identify by her full name, said the loss of in-person meetings was one of her main concerns when the first round of pandemic restrictions was announced in March 2020.
She said while her group was able to switch to Zoom-based meetings that are more convenient, there were technical and other barriers for some people.
"We definitely saw, in our small group, the attendance reduce by approximately half, for a variety of reasons," she said.
The local AA said about two dozen of their 90 Ottawa-region groups are currently inactive, but it's unclear how many people no longer participate.
Virtual helps ease in new attendees
The remaining groups are hosting about 140 virtual meetings a week, according to an AA spokesperson.
"We've had new people that have never attended a single in-person meeting who are now celebrating a year of continuous sobriety," Joanne said.
She said virtual meetings allow people to attend groups all over North America, as well as attend fellowship conferences.
Joanne said her group has added in-person walks or delivered literature and sobriety medallions to some new members in person to "supplement" the virtual format when public health guidelines allow.
Garner said virtual meetings have helped people discover and ease their way into peer support groups.
"They'll come to our meetings, they'll keep their camera off, they may stay quiet for the first half of the meeting and then there's this moment that comes when they turn their camera on and feel comfortable," he said.
Services struggle to meet need
Overall there's been a decline in access to services even as Canadians say they've used substances more over the course of the pandemic.
Almost one-third of Canadian respondents reported an increase in alcohol use and 40 per cent reported an increase in cannabis use during the pandemic, according to a study by the Canadian Centre on Substance Use and Addictions (CCSA).
According to that study, conducted along with the Canadian Mental Health Commission, only about 11 per cent of people with substance use problems seek virtual help — whether peer support or more formal services — and that drops to seven per cent of people who receive in-person support.
Rebecca Jesseman, a CCSA policy director, says there has been a decrease in services at a time of growing need, when building relationships is an important part of healing.
"The challenge of building and sustaining relationships virtually than in person is something that we can all relate to right now," Jesseman said.
She said access to internet, a safe space at home, and a level of comfort with online services have all played a role in the lower demand — but other health-care statistics underscore the need.
The Canadian Institute of Health Information (CIHI) released data last week showing a ninr per cent increase in substance use-related hospitalizations during the first 16 months of the pandemic.
"The longer somebody goes without being able to access the support they need, the greater the health and social impacts when they access the health-care system," Jesseman said.
"It's invisible to the extent that it's stigmatized and it's often because of that stigma unrecognized."