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Substance Use, Treatment, and Harms during COVID-19

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 20220

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Special Issue Editors

Dr. Jakob Manthey

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Guest Editor

Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
Interests: epidemiology of alcohol and cannabis use; evaluation of alcohol control policies

Dr. Carolin Kilian

E-Mail Website
Guest Editor Assistant

Institute of Clinical Psychology and Psychotherapie, Technische Universität Dresden, Chemnitzer Straße 46, 01187 Dresden, Germany
Interests: epidemiology of alcohol; public health; alcohol policy

Special Issue Information

Dear Colleagues,

The global COVID-19 pandemic has posed major challenges to communities and the public health sector for more than a year now. Rigorous restrictions to curb the pandemic have disrupted daily routines and public life, with notable impacts on substance use behaviour. Concerns about a potential public health crisis caused by exacerbating substance use combined with a disruption in healthcare provisions have been raised.

More than one year into the pandemic, an ever-growing body of research has demonstrated both increases and decreases in substance use. Individual characteristics, such as age, gender, socioeconomic status, drinking levels before the pandemic, and distress experienced during the pandemic have been linked to patterns of substance use changes. Furthermore, societal factors, including substance-specific restrictions, e.g., closure of bars and clubs, are likely drivers of changes in substance use behaviour. While changes in substance use behaviour are increasingly well understood, there is a paucity of research on the implications for substance treatment and attributable harms.

In this Special Issue on “Substance Use, Treatment, and Harms during COVID-19”, we call for papers examining how substance use and treatment, as well as attributable harms, have changed with the COVID-19 pandemic. We welcome both theoretical and empirical papers addressing this subject and aim to bring together different perspectives on substance use, health care provision, and substance-attributable harm. This includes both qualitative and quantitative approaches examining changes in substance use, treatment provision, as well as community and policy responses during COVID-19. Submission of articles focussing on high-risk and marginalized communities that have been most severely hit by the pandemic are particularly appreciated.

Dr. Jakob Manthey
Dr. Carolin Kilian
Guest Editors

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Keywords

alcohol
tobacco
cannabis
opioid
cocaine
drug
COVID-19
harm
treatment
public health

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Published Papers (7 papers)

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Research

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14 pages, 1547 KiB

Open AccessFeature PaperArticle

Smoking Behavior and Smoking Cessation Because of and during the COVID-19 Pandemic: A Brief Online Survey 12 Months into the Pandemic and during the Second Wave in Europe

by Jule M. Finck, Sabine Bohnet, Katharina Auth, Imke Tangemann-Münstedt, Daniel Drömann and Klaas F. Franzen

Int. J. Environ. Res. Public Health 2022, 19(24), 16540; https://doi.org/10.3390/ijerph192416540 - 9 Dec 2022

Cited by 4 | Viewed by 1856

Abstract

Smoking is considered a major preventable cause of cardiovascular and lung diseases, as well as cancer. During the COVID-19 pandemic, there was extensive discussion about the influence of nicotine use; ultimately, smoking was considered a major risk factor for poor disease progression. Therefore, in April 2021, we conducted an anonymous cross-sectional online survey on smoking and vaping behavior, as well as smoking cessation, in four different countries in Europe (the United Kingdom, Germany, Spain, and Italy). A total of 3605 participants completed a questionnaire on their smoking and vaping behaviors and smoking cessation because of and during the COVID-19 pandemic. Fear of COVID-19 infection, a high percentage of quarantine stays (44.9% Italy and 52.1% Spain), and high infection (75.5% Italy and 52.4% Spain) and death (42% Italy) rates in respondents’ personal circles were observed mostly in the surveyed populations of Italy and Spain. Smoking cessation attempts and success were mainly seen in the Italian population and were linked to psychological distress, while the same effects were shown for vaping in Spain. In summary, health anxiety was detected in all cohorts. Despite these findings, smoking as a risk factor for severe outcomes of COVID-19 infection did not lead to a higher rate of smoking cessation attempts. Full article

(This article belongs to the Special Issue Substance Use, Treatment, and Harms during COVID-19)

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10 pages, 859 KiB

Open AccessArticle

Retrospective Self-Reports of How Adolescent Substance Use Changed with the COVID-19 Pandemic

by Janni Leung, Catherine Quinn, Molly Carlyle, Rhiannon Ellem, Calvert Tisdale, Lily Davidson, Melanie J. White, David J. Kavanagh and Leanne Hides

Int. J. Environ. Res. Public Health 2022, 19(20), 13680; https://doi.org/10.3390/ijerph192013680 - 21 Oct 2022

Cited by 1 | Viewed by 1669

Abstract

The final year of high school is a challenging phase of adolescents’ lives and substance use can play an important role. We examined changes in the frequency and quantity of alcohol and cannabis use, and demographic correlates among Grade 12 students of 2020. Students (N = 844) from nine schools retrospectively self-reported changes in substance use after the easing of COVID-19 lockdowns (back to school), compared to before the pandemic. Changes in use were examined with age, gender, Aboriginal or Torres Islander, parental and family characteristics, and truancy. Thirty-one percent of students reported that they used alcohol less frequently, and 24% reported that they used it more frequently compared to pre-COVID-19. Most students (46%) reported that they used cannabis less, while a subset reported using more frequently (22%). A history of truancy was associated with an increased frequency (OR = 2.13 [1.18–3.83]) of cannabis use. A substantial minority of adolescents used more alcohol and cannabis after the initial COVID-19 lockdown period. Students in their final year who reported increased use may benefit from increased support to manage their substance use. Full article

(This article belongs to the Special Issue Substance Use, Treatment, and Harms during COVID-19)

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13 pages, 1717 KiB

Open AccessArticle

Impact of the COVID-19 Pandemic on the Evolution of Prevalence and Patterns of Cannabis Use among First-Year University Students in Spain—UniHcos Project

by Lorena Botella-Juan, Carmen Amezcua-Prieto, María M. Morales-Suarez-Varela, Ramona Mateos-Campos, Carlos Ayán-Pérez, Antonio José Molina, Rocío Ortiz-Moncada, Susana Redondo-Martín, Juan Alguacil, Gemma Blázquez-Abellán, Miguel Delgado-Rodríguez, Jessica Alonso-Molero and Tania Fernández-Villa

Int. J. Environ. Res. Public Health 2022, 19(18), 11577; https://doi.org/10.3390/ijerph191811577 - 14 Sep 2022

Cited by 1 | Viewed by 2946

Abstract

Among university students there has been evidence that the COVID-19 pandemic increased their psychological distress, exacerbated by social restrictions. The main objective of this study was to explore the impact of the COVID-19 pandemic on the prevalence and patterns of cannabis use among university students, in contrast to previous trends since 2012. Data from 10,522 first-year university students (73.3% female, M_age 19 (SD = 1.6)) from eleven Spanish universities collected between 2012 and May 2022 was analysed. Prevalences of cannabis use and their differences by sex were studied, as well as changes in patterns of use and its use for coping during the pandemic. It was found that during lockdown, all prevalence rates of cannabis use decreased in both sexes, showing no statistically significant differences and increasing again in the new normal period in both. Among regular cannabis users, 79.7% reported maintaining or increasing their cannabis use during the pandemic, and of these, half reported using cannabis to cope. Moreover, cannabis use in the usual household increased during the lockdown. These results show that although the overall prevalence of cannabis use was reduced during the lockdown, regular users tended to maintain or increase cannabis use. This could imply two different patterns of use among students, one social and occasional versus the other regular, providing new lines of research for prevention and the implementation of social policies. Full article

(This article belongs to the Special Issue Substance Use, Treatment, and Harms during COVID-19)

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23 pages, 1413 KiB

Open AccessArticle

Profiles of Ecosystemic Resilience and Risk: American Indian Adolescent Substance Use during the First Year of the COVID-19 Crisis

by Meghan A. Crabtree, Linda R. Stanley, Randall C. Swaim and Mark A. Prince

Int. J. Environ. Res. Public Health 2022, 19(18), 11228; https://doi.org/10.3390/ijerph191811228 - 7 Sep 2022

Cited by 2 | Viewed by 1813

Abstract

The COVID-19 pandemic has caused an unprecedented disruption to the lives of American Indian (AI) adolescents. While reservation-area AI youth already have a higher risk of substance use (SU) compared to their non-AI peers, COVID-19 stressors likely exacerbated this risk. However, COVID-19-specific and general resilience factors may have buffered against increased SU over the course of the pandemic. Using a person-centered, ecosystemic framework of resilience, we used latent profile analysis to identify ecosystemic resilience profiles indicated by general and COVID-19-specific risk and resilience factors, then examined inter-profile changes in alcohol and cannabis use after the onset of the COVID-19 pandemic from the spring of 2020 to the spring of 2021. The sample was 2218 reservation-area AI adolescents (7–12th grade; schools = 20; M_age = 15, SD = 1.7; 52% female). Four profiles emerged: Average Risk and Resilience, High Resilience, Low Resilience, and High Risk. Adolescents with a High-Risk profile demonstrated increases in alcohol and cannabis use, while High Resilience youth demonstrated decreases. These findings support the hypothesized COVID-19-specific ecosystemic resilience profiles and the application of a person-centered ecosystemic framework to identify which AI adolescents are most likely to experience substance use changes during a life-altering crisis like COVID-19. Full article

(This article belongs to the Special Issue Substance Use, Treatment, and Harms during COVID-19)

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12 pages, 334 KiB

Open AccessArticle

Impacts of the COVID-19 Pandemic on a Rural Opioid Support Services Program

by Jayme E. Walters, Aubrey E. Jones, Aaron R. Brown and Dorothy Wallis

Int. J. Environ. Res. Public Health 2022, 19(18), 11164; https://doi.org/10.3390/ijerph191811164 - 6 Sep 2022

Cited by 2 | Viewed by 2757

Abstract

During 2020, Kentucky saw the third highest increase in overdose deaths in the U.S. Employment issues, inadequate housing, transportation problems, and childcare needs present barriers to accessing treatment in rural areas. These barriers and others (e.g., technology) arose during the pandemic negatively affecting individuals in recovery and service providers as they adjusted services to provide primarily telehealth and remote services. This study examines the impact of COVID-19 in its early stages on an opioid use disorder (OUD) support services program in a nonprofit located in rural eastern Kentucky, part of the central Appalachia region. A qualitative design was applied, employing semi-structured interviews in early fall 2020. Participants were associated with one OUD support services program, including service recipients, program coordinators, and business vendors. Guided by the Social Determinants of Health framework, two-cycle coding–descriptive coding and pattern coding–was utilized. Codes were sorted into three patterns: changes to daily life; financial impacts; and service access and provision. Overall, early stages of COVID-19 brought increased stress for individuals in recovery, as they were taking on more responsibility and navigating a changing environment. Coordinators were under pressure to provide services in a safe, timely manner. Vendors vocalized their struggles and successes related to finances. These findings can help organizations make realistic adjustments and policymakers set reasonable expectations and consider additional financial support. Full article

(This article belongs to the Special Issue Substance Use, Treatment, and Harms during COVID-19)

12 pages, 518 KiB

Open AccessArticle

Changes in Alcohol Consumption during the COVID-19 Pandemic Are Dependent on Initial Consumption Level: Findings from Eight European Countries

by Ingeborg Rossow, Miroslav Bartak, Kim Bloomfield, Fleur Braddick, Elin K. Bye, Carolin Kilian, Hugo López-Pelayo, Pia Mäkelä, Inger Synnøve Moan, Jacek Moskalewicz, Benjamin Petruzelka, Vladimír Rogalewicz and Jakob Manthey

Int. J. Environ. Res. Public Health 2021, 18(19), 10547; https://doi.org/10.3390/ijerph181910547 - 8 Oct 2021

Cited by 27 | Viewed by 4194

Abstract

Evidence suggests that changes in alcohol consumption during the first months of the COVID-19 pandemic were unevenly distributed over consumer groups. We investigated possible inter-country differences in how changes in alcohol consumption are contingent on initial consumption (before or at the start of the pandemic), and how changes in consumption translate into possible changes in the prevalence of heavy drinking. We used data from the European Survey on Alcohol use and COVID-19 (ESAC) conducted in Czechia, Denmark, Finland, Germany, Norway, Poland, Spain, and the UK (N = 31921). Past-year alcohol consumption and changes in consumption were measured by AUDIT-C. Drinking habits were compared according to percentiles of pre-pandemic consumption levels, below versus above the 90th percentile. Across countries, drinkers in the highest 10% for pre-pandemic consumption increased their drinking during the pandemic, whereas absolute changes among those initially drinking below this level were modest. The percentage of people reporting >28 alcohol units/week increased significantly in seven of eight countries. During the first months of the COVID-19 pandemic, alcohol consumption in the upper decile of the drinkers increased as did the prevalence of heavy drinkers, in contrast with a declining consumption in other groups in the sample. Full article

(This article belongs to the Special Issue Substance Use, Treatment, and Harms during COVID-19)

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Review

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28 pages, 2777 KiB

Open AccessReview

Illicit Substance Use and the COVID-19 Pandemic in the United States: A Scoping Review and Characterization of Research Evidence in Unprecedented Times

by Anh Truc Vo, Thomas Patton, Amy Peacock, Sarah Larney and Annick Borquez

Int. J. Environ. Res. Public Health 2022, 19(14), 8883; https://doi.org/10.3390/ijerph19148883 - 21 Jul 2022

Cited by 7 | Viewed by 3616

Abstract

We carried out a scoping review to characterize the primary quantitative evidence addressing changes in key individual/structural determinants of substance use risks and health outcomes over the first two waves of the COVID-19 pandemic in the United States (US). We systematically queried the LitCovid database for US-only studies without date restrictions (up to 6 August 2021). We extracted quantitative data from articles addressing changes in: (a) illicit substance use frequency/contexts/behaviors, (b) illicit drug market dynamics, (c) access to treatment and harm reduction services, and (d) illicit substance use-related health outcomes/harms. The majority of 37 selected articles were conducted within metropolitan locations and leveraged historical timeseries medical records data. Limited available evidence supported changes in frequency/behaviors/contexts of substance use. Few studies point to increases in fentanyl and reductions in heroin availability. Policy-driven interventions to lower drug use treatment thresholds conferred increased access within localized settings but did not seem to significantly prevent broader disruptions nationwide. Substance use-related emergency medical services’ presentations and fatal overdose data showed a worsening situation. Improved study designs/data sources, backed by enhanced routine monitoring of illicit substance use trends, are needed to characterize substance use-related risks and inform effective responses during public health emergencies. Full article

(This article belongs to the Special Issue Substance Use, Treatment, and Harms during COVID-19)

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