Substance Use Disorder in the COVID-19 Pandemic: A Systematic Review of Vulnerabilities and Complications.
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ABSTRACT:
SUBMITTER: Wei Y
PROVIDER: S-EPMC7407364 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Purpose of reviewTo review the literature on the trends in substance use among youth during the coronavirus SARS-CoV-2 (COVID-19) pandemic.Recent findingsThe pandemic has given rise to concerns about the mental health and social well-being of youth, including its potential to increase or exacerbate substance use behaviors. This systematic review identified and included 49 studies of use across alcohol, cannabis, tobacco, e-cigarettes/vaping, and other drugs, and unspecified substances. The majority of studies across all categories of youth substance use reported reductions in prevalence, except in the case of other drugs and unspecified drug and substance use, which included three studies that reported an increase in use and three studies that reported decrease in use. Overall, the results of this review suggest that the prevalence of youth substance use has largely declined during the pandemic. Youth substance use in the post-pandemic years will require monitoring and continued surveillance.
| S-EPMC9043089 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic is creating severe issues for healthcare and broad social structures, exposing societal vulnerabilities. Among the populations affected by COVID-19 are people engaged in substance use, such as people who smoke; vape (e-cigarette use); use opioids, cannabis, alcohol, or psychoactive prescription drugs; or have a substance use disorder (SUD). Monitoring substance use and SUD during the pandemic is essential, as people who engage in substance use or present with SUD are at greater risk for COVID-19, and the economic and social changes resulting from the pandemic may aggravate SUD. There have been several reviews focused on COVID-19 in relation to substance use and SUD. Reviews generally did not consider on a large range of substance use variants or SUDs. We plan a scoping review that seeks to fill gaps in our current understanding of substance use and SUD, in the COVID-19 era.MethodsA scoping review focused on substance use and SUD, in relation to COVID-19, will be conducted. We will search (from January 2020 onwards) Cumulative Index to Nursing and Allied Health Literature, Africa-Wide Information, Web of Science Core Collection, Embase, Global Health, WHO Global Literature on Coronavirus Disease Database, WHO Global Index Medicus, PsycINFO, PubMed, Middle Eastern Central Asian Studies, CINAHL Complete, and Sociological Abstracts. Grey literature will be identified using Disaster Lit, Google Scholar, HSRProj, governmental websites, and clinical trials registries (e.g., ClinicalTrial.gov , World Health Organization, International Clinical Trials Registry Platform and International Standard Randomized Con-trolled Trial Number registry). Study selection will conform to Joanna Briggs Institute Reviewers' Manual 2015 Methodology for JBI Scoping Reviews. Only English language, original studies investigating substance use and SUD, in relation to COVID-19 in all populations and settings, will be considered for inclusion. Two reviewers will independently screen all citations, full-text articles, and abstract data. A narrative summary of findings will be conducted. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., content and thematic analysis) methods.DiscussionOriginal research is urgently needed to mitigate the risks of COVID-19 on substance use and SUD. The planned scoping review will help to address this gap.Systematic review registrationOpen Science Framework (osf/io/tzgm5).
| S-EPMC7857102 | biostudies-literature
Project description:Purpose of reviewThis systematic review evaluated the impact of the COVID-19 pandemic on obsessive-compulsive symptoms.Recent findingsMost studies showed that obsessive-compulsive symptoms worsened during the early stages of the pandemic, particularly for individuals with contamination-related obsessive-compulsive disorder (OCD), though other symptoms dimensions were found to worsen as well. Many patients and individuals in the general population experienced new obsessive-compulsive-like symptoms centered on COVID-19. Self-reported rates of symptom exacerbation and COVID-19-focused symptoms were consistently lower in studies that recruited patients from specialty clinics (compared to online samples). Most studies were conducted in Spring/Summer, 2020. The COVID-19 pandemic has been an enormous stressor for individuals with OCD, especially for those with contamination symptoms. Regardless, there is strong reason to believe gold standard treatment approaches for OCD have maintained strong efficacy. Disseminating and effectively delivering evidence-based treatments for OCD is an urgent public health priority.
| S-EPMC8493778 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic and its associated restrictions may contribute to a deterioration in mental health; individuals with obsessive-compulsive disorder (OCD) may be particularly affected. This systematic review aimed to investigate the effects of the current pandemic on people diagnosed with OCD, and whether pandemics may affect the development of OCD symptoms.MethodsWe conducted a systematic search using NCBI PubMed, SCOPUS, and Google Scholar on February 9, 2021. Research articles related to OCD and COVID-19 or other pandemics were attempted to be identified using pre-defined search terms. Case reports, clinical guidelines, letters, and clinical research articles including ≥100 participants were included; reviews were excluded. The systematic review adheres to PRISMA guidelines and the Newcastle-Ottawa Scale was used to assess the quality of the included clinical research articles.ResultsA total of 79 articles were included in the full-text assessment. Of these, 59 were clinical research articles, two were clinical guidelines, six were case reports, and 12 were letters. The research articles examined OCD symptoms in adult patients with diagnosed OCD, the general population, pregnant women, healthcare workers, students, and young adults, children, and adolescents. Only one study on OCD in previous pandemics was identified.ConclusionThis systematic review found that people both with and without diagnosed OCD prior to the pandemic generally experienced a worsened landscape of symptoms of OCD during the COVID-19 pandemic. However, the responses are heterogeneous and many factors other than the pandemic seemed to affect the development of OCD symptoms. To prevent the impairment of symptoms and the development of new cases, close monitoring of patients with OCD and education of the general public is essential. Literature is still limited; thus, multinational and cross-cultural, longitudinal studies are warranted to gain further insights on this topic.
| S-EPMC8989845 | biostudies-literature
Project description:BackgroundTelehealth has the potential to improve health care access for patients but it has been underused and understudied for examining patients with substance use disorders (SUD). VA began distributing video-enabled tablets to veterans with access barriers in 2016 to facilitate participation in home-based telehealth and expanded this program in 2020 due to the coronavirus COVID-19 pandemic.ObjectiveExamine the impact of VA's video-enabled telehealth tablets on mental health services for patients diagnosed with SUD.MethodsThis study included VA patients who had ≥1 mental health visit in the calendar year 2019 and a documented diagnosis of SUD. Using difference-in-differences and event study designs, we compared outcomes for SUD-diagnosed patients who received a video-enabled tablet from VA between March 15th, 2020 and December 31st, 2021 and SUD-diagnosed patients who never received VA tablets, 10 months before and after tablet-issuance. Outcomes included monthly frequency of SUD psychotherapy visits, SUD specialty group therapy visits and SUD specialty individual outpatient visits. We examined changes in video visits and changes in visits across all modalities of care (video, phone, and in-person). Regression models adjusted for several covariates such as age, sex, rurality, race, ethnicity, physical and mental health chronic conditions, and broadband coverage in patients' residential zip-code.ResultsThe cohort included 21,684 SUD-diagnosed tablet-recipients and 267,873 SUD-diagnosed non-recipients. VA's video-enabled tablets were associated with increases in video visits for SUD psychotherapy (+3.5 visits/year), SUD group therapy (+2.1 visits/year) and SUD individual outpatient visits (+1 visit/year), translating to increases in visits across all modalities (in-person, phone and video): increase of 18 % for SUD psychotherapy (+1.9 visits/year), 10 % for SUD specialty group therapy (+0.5 visit/year), and 4 % for SUD specialty individual outpatient treatment (+0.5 visit/year).ConclusionsVA's distribution of video-enabled tablets during the COVID-19 pandemic were associated with higher engagement with video-based services for SUD care among patients diagnosed with SUD, translating to modest increases in total visits across in-person, phone and video modalities. Distribution of video-enabled devices can offer patients critical continuity of SUD therapy, particularly in scenarios where they have heightened barriers to in-person care.
| S-EPMC10164656 | biostudies-literature
Project description:ObjectiveThe goal of this study was to examine the impact of substance use disorder on the risk of hospitalization, complications, and mortality among adult patients diagnosed as having COVID-19.MethodsThe authors conducted a propensity score (PS)-matched double-cohort study (N=5,562 in each cohort) with data from the TriNetX Research Network database to identify 54,529 adult patients (≥18 years) diagnosed as having COVID-19 between February 20 and June 30, 2020.ResultsPrimary analysis (PS matched on demographic characteristics and presence of diabetes and obesity) showed that substance use disorder was associated with an increased risk of hospitalization (odds ratio [OR]=1.84, 95% confidence interval [CI]=1.69-2.01), ventilator use (OR=1.45, 95% CI=1.22-1.72), and mortality (OR=1.30, 95% CI=1.08-1.56).ConclusionsThe findings suggest that COVID-19 patients with substance use disorders are at increased risk for adverse outcomes. The attenuation of ORs in the model that matched for chronic respiratory and cardiovascular diseases associated with substance abuse suggests that the observed risks may be partially mediated by these conditions.
| S-EPMC8089118 | biostudies-literature
Project description:The COVID-19 pandemic influenced individuals' anxiety and depression across the United States over a short period, and some Americans relied on drugs for coping. This study examines American adults' drug use trajectories in response to changing anxiety and depression levels during the COVID-19 pandemic and the moderating role of substance use disorder (SUD) services provided by non-profit facilities in anxiety/depression-induced drug use. Heterogeneity in such relationships is further explored based on race/ethnicity. This study used a nationally representative sample of 1,176 American adults who reported drug use between May 1, 2020, and June 30, 2021. Using individual-fixed effects Poisson estimators, the current study empirically modeled drug use changes according to changing anxiety/depression levels. Interaction terms between anxiety/depression levels and per capita spending by non-profit SUD facilities were used to explore the moderating effect of SUD service expenditures. Racial/ethnic disparities were explored in subgroup analyses on non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Asian samples. We found more frequent drug use in response to elevated anxiety and depression during the COVID-19 pandemic. Greater spending on SUD service by non-profit facilities at the county level was associated with reduced drug consumption associated with anxiety and depression, with greater benefits for racial/ethnic minorities. Findings provide important policy implications for distributing public funds for non-profit SUD facilities for mitigating SUD risks, especially among racial/ethnic minorities.
| S-EPMC9246210 | biostudies-literature
Project description:PurposeTo assess changes in adolescent visits with substance use disorders (SUDs) at children's hospitals during COVID-19.MethodsWe conducted a retrospective cohort study of adolescents (11-18 years) with SUD diagnoses during a hospital visit in the Pediatric Health Information System. Study periods were defined as spring (03/15-05/31), summer (06/01-08/31), and fall (09/01-12/31), pre-COVID-19 (2017-2019), or during COVID-19 (2020). We summarized the change in weekly median visits and interquartile range (IQR) by characteristics and compared between the two periods (e.g., spring pre-COVID-19 [3/15-05/31/2017-2019] versus spring COVID-19 [3/15-05/31/2020]) using median regression.ResultsThere were 42,979 SUD visits (10,697 COVID-19; 32,282 pre-COVID-19) and 256 annual weekly median adolescent SUD visits [IQR 235, 280] pre-COVID-19 and 268 [IQR 245, 278] during COVID-19. The median number of weekly SUD visits increased by 14.3% during summer COVID-19 (median visits, [IQR]: 272 [268, 278]) compared to pre-COVID-19 (median visits: 237, IQR [216, 249]; p < .001) but did not significantly differ in spring (p = .091) or fall (p = .65) COVID-19.DiscussionOur findings suggest increased problematic adolescent substance use during summer COVID-19. Efforts to increase the identification and treatment of adolescent SUDs remain critical.
| S-EPMC9768470 | biostudies-literature
Project description:Background and aimsTo prevent COVID-19 transmission, some United States (US) federal regulations on substance use disorder (SUD) treatment were suspended in March 2020. This study aimed to quantify the extent of state-level policy uptake and the potential number of people with SUD affected by these policy changes across the US, as well as to assess if policy uptake correlated with rates of people with SUD already in treatment or needing treatment.DesignCross-sectional analysis of policies implemented as of April 13, 2020.Setting and participantsA total of 50 US states and the District of Columbia MEASUREMENTS: State-level implementation of: oral schedule II controlled substances emergency prescription, extended take-home doses for medication for opioid use disorders (MOUD), home-delivery of take-home medications, telemedicine for schedule II-IV prescriptions, telemedicine for buprenorphine prescribing initiation, and waiver of out-of-state Drug Enforcement Administration (DEA) registration. Rates per 100 000 population of: adults in treatment for SUD, MOUD treatment at facilities with opioid treatment programs, SUD based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria, and needing, but not receiving treatment.FindingsHalf of the states (n = 24) enacted no policies, leaving ~460 955 people in treatment and 114 370 people on MOUD pre-pandemic uncovered by any policy expansion. Only telemedicine for buprenorphine initiation was marginally associated with pre-pandemic rate of SUD treatment (OR = 1.003, 95% CI = [1.001, 1.006]) and rate of MOUD therapy (OR = 1.006, 95% CI = [1.002, 1.011]) in univariable analysis, but these associations were no longer significant when controlling for state-level demographics. No policies were associated with state-wide SUD prevalence or rate of unmet treatment need (P > 0.05).ConclusionsTwenty-four United States states did not implement at least one federal policy for substance use disorder treatment expansion as of April 2020, leaving approximately half a million people in treatment pre-pandemic potentially without access to treatment or risking exposure to COVID-19 to continue in-person therapies.
| S-EPMC9081157 | biostudies-literature
Project description:Since the onset of the COVID-19 pandemic, researchers around the world have made efforts to assess its impact on youth mental health; however, the breadth of this topic has impeded a clear assessment of pandemic outcomes. This study aimed to address this gap by reviewing changes in youth (age ≤ 25) mental health, psychological wellbeing, substance use, and the use or delivery of relevant services during the pandemic. PubMed and Embase were searched in May 2021 to conduct a rapid review of the literature. The results encompass 156 primary publications and are reported using a narrative synthesis. Studies of mental health (n = 122) and psychological wellbeing (n = 28) generally indicated poor outcomes in many settings. Publications regarding substance use (n = 41) noted overall declines or unchanged patterns. Studies of service delivery (n = 12) indicated a generally positive reception for helplines and telehealth, although some youth experienced difficulties accessing services. The findings indicate negative impacts of the pandemic on youth mental health, with mixed results for substance use. Services must support marginalized youth who lack access to telehealth.Supplementary informationThe online version contains supplementary material available at 10.1007/s40894-022-00185-6.
| S-EPMC8881192 | biostudies-literature