Impact of the COVID-19 pandemic on alcohol or drug use symptoms and service need among youth: a cross-sectional sample from British Columbia, Canada

Abstract

Background Concerns about youth alcohol and drug use have risen since the declaration of the global COVID-19 pandemic due to the pandemic’s impact on known risk and protective factors for substance use. However, the pandemic’s immediate and long-term impact on youths’ substance use patterns has been less clear. Thus, this study sought to determine how the COVID-19 pandemic impacted alcohol or drug use and its risk and protective factors among youth accessing integrated youth services. Methods We conducted a repeated cross-sectional study of patient-reported outcomes data collected between May 2018 and February 2022 among youth (n = 6022) ages 10–24 accessing a provincial network of integrated youth services in Canada. The main exposure of interest was the COVID-19 pandemic (March 2020 – February 2022) compared with a pre-pandemic period (May 2018 – February 2020). As measured by the Global Appraisal of Individual Needs – Short Screener, outcomes included the average number of past month alcohol or drug use symptoms and past month likelihood of service need for alcohol/drug use (moderate/high vs. low need). Interrupted time series (ITS) examined change in average monthly alcohol/drug use symptoms between the pre- and pandemic periods. Stratified multivariable logistic regression investigated how the pandemic modified the effects of established risk/protective factors on likelihood of alcohol/drug use service need. Results Fifty-percent of youth met the criteria for moderate/high likelihood of alcohol/drug use service need, with the odds being 2.39 times (95% confidence interval = 2.04, 2.80) greater during the pandemic compared to the pre-pandemic period. Results from the ITS indicated significant immediate effects of the pandemic on monthly substance use symptoms (p = 0.01). Significant risk/protective factors for service need included exposure to violence, engagement in meaningful activities, and self-rated physical and mental health; and the direction of their effects remained consistent across pandemic and pre-pandemic periods. Conclusions This study demonstrated that the COVID-19 pandemic corresponded with increased alcohol or drug use among youth accessing integrated services. This signals an urgent need for increased clinical capacity in existing youth services and policies that can respond to risk/protective factors for substance use earlier.

Informing youth‐centred opioid agonist treatment: Findings from a retrospective chart review of youths' characteristics and patterns of opioid agonist treatment engagement in a novel integrated youth services program

“…To address these concerns, future research and service providers may consider the role and benefit of integrating peer support from other youth who have accessed OAT into OAT care. This recommendation aligns with recent research showing that peer‐based opioid use services are a strong preference for youth using opioids (Marchand, Fogarty, et al, 2022; Marchand, Liu, et al, 2022) and may promote youths' understanding of OAT and its benefits and challenges.…”

“…Despite the youth-centredness of our novel program, OAT stability was still difficult for 58% of youth. Based on these findings and those few studies that have explored youths' preferences for OAT and opioid use services (Chai et al, 2021;Giang et al, 2020;Marchand, Fogarty, et al, 2022;Marchand, Liu, et al, 2022), it is critical that individual treatment preferences be considered and revisited throughout treatment, as these are likely to be youth-specific and to evolve over time.…”

“…It has also been recommended that OAT be integrated into primary care environments where youth are already engaged and where other health needs can be simultaneously met (British Columbia Centre on Substance Use et al, 2018;Hadland, 2019;Krausz et al, 2022;Saloner et al, 2017). These recommendations are also in line with youths' preferences to receive opioid use services/ treatments in settings that can address multiple social, health, and substance use needs (Marchand, Fogarty, et al, 2022;Marchand, Liu, et al, 2022).…”

“…The increasing toxicity of the street drug supply due to adulteration with fentanyl, carfentanil, and other fentanyl analogues and synthetic opioids (Armenian et al, 2018; Tupper et al, 2018) is one contributing factor. Another is the COVID‐19 pandemic, which has disrupted daily routines and supply chains (including for street drugs) and affected physical and mental health, substance use, and access to services for these concerns (Marchand, Fogarty, et al, 2022; Marchand, Liu, et al, 2022; Ross et al, 2022). This opioid crisis affects all age groups, including adolescents and young adults, ages 12–24 (referred to as youth hereafter) (Patton et al, 2016).…”

Illicit Drugs in Surface Waters: How to Get Fish off the Addictive Hook

“…Considering the market value and continuous increase in ID usage, it is valuable to project a significant increase in detectable amounts of drugs and their active metabolites in waste and surface waters. Moreover, the COVID-19 pandemic has likely exacerbated the drug crisis, as highlighted not only by a higher number of substance use symptom records and an increased number of overdose fatalities but also by the elevated concentrations of selected psychoactive substances in wastewater, indicating increased drug use [ 5 , 6 , 7 ].…”