Substance Use Disorder in the COVID-19 Pandemic: A Systematic Review of Vulnerabilities and Complications

Abstract

<jats:p>As the world endures the coronavirus disease 2019 (COVID-19) pandemic, conditions of 35 million vulnerable individuals struggling with substance use disorders (SUDs) worldwide have not received sufficient attention for their special health and medical needs. Many of these individuals are complicated by underlying health conditions, such as cardiovascular and lung diseases and undermined immune systems. During the pandemic, access to the healthcare systems and support groups is greatly diminished. Current research on COVID-19 has not addressed the unique challenges facing individuals with SUDs, including the heightened vulnerability and susceptibility to the disease. In this systematic review, we will discuss the pathogenesis and pathology of COVID-19, and highlight potential risk factors and complications to these individuals. We will also provide insights and considerations for COVID-19 treatment and prevention in patients with SUDs.</jats:p>

Suicide during COVID-19 and other major international respiratory outbreaks: A systematic review

“…As a result, confinement creates a sense of “collective hysteria”, which can be a major driving force toward suicide ( Barbisch et al, 2015 ). Finally, quarantine and social isolation might increase drug consumption or relapse into substance misuse, even in long-term abstainers ( Ornell et al, 2020 ; Wei and Shah, 2020 ). For instance, in an online survey conducted in China, 19% and 32% of participants relapsed or increased their alcohol use during the pandemic, respectively ( Sun et al, 2020 ).…”

‘They already operated like it was a crisis, because it always has been a crisis’: a qualitative exploration of the response of one homeless service in Scotland to the COVID-19 pandemic

“…The novel coronavirus 2019, commonly referred to as COVID-19, is a disease of the respiratory system [ 1 ]. The disease has now spread to over 150 countries and has been reported on almost all continents [ 2 ]. On 11 March 2020 the World Health Organization declared COVID-19 a pandemic, and concern grew quickly due to the rapid spread and levels of severity worldwide [ 3 ].…”

“…The reasons for use are complex, with many people using substances to cope with previous/current violence, trauma, or extremely challenging life circumstances [ 8 ]. People who are homeless and use substances are at significant risk of being negatively affected by COVID-19 [ 2 , 9 – 11 ]. Although only 16 people in this population group are confirmed to have died from the disease in England and Wales [ 12 ], this has largely been attributed to the rapid rehousing of people in private rooms, for example in hotels where they could self-isolate more easily [ 13 ].…”

Clinical impact of COVID-19 on people with substance use disorders

“…People with substance use disorders (SUD) are considered at increased risk of COVID-19 and its more serious complications for multiple physiological and social causes. 6–9 …”

“…Moreover, high-risk behaviors such as sharing drug-using paraphernalia, difficulties to maintain quarantines and living in close contact with others in crowded shelters may contribute to the spread of COVID-19 among people with SUD. 6–9 …”