Substance Use in Healthcare Professionals During the COVID-19 Pandemic in Latin America: A Systematic Review and a Call for Reports

Abstract

Background: The COVID-19 pandemic has generated a remarkable change in the behaviour of Healthcare workers (HCWs) around the world. However, there is a lack of evidence on substance use among HCWs in Latin America. Therefore, this study aimed to determine the current frequency of substance use among Latin American among HCWs. Methods: We searched 8 databases (PubMed, Scopus, ScientDirect, Web of Science, Cochrane, Scielo, LILACS and Latindex), 4 public prepublication servers (SocArXiv, medRxiv, bioRxiv and Preprints) and Google scholar from 1/9/2019 to 11/1/2021. We determined the frequency of each study based on original studies, scientific letters, and clinical trials in English, Spanish and Portuguese. Results: A total of 17 175 study articles were identified from electronic databases and preprints, and 2 cross-sectional studies conducted in 2020 were included in the qualitative analysis. Both studies included HCWs but did not perform a differential analysis. The first was developed by the Pan-American Health Organization and included interviewees from 35 countries, while the second was conducted with 1145 Brazilian participants. Both studies showed increases in substance use during the pandemic, with alcohol being the most commonly used substance (30%), but PAHO’s study reported a 13.8% increase in self-reported heavy-episodic drinking, with differences among genders (males, 15.4%), age groups (highest increase in the 40-49 age group, 16.5%) and area of residence (urban with 14%). The second study showed that 21 32% of participants reported initiating psychoactive substance use, 29.3% added some substance to their initial use and 4% of them had to replace the substance, mainly due to difficulty of access. Other substances of abuse that showed significant increases were tobacco (0.5%) and marijuana (0.3%). Conclusion: Overall, despite the analysis of the 2 studies, the results provided are not a conclusive description of the frequency of substance use by HCWs in Latin America during the COVID-19 pandemic. Further research is required to understand the impact of the pandemic on drug abuse in the region. Protocol Registration: The protocol has been registered on 30 November 2021 on the International Prospective Register of Systematic Reviews (PROSPERO) with ID: CRD420212919700.

Alcohol Consumption, Hangovers, and Smoking among Buenos Aires University Students during the COVID-19 Pandemic

“…A recent nation-wide study in Uruguay revealed that among participants aged 15–65 years, alcohol (52%) and tobacco (33%) were the substances with the highest level of habitual consumption, with women being more likely to increase tobacco use during the COVID-19 pandemic compared with men [ 13 ]. Another study reported that among healthcare workers from Latin America, smoking tobacco increased between 2020 and 2021 [ 14 ]. In contrast, a study in cardiometabolic patients in Latin America revealed that women reported lower tobacco use during the pandemic [ 15 ].…”

Effects of working in vulnerable contexts on the mental health of primary healthcare professionals during the COVID-19 pandemic: a mixed-methods study

“… 36 Insomnia is one of the main factors associated with PAS use in this population group, 37 38 which has been a general increase in the consumption of prescription psychotropic drugs 39 as observed in the prevalence of psychotropic medication use identified in the study. A systematic review 39 demonstrated significant changes in PAS use among healthcare professionals during the COVID-19 pandemic that correlates with findings in the present study regarding the use of alcohol and other PAS. Alcohol was the most used substance with an increase of almost 14% in binge drinking, 1.3% in new alcohol users and a relationship between the alcohol use with the context generated by the pandemic, such as exposure to stressful environments, risk of contagion, neuropsychological conditions and high professional demands.…”

“…35 It showed that healthcare professionals who worked directly with COVID-19-infected/suspected clients were more likely to experience depression, stress and burn-out than those who were not personally involved in this fieldwork. 36 Insomnia is one of the main factors associated with PAS use in this population group, 37 38 which has been a general increase in the consumption of prescription psychotropic drugs 39 as observed in the prevalence of psychotropic medication use identified in the study. A systematic review 39 demonstrated significant changes in PAS use among healthcare professionals during the COVID-19 pandemic that correlates with findings in the present study regarding the use of alcohol and other PAS.…”

Assessing empathy in healthcare services: a systematic review of South American healthcare workers’ and patients’ perceptions

“…Bias assessment was conducted using the Cochrane risk of bias tool (Robvis 2.0), and the studies that did not contribute to the study objective (analyzing at least one variable) were considered to have a high risk of confusion and were reported. Robvis enables a comprehensive assessment of the overall confidence in the set of tests, taking into account factors such as the accuracy and relevance of the chosen studies as previously reported (22). Disagreements were resolved through consensus among the authors.…”