The COVID-19 pandemic and its impact on substance use: Implications for prevention and treatment

Ornell, Felipe; Moura, Helena Ferreira; Scherer, Juliana Nichterwitz; Pechansky, Flávio; Kessler, Félix Henrique Paim; Diemen, Lísia von

doi:10.1016/j.psychres.2020.113096

Cited by 259 publications

(241 citation statements)

References 19 publications

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“…Currently, admitting athletes with severe substance use disorders into the higher-level care they need may be challenging, but should be considered, since postponement could have negative consequences. 86 Across diagnostic categories, providers should continue to seek higher levels of care for their athletes when risks of continuing outpatient management are too great. For example, athletes who are suicidal with plan and intent to act, manic, acutely psychotic or grossly negligent in self-care because of mental health symptoms should undergo inpatient hospitalisation.…”

Section: Reviewmentioning

confidence: 99%

Mental health management of elite athletes during COVID-19: a narrative review and recommendations

Bindra²,

et al. 2020

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Elite athletes suffer many mental health symptoms and disorders at rates equivalent to or exceeding those of the general population. COVID-19 has created new strains on elite athletes, thus potentially increasing their vulnerability to mental health symptoms. This manuscript serves as a narrative review of the impact of the pandemic on management of those symptoms in elite athletes and ensuing recommendations to guide that management. It specifically addresses psychotherapy, pharmacotherapy and higher levels of care. Within the realm of psychotherapy, crisis counselling might be indicated. Individual, couple/family and group psychotherapy modalities all may be helpful during the pandemic, with novel content and means of delivery. Regarding pharmacotherapy for mental health symptoms and disorders, some important aspects of management have changed during the pandemic, particularly for certain classes of medication including stimulants, medications for bipolar and psychotic disorders, antidepressants and medications for substance use disorders. Providers must consider when in-person management (eg, for physical examination, laboratory testing) or higher levels of care (eg, for crisis stabilisation) is necessary, despite potential risk of viral exposure during the pandemic. Management ultimately should continue to follow general principles of quality health care with some flexibility. Finally, the current pandemic provides an important opportunity for research on new methods of providing mental health care for athletes, and consideration for whether these new methods should extend beyond the pandemic.

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Section: Reviewmentioning

confidence: 99%

Mental health management of elite athletes during COVID-19: a narrative review and recommendations

Bindra²,

et al. 2020

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“…This domestic public health crisis is heightened by the collision of the COVID-19 pandemic with the addiction (Volkow 2020) and loneliness (Cacioppo and Cacioppo 2018;Murthy 2017) epidemics that have affected the US for the past years. Public health practitioners and mental health experts (Galea, Merchant, and Lurie 2020;Holmes et al 2020;Ornell et al 2020;Panchal et al 2020;Rehm et al 2020) have raised concerns about the potential effects of COVID-19 and anticipated repercussions of social restrictions on wellbeing and mental health disorders, predicting increases in loneliness, anxiety, depression, and substance use.…”

Section: Introductionmentioning

confidence: 99%

Loneliness, Mental Health, and Substance Use among US Young Adults during COVID-19

Horigian

Schmidt

Feaster

2020

Journal of Psychoactive Drugs

281

196

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As COVID-19 converges with loneliness and addiction epidemics in the US, both public health and mental health experts forecast dramatic increases in substance use and mental health conditions. This cross-sectional study evaluated relationships of loneliness with depression, anxiety, alcohol use, and drug use during COVID-19, and assessed perceived increases in these symptoms in young adults. Between April 22 and May 11, 2020, 1,008 participants ages 18-35 were recruited through social media to a one-time, online anonymous survey. Symptomatology was assessed using six scales. Perceived changes since COVID-19 were evaluated using 5-point Likert scales. Forty-nine percent of respondents reported loneliness scores above 50; 80% reported significant depressive symptoms; 61% reported moderate to severe anxiety; 30% disclosed harmful levels of drinking. While only 22% of the population reported using drugs, 38% reported severe drug use. Loneliness was associated with higher levels of mental health symptomatology. Participants reported significant increases across mental health and substance use symptoms since COVID-19. While direct impacts of COVID-19 could only be calculated with pre-pandemic assessments of these symptoms, estimates indicate elevated psychosocial symptomatology and suggest that symptoms could have worsened since the pandemic. Findings underscore the importance of prevention and intervention to address these public health problems.

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“…It was recognised early on that drug users may face loss of access to supply of drugs and that those on OST may face risks of COVID-19 infection when having their OST dispensed ( Dubey et al., 2020 ; Dunlop et al., 2020 ; Marsden et al., 2020 ; Ornell et al., 2020 ). Thus, it was advised that rapid access to OST and flexibility in delivery of OST were required ( Becker & Fiellin, 2020 ; Dubey et al., 2020 ; Dunlop et al., 2020 ; Heimer, McNeil & Vlahov, 2020 ; Salamat, Hegarty & Patton, 2019 ).…”

Section: Methadone Provisionmentioning

confidence: 99%

“…It was recognised early on in the COVID-19 Pandemic that both homeless and drug-using populations were particularly vulnerable to the effects of coronoavirus infection. This is due to the high morbidity burden of these populations; the poor living conditions they experience and their lack of access to health services ( Alexander, Stoller, Haffajee & Saloner, 2020 ; Baggett et al., 2020 ; Dubey et al., 2020 ; Kar et al., 2020 ; López-Pelayo et al., 2020 ; Marsden et al., 2020 ; McCann Pineo& Schwartz, 2020 ; Mosites et al., 2020 ; Ornell et al., 2020 ; Reece, 2008 ; Tobolowsky et al., 2020 ; Volkow, 2020 ). For example, Albon et al.…”

Section: Introductionmentioning

confidence: 99%

Harm reduction in the time of COVID-19: Case study of homelessness and drug use in Dublin, Ireland

O'Carroll¹,

Duffin²,

Collins

2021

International Journal of Drug Policy

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Dublin appears to have performed very well as compared to various scenarios for COVID-19 mortality amongst homeless and drug using populations. The experience, if borne out by further research, provides important lessons for policy discussions on the pandemic, as well as broader lessons about pragmatic responses to these key client groups irrespective of COVID-19. The overarching lesson seems that when government policy is well coordinated and underpinned by a science-driven and fundamentally pragmatic approach, morbidity and mortality can be reduced. Within this, the importance of strategic clarity and delivery, housing, lowered thresholds to methadone provision, Benzodiazepine (BZD) provision and Naloxone availability were key determinants of policy success. Further, this paper argues that the rapid collapse in policy barriers to these interventions that COVID-19 produced should be secured and protected while further research is conducted.

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The COVID-19 pandemic and its impact on substance use: Implications for prevention and treatment

Cited by 259 publications

References 19 publications

Mental health management of elite athletes during COVID-19: a narrative review and recommendations

Mental health management of elite athletes during COVID-19: a narrative review and recommendations

Loneliness, Mental Health, and Substance Use among US Young Adults during COVID-19

Harm reduction in the time of COVID-19: Case study of homelessness and drug use in Dublin, Ireland

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