A Global Survey on Changes in the Supply, Price, and Use of Illicit Drugs and Alcohol, and Related Complications During the 2020 COVID-19 Pandemic

  1. Ali Farhoudian
  2. Seyed Ramin Radfar
  3. Hossein Mohaddes Ardabili
  4. Parnian Rafei
  5. Mohsen Ebrahimi
  6. Arash Khojasteh Zonoozi
  7. Cornelis A. J. De Jong
  8. Mehrnoosh Vahidi
  9. Masud Yunesian
  10. Christos Kouimtsidis
  11. Shalini Arunogiri
  12. Helena Hansen
  13. Kathleen T. Brady

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Abstract

Background and Aims: COVID-19 has infected more than 77 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing, and “lockdown” measures have affected drug and alcohol supply chains and subsequently their availability, price, and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic.

Design: Cross-sectional survey.

Setting: Worldwide.

Participants: Starting on April 4, 2020 during a 5-week period, the survey received 185 responses from 77 countries.

Measurements: To assess addiction medicine professionals' perceived changes in drug and alcohol supply, price, use pattern, and related complications during the COVID-19 pandemic.

Findings: Participants reported (among who answered “decreased” or “increased”) a decrease in drug supply (69.0%) and at the same time an increase in price (95.3%) globally. With respect to changes in use patterns, an increase in alcohol (71.7%), cannabis (63.0%), prescription opioids (70.9%), and sedative/hypnotics (84.6%) use was reported, while the use of amphetamines (59.7%), cocaine (67.5%), and opiates (58.2%) was reported to decrease overall.

Conclusions: The global report on changes in the availability, use patterns, and complications of alcohol and drugs during the COVID-19 pandemic should be considered in making new policies and in developing mitigating measures and guidelines during the current pandemic (and probable future ones) in order to minimize risks to people with SUD.

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  1. Version published to 10.3389/fpsyt.2021.646206
  2. ScreenIT

    SciScore for 10.1101/2020.07.16.20155341: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: 2.4 Ethics Approval: The survey protocols and all materials, including the survey questionnaires, received approval from the University of Social Welfare and Rehabilitation Sciences, ethics committee in Tehran, Iran (Code: IR.USWR.REC.1399.061).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    2.3 Statistical Analysis: All statistical analyses were conducted using RStudio (v. 1.2.1335).
    RStudio
    suggested: (RStudio, RRID:SCR_000432)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    However, there are limitations such as heterogeneity in numbers of responders from different countries and their disciplines and educational levels. The convenience sample also may impact response rates and other factors. The lack of validated measures is a limitation, as is the lack of options for open ended responses that would provide a window on the mechanisms driving reported trends. Given the dynamic nature of pandemics and lack of multicentric epidemiological studies, the survey is a timely approach to provide a snapshot of global clinical addiction medicine concerns during these unprecedented times. The objective the ISAM survey was to provide initial, rapid preliminary evidence about how COVID-19 has affected different situational aspects experienced by people with SUDs globally in order to help reach a better understanding of the current status, provision of this information to international organizations and regional policy makers should help authorities plan for addressing urgent needs and providing suitable services not only in the current pandemic, but also in future similar situations. To properly respond to the emerging demands and situational shifts during the COVID-19 pandemic in the addiction treatment services across the world, at a macro (policy) level, it is critical to recognize the importance of (1) the social safety net and measures used to reduce the social inequality widening gap when such epidemics deteriorate an already vulnerable system, (2) resp...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

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  3. Version published to 10.1101/2020.07.16.20155341v2 on medRxiv
  4. Version published to 10.1101/2020.07.16.20155341v1 on medRxiv