ABSTRACT
Introduction A quarantine related to the spread of coronavirus SARS-CoV-2 was mandatory in France from March 17 to May 10, 2020. This quarantine could have psychological consequences on general population and vulnerable people such as substances users [1]. Anticipated consequences of behavioral changes related to substance use in context of quarantine have emerged in literature [2]. Changes in substances use could led to an increase of health issues such as mortality due to overdose notably [3]. Some authors suggested that quarantine related to covid-19 pandemic could increase alcohol use [4,5]. The objective of this study was to assess the frequency of polysubstance users who have increased their alcohol use and determine risk factors for these changes. Methods: An anonymous Internet-based cross-sectional survey was conducted between April 8 and May 10, 2020. Participants were recruited via posts and Internet messages on a French online Forum related to drug use (www.psychoactif.org). This website is a forum dedicated to harm reduction and information on psychoactive drugs and lead by volunteers. We included participants that reported at least the use of two substances including alcohol. Only French citizen living on French territories were included Since 30 % of visitors on psychoactif web site are living in others francophone countries, we excluded them, due to different quarantine conditions between countries. Study variables were collected by using a questionnaire designed for the present study. Declarative data from this survey questions included socio demographical informations and questions on quarantine conditions notably number of days of quarantine and quarantine domestic conditions. Participants were asked on questions pertaining to use of alcohol (“Since the beginning of the quarantine, have you increased, diminished, quitted or maintained your alcohol consumption). Current alcohol use was examined using the Alcohol Use Disorder Identification Test Consumption (AUDIT). Alcohol craving during quarantine was assessed using Obsessive Compulsive Drinking Scale (OCDS), and Depressive and anxiety symptoms were assessed using Hospital Depression and Anxiety scale (HAD). Substances use and medication use were reported. The rates of users were presented with 95% confidence intervals (CI) and the associations of demographic or clinical variables with alcohol increase were assessed using odds ratios (OR) with 95% CI from a multivariate logistic regression. Results: 1310 polysubstance users completed the survey. A total of 974 (74.3%, [95%CI, 72.2-76.4]) participants reported alcohol use of whom 405 participants (41.6 %, [IC95 38.5-44.7]) reported an increase in alcohol use since the start of quarantine. Odds of alcohol use increase was higher for participants with married/domestic partnership (OR, 1.8 [95%CI, 1.4- 2.5]), and those with HAD scores higher than 7 (OR, 1.7 [95%CI, 1.2-2.3]), AUDIT scores lower than 8 (OR, 2.0 [95%CI, 1.4-2.8]), and OCDS scores greater than 7(IQR) (OR, 3.2 [95%CI, 2.3 - 4.5]). Odds of alcohol use increase was higher for psychostimulant users (OR, 1.7 [95%CI, 1.3 -2.5]). Conclusion: Prevention on the emergence of alcohol use disorders in light and moderate drinkers during quarantine should be considered by health policies and target specifically polysubstance users who reported psychostimulant use, higher levels of alcohol craving, anxiety and depression. No conflict of interest