ABSTRACT
Background: The impact of the COVID-19 pandemic on the mental health of patients suffering from addictive disorders is of major concern. This study aimed to explore the presence and potential increase in post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety since the beginning of the pandemic for patients in opioid substitution therapy (OST). Methods: This cross-sectional survey study evaluated a clinical sample of patients in OST (N = 123). Symptoms of post-traumatic stress disorder (PTSD) due to the COVID-19 pandemic were assessed by an adapted version of the impact of event scale (IES-R), resulting in two subgroups of low and high risk for PTSD. The depression, anxiety, and stress scale (DASS-21) was applied to collect data on the respective symptoms, and changes since the onset of the pandemic were reported on separate scales. Sociodemographic and COVID-19 related factors, as well as data on craving, consumption patterns, concomitant use, and the drug market were further assessed. Results: A binary logistic regression analysis confirmed the impact of self-perceived higher burden by psychological and economic factors on the elevated risk for PTSD due to the pandemic. The high-risk PTSD group also showed higher levels of depression, anxiety and stress, as well as a more pronounced deterioration in these symptoms since the pandemic. While reported levels of craving did not differ between the two groups, the high-risk PTSD group indicated a significantly higher increase in craving since the crisis, when compared to the low-risk group. Discussion: Our findings demonstrate elevated levels of clinical symptoms among patients in OST, with more than a quarter of patients found at risk for PTSD due to the COVID-19 pandemic. Furthermore, about 30-50% of our patients reported concerning levels of depression, anxiety, or stress. Special attention should be drawn to these findings, and potential deterioration of the situation should be addressed by health care facilities. Particularly, psychological, and financial burden due to the crisis were identified as factors increasing the risk for PTSD. These factors can easily be evaluated during routine anamneses, and might be a valuable source of information, when special attention is needed.
ABSTRACT
Background: The impact of the ongoing COVID-19 pandemic on vulnerable groups like patients suffering from substance use disorders is expected to be tremendous, and corresponding concerns were raised early on by many experts around the world. Psychosocial distress, financial insecurities and physiological problems associated with the COVID-19 crisis could be especially challenging for this group of patients. Methods: In the current study data was collected from a clinical sample of patients with alcohol use disorder (AUD; N = 127) during the initial stage of the pandemic. The impact of various COVID-19 related factors (physiological, psychosocial, economic and others) on patients' personal life was evaluated. Alcohol consumption, craving, and potential posttraumatic stress disorder (PTSD) symptoms were assessed using different scales and their associations were analyzed. Furthermore, differences regarding these variables between comparably sized groups of patients who remained abstinent (N = 37), relapsed (N = 41), or reported unaltered drinking behavior (consuming subgroup, N = 49) were investigated. The impact of sociodemographic and COVID-19 factors on relapse (in comparison to abstinence) was evaluated using binary logistic regression analysis. Results: Our results confirmed the expected positive associations between alcohol consumption, craving, and PTSD symptoms, respectively, among patients with AUD. Furthermore, group differences indicate significantly lower levels on all three scales for abstinent patients. Although generally low PTSD scores were observed, 8% of our participants were found to be at risk of PTSD. Results of a binary logistic regression analysis indicated the presence of psychosocial COVID-19 factors (e.g., isolation, anxiety, and depression) as well as living alone as two major risk factors for relapse. Discussion: Our findings based on actual patient data support the anticipated negative consequences of the pandemic on persons with AUD. Crucially, our results regarding relapse emphasized psychosocial COVID-19 factors and isolation as especially challenging circumstances for persons with AUD, whereas economic and physiological health aspects seemed of minor impact on relapse. Our results reflect the initial stage of the pandemic, whereas long-term developments should be closely monitored.
ABSTRACT
Concerns about the negative consequences of the COVID-19 pandemic on people with substance use disorder (SUD) were raised by experts in the field around the world. Here we provide an Austrian perspective, discussing the impact of the pandemic on help-seeking patient with drug use disorder during the initial stage of the pandemic. Our perspectives are based on the situation as perceived at our clinical facility, and supported by original data collected from a small clinical sample of patients with drug use disorder (N = 32). The viewpoints and related descriptive data include the perceived individual impact of COVID-19, as well as various aspects of drug use behavior and the Austrian drug market before and after the onset of the pandemic. The consequences for a subgroup of patients in opioid substitution treatment (N = 24) are discussed. Surprisingly and in contrast to anticipated developments, we had the impression of a rather stable situation in Austria, at least at this early stage of the pandemic. The immediate impact of COVID-19 on these help-seeking patients with high levels of drug dependency seemed less severe than anticipated so far. Importantly, this observation might be a short-term effect for this already fragile group and careful monitoring of further developments as well as preparation of long-term strategies are advised. In general, problematic drug use is associated with many health risk factors and finding appropriate long-term health care strategies has to remain a top priority facing the pandemic. Our perspectives are restricted to observations from help-seeking patients at our clinic, and no conclusions for the general population can be directly drawn.