Alcohol and Substance Use Disorders Diagnostic Criteria Changes and Innovations in ICD-11: An Overview

Background The new revision of the ICD came into effect on January 1st, 2022, and significant changes have been introduced in the section related to substance use disorders. Method In the present work we describe the new ICD-11 section "Disorders due to Substance Use and Addictive Behaviors” and outline the innovations in classification and diagnosis introduced, with a view to addressing the most important issues in terms of new opportunities for identifying and caring for people in need of treatment. Results The main innovations introduced in the ICD-11 chapter of interest are the expanded classes of psychoactive substances, the introduction of single episodes of substance use, the introduction of harmful patterns of substance use and severity qualifiers for substance intoxication. Furthermore, the new category "Disorders due to addictive behaviors” has been added, including "Gambling disorder” and the new diagnostic category "Gaming disorder”. Conclusions ICD-11 calls for renewed public health response and policies fostering the multi-professional and multidisciplinary management of alcohol and substance abuse treatment, giving to these forms of addiction new chances also towards the reaching of the UN 2030 Agenda Sustainable Development Goals. Highlights ICD-11 represents a new opportunity for those who are in need for treatment to be timely identified. ICD-11 allows to fill the existing therapeutic gap and increase the coverage of substance use disorders. ICD-11 pushes for necessary changes in the post-COVID era: an integrated approach aimed at using standard tools and training for adequate intervention. The new definitions adopted by ICD-11 are in line with the UN 2030 Agenda, aimed at ensuring healthy lives and promote well-being for all ages.

Alcohol consumption and COVID-19 in Europe: how the pandemic hit the weak.

INTRODUCTION: The COVID-19 pandemic came along with several health and social unprecedented emergencies, among which handling people with substance use disorder issues. METHODS: In this work, data from a cross-sectional online survey conducted among more than 40,000 adults in 21 European countries during the spring of 2020 are analyzed. The survey recorded participants drinking habits during the year preceding the survey and the changes in alcohol consumption during lockdown. The analyses focused on alcohol consumers' type, investigating on the behavioral change in people who already had a problematic alcohol consumption attitude. RESULTS AND CONCLUSION: The results show how subjects with risky or hazardous use of alcohol increased both drinking quantity and frequency in most European countries, underlining the urge to establish regulations on online and home delivered alcoholic beverages availability and reinforcing and restructuring health care services.

Alcohol consumption and COVID-19 in Europe: how the pandemic hit the weak

Introduction. The COVID-19 pandemic came along with several health and social unprecedented emergencies, among which handling people with substance use disorder issues. Methods. In this work, data from a cross-sectional online survey conducted among more than 40,000 adults in 21 European countries during the spring of 2020 are analyzed. The survey recorded participants drinking habits during the year preceding the survey and the changes in alcohol consumption during lockdown. The analyses focused on alcohol consumers’ type, investigating on the behavioral change in people who already had a problematic alcohol consumption attitude. Results and conclusion. The results show how subjects with risky or hazardous use of alcohol increased both drinking quantity and frequency in most European countries, underlining the urge to establish regulations on online and home delivered alcoholic beverages availability and reinforcing and restructuring health care services.

Alcohol use disorder in the COVID-19 era: Position paper of the Italian Society on Alcohol (SIA).

Coronavirus disease 2019 (COVID-19) first emerged in China in November 2019. Most governments have responded to the COVID-19 pandemic by imposing a lockdown. Some evidence suggests that a period of isolation might have led to a spike in alcohol misuse, and in the case of patients with alcohol use disorder (AUD), social isolation can favour lapse and relapse. The aim of our position paper is to provide specialists in the alcohol addiction field, in psychopharmacology, gastroenterology and in internal medicine, with appropriate tools to better manage patients with AUD and COVID-19,considering some important topics: (a) the susceptibility of AUD patients to infection; (b) the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) the reorganization of the Centre for Alcohol Addiction Treatment for the management of AUD patients in the COVID-19 era (group activities, telemedicine, outpatients treatment, alcohol-related liver disease and liver transplantation, collecting samples); (d) AUD and SARS-CoV-2 vaccination. Telemedicine/telehealth will undoubtedly be useful/practical tools even though it remains at an elementary level; the contribution of the family and of caregivers in the management of AUD patients will play a significant role; the multidisciplinary intervention involving experts in the treatment of AUD with specialists in the treatment of COVID-19 disease will need implementation. Thus, the COVID-19 pandemic is rapidly leading addiction specialists towards a new governance scenario of AUD, which necessarily needs an in-depth reconsideration, focusing attention on a safe approach in combination with the efficacy of treatment.

Alcohol use disorder in the COVID-19 era: Position paper of the Italian Society on Alcohol (SIA)

Abstract Coronavirus disease 2019 (COVID-19) first emerged in China in November 2019. Most governments have responded to the COVID-19 pandemic by imposing a lockdown. Some evidence suggests that a period of isolation might have led to a spike in alcohol misuse, and in the case of patients with alcohol use disorder (AUD), social isolation can favour lapse and relapse. The aim of our position paper is to provide specialists in the alcohol addiction field, in psychopharmacology, gastroenterology and in internal medicine, with appropriate tools to better manage patients with AUD and COVID-19,considering some important topics: (a) the susceptibility of AUD patients to infection;(b) the pharmacological interaction between medications used to treat AUD and to treat COVID-19;(c) the reorganization of the Centre for Alcohol Addiction Treatment for the management of AUD patients in the COVID-19 era (group activities, telemedicine, outpatients treatment, alcohol-related liver disease and liver transplantation, collecting samples);(d) AUD and SARS-CoV-2 vaccination. Telemedicine/telehealth will undoubtedly be useful/practical tools even though it remains at an elementary level;the contribution of the family and of caregivers in the management of AUD patients will play a significant role;the multidisciplinary intervention involving experts in the treatment of AUD with specialists in the treatment of COVID-19 disease will need implementation. Thus, the COVID-19 pandemic is rapidly leading addiction specialists towards a new governance scenario of AUD, which necessarily needs an in-depth reconsideration, focusing attention on a safe approach in combination with the efficacy of treatment.

Alcohol-Related Liver Disease in the Covid-19 Era: Position Paper of the Italian Society on Alcohol (SIA).

BACKGROUND: Coronavirus Disease 2019 (COVID-19), firstly reported in China last November 2019, became a global pandemic. It has been shown that periods of isolation may induce a spike in alcohol use disorder (AUD). In addition, alcohol-related liver disease (ALD) is the most common consequence of excessive alcohol consumption worldwide. Moreover, liver impairment has also been reported as a common manifestation of COVID-19. AIMS: The aim of our position paper was to consider some critical issues regarding the management of ALD in patients with AUD in the era of COVID-19. METHODS: A panel of experts of the Italian Society of Alcohology (SIA) met via "conference calls" during the lockdown period to draft the SIA's criteria for the management of ALD in patients with COVID-19 as follows: (a) liver injury in patients with ALD and COVID-19 infection; (b) toxicity to the liver of the drugs currently tested to treat COVID-19 and the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) reorganization of the management of compensated and decompensated ALD and liver transplantation in the COVID-19 era. RESULTS AND CONCLUSIONS: The COVID-19 pandemic has rapidly carried us toward a new governance scenario of AUD and ALD which necessarily requires an in-depth review of the management of these diseases with a new safe approach (management of out-patients and in-patients following new rules of safety, telemedicine, telehealth, call meetings with clinicians, nurses, patients, and caregivers) without losing the therapeutic efficacy of multidisciplinary treatment.

"The post-COVID era": challenges in the treatment of substance use disorder (SUD) after the pandemic.

BACKGROUND: Citizens affected by substance use disorders are high-risk populations for both SARS-CoV-2 infection and COVID-19-related mortality. Relevant vulnerabilities to COVID-19 in people who suffer substance use disorders are described in previous communications. The COVID-19 pandemic offers a unique opportunity to reshape and update addiction treatment networks. MAIN BODY: Renewed treatment systems should be based on these seven pillars: (1) telemedicine and digital solutions, (2) hospitalization at home, (3) consultation-liaison psychiatric and addiction services, (4) harm-reduction facilities, (5) person-centered care, (6) promote paid work to improve quality of life in people with substance use disorders, and (7) integrated addiction care. The three "best buys" of the World Health Organization (reduce availability, increase prices, and a ban on advertising) are still valid. Additionally, new strategies must be implemented to systematically deal with (a) fake news concerning legal and illegal drugs and (b) controversial scientific information. CONCLUSION: The heroin pandemic four decades ago was the last time that addiction treatment systems were updated in many western countries. A revised and modernized addiction treatment network must include improved access to care, facilitated where appropriate by technology; more integrated care with addiction specialists supporting non-specialists; and reducing the stigma experienced by people with SUDs.