Research into Alcohol-Dependent Persons in Treatment during the Covid-19 Pandemic. Part Two- the Role of the Pandemic and Its Consequences

Introduction: The aim of the study was to de-termine the influence of experiences, both personal , those occurring during therapy, of the COVID-19 pandemic on mental perfor-mance of alcohol dependent people receiving treatment.Material and methods: The 2021 study includ-ed 454 people (351 men and 103 women) completing therapy in various treatment centres in Poland. The tools comprised the Scale of Pan-demic-Related Difficulty, the Patient Health Questionnaire (PHQ-9), the Generalized Anx-iety Disorder (GAD-7), the Penn Alcohol Crav-ing Scale (PACS), the Suicidal Behavior Ques-tionnaire-Revised (SBQ-R), the International Trauma Questionnaire (ITQ), the Life Satisfac-tion Scale (SWLS), the Working Alliance Inven-tory-Short Revised (WAI-SR).Results: Among the participants, the women ex-perienced many more associated difficulties , anxiety than the men in the pandemic. During treatment, 13% of respondents have relapsed, with this being more likely among those reporting re-stricted access to therapy. Difficulties at home and in close relationships were strongly associated with symptoms of depression and anxiety. Patients with COVID-19 symptoms were characterised by a high-er degree of psychopathological severity compared to those who did not. No differences were found be-tween those who received the entire therapy "face to face", those who participated remotely and those who received a combination of the two models.Discussion: The experience of a pandemic by those in therapy did not appear to be strong-ly influenced by its course. The greatest neg-ative effects concerned domestic difficulties and problems with close relationships. How-ever, women, those who displayed COVID-19 symptoms and those who lost their jobs during the pandemic period demonstrated worse men-tal performance.Conclusions: Remaining in therapy may have played a protective role in patients with alcohol dependence during the pandemic.

Research into Alcohol-Dependent Persons in Treatment during the Covid-19 Pandemic. Part One- the Mental Health of Patients

Introduction: Although it is widely acknowl-edged that the COVID-19 pandemic has negative-ly affected the populations mental health, there has been little research into its effect on those with alcohol dependence, or those in addiction therapy during the period. The aim of the pres-ent study was to determine the level of mental performance of patients receiving treatment for alcohol dependence during the COVID-19 pan-demic.Material and methods: The study included 454 people (351 men and 103 women) completing inpatient, day-care and outpatient therapy in various dependence treatment centres in Po-land in 2021. All were surveyed with the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Questionnaire (GAD-7), the Penn Alco-hol Craving Scale (PACS), the Suicidal Behavior Questionnaire-Revised (SBQ-R), the International Trauma Questionnaire (ITQ) and the Satisfaction with Life Scale (SWLS).Results: The alcohol dependent patients finish-ing therapy demonstrated an intermediate level of mental performance, while about 20% exhib-ited serious disorders (elevated levels of depres-sion, anxiety, suicidal tendencies and alcohol craving). The patients completing inpatient ther-apy demonstrated more intense disorders than those completing day-care and outpatient thera-py. Intense disorders characterised also women, people with accompanying mental disorders and those who had previously used drugs in addition to alcohol.Discussion: Around 20% of those completing therapy displayed serious mental disorders, i.e. less than those identified in the research on the func-tioning of the general population during the pan-demic. The weaker performance of women and people with co-occurring mental disorders was confirmed.Conclusions: People completing therapy during a pandemic generally display an intermediate level of mental performance and life satisfaction. However, our findings regarding the more intense disorders require confirmation in further studies conducted after the end of the pandemic.

Alcohol dependence during COVID-19 lockdowns.

To determine whether the past half-year of COVID-19-related lockdowns, stay-at-home orders, and social isolation were associated with changes in high-risk alcohol use, a total of 5,931 individuals completed the Alcohol Use Disorders Identification Test (AUDIT) at one of six time points from April through September 2020. Over the 6-month period, hazardous alcohol use and likely dependence increased month-by-month for those under lockdowns compared to those not under restrictions. This increase in harmful alcohol use and related behaviors is likely to have prolonged adverse psychosocial, interpersonal, occupational, and health impacts as the world attempts to recover from the pandemic crisis.

The Potential for Managed Alcohol Programmes in Scotland during the COVID-19 Pandemic: A Qualitative Exploration of Key Areas for Implementation Using the Consolidated Framework for Implementation Research.

People experiencing homelessness and alcohol dependence are at increased risk of a range of harms, including from COVID-19. Managed Alcohol Programmes (MAPs) are an alcohol harm reduction intervention specifically for this group. In this paper we report on qualitative findings of a mixed methods study investigating the potential utility of MAPs during the COVID-19 pandemic in Scotland. Interviews, conducted with 40 participants, explored potential views of implementing MAPs during the pandemic. Theoretically, we drew on the Consolidated Framework for Implementation Research (CFIR) to inform data collection and analysis. Six themes were identified which mapped onto three CFIR domains: perceptions of MAPs and the evidence base; necessary components of MAPs; changing culture of alcohol harm reduction; MAPs as a moral and ethical grey area; addressing a service gap; and securing buy-in and partnership working. Participants were generally positive about MAPs and viewed them as a key intervention to address a service gap. Several necessary components were identified for successful implementation of MAPs. Securing buy-in from a range of stakeholders and partnership working were deemed important. Finally, MAPs require careful, long-term planning before implementation. We conclude that MAPs are needed in Scotland and require long-term funding and appropriate resources to ensure they are successful.

Alcohol use disorder and liver injury related to the COVID-19 pandemic.

Alcohol use disorder is a complex and heterogeneous phenomenon that can be studied from several points of view by focusing on its different components. Alcohol is a hepatotoxin whose metabolism creates profound alterations within the hepatocyte. The liver is the central organ in the metabolism of alcohol, a process that also involves other organs and tissues such as the brain, heart and muscles, but the most relevant organ is the liver. The anatomopathological alterations in the liver associated with the prolonged use of alcohol range from the simple accumulation of neutral fats in the hepatocytes, to cirrhosis and hepatocellular carcinoma. Alcohol abuse frequently leads to liver disease such as steatosis, steatohepatitis, fibrosis, cirrhosis, and tumors. Following the spread of coronavirus disease 2019 (COVID-19), there was an increase in alcohol consumption, probably linked to the months of lockdown and smart working. It is known that social isolation leads to a considerable increase in stress, and it is also recognized that high levels of stress can result in an increase in alcohol intake. Cirrhotic patients or subjects with liver cancer are immunocompromised, so they may be more exposed to COVID-19 infection with a worse prognosis. This review focuses on the fact that the COVID-19 pandemic has made the emergence of alcohol-induced liver damage a major medical and social problem.

A Case-Control Study on Severity of Covid Infection in Alcohol-Dependent Individuals in a Tertiary Care Hospital in South India

BACKGROUND. In the Indian population, it is estimated that 34-42% of adults have been the users of alcohol in their lifetime. coronavirus disease (COVID-19), undoubtedly the greatest public health catastrophe of our times, has been making a universal concern throughout the world over the past few months and is throwing up several challenges for us in numerous ways. AIM OF THE STUDY:To assess the impact of Covid 19 infection in alcohol-dependent individuals METHODS: This case-control study was conducted in the year October-2021 to January 2022 in the psychiatrySRM Medical College Hospital and Research Centre, Kaatankulathur, Tamilnadu, India. A total of 200 patients are selected for the study. 100 cases with alcohol dependence syndrome & 100 healthy controls without alcoholic usage. In case as well controls COVID positivity was either confirmed with RT-PCR (or) CT severity score(or) by clinical evaluation. Severity of the COVID infection were assessed by, CT severity score. RESULT(S): The proportion of participants with COVID infection was significantly more in the controls than in the Alcohol-dependent patients (P-value < 0.05).The duration of stay was higher in the control group (80.6 %) than the cases (66.6%) with a P value of less than 0.05.Though the oxygen requirement was more in the control group than in the cases the difference was not statistically significant. CONCLUSION(S): The risk of covid infections was higher in the controls than in Alcohol-dependent cases. Copyright © 2022, Anka Publishers. All rights reserved.

Problem drinkers and high risk-taking behaviors under the stay-at-home policy of the COVID-19 emergency declaration.

BACKGROUND: To the best of the authors' knowledge, this is the first study to examine whether problem drinkers have had high risk-taking behaviors during the stay-at-home policy (e.g., dining out at a bar) under the COVID-19 emergency declaration. METHODS: We investigated data from Japan COVID-19 and Society Internet Survey(JACSIS)study-a web-based nationwide survey, conducted from August to September 2020. From a total of 12,076 current drinkers, problem drinkers were detected by Cut, Annoyed, Guilty, and Eye-opener (CAGE) questions. A CAGE score of 4 showed potential alcohol use disorder and scores of 2 to3 showed potential alcohol abuse; individuals with these scores were regarded as problem drinkers compared to light-or-no-risk drinkers, with a CAGE score of 0 to 1. The outcome assessed the presence of 18 behaviors against the stay-at-home policy, such as dining out at a bar, meeting people, or going to crowded places. All these behaviors were limited in Japan during the first declaration of emergency between April and May 2020. RESULTS: Based on the multivariable logistic regression, the participants with potential alcohol use disorder demonstrated 16 out of the 18 risk-taking behaviors, such as dining out at a bar (adjusted odds ratio (aOR): 2.08; 95% confidence interval (CI): 1.56-2.79), dining out at a restaurant (aOR: 1.79; 95% CI:1.37-2.35), visiting friends (aOR: 1.81; 95% CI: 1.34-2.44), going to karaoke (1.97; 95% CI: 1.26-3.10), and riding on a crowded train (aOR: 1.46; 95% CI: 1.07-1.99), compared to light-or-no risk drinkers with a CAGE score of 0 to 1. Additionally, participants with potential alcohol abuse (CAGE score of 2 to 3) had 10 out of 18 behaviors against the stay-at-home policy: the corresponding aORs for the aforementioned behaviors were 1.45 (95% CI: 1.25-1.67), 1.27 (95% CI: 1.12-1.44), 1.17 (95% CI: 1.01-1.36), 1.49 (95% CI: 1.17-1.90), and 1.19 (95% CI: 1.03-1.38), respectively. Problem drinkers had a significant association with being men, a higher income and job position, smoking, sleep deprivation, depression, and other mental diseases. CONCLUSIONS: Overall, problem drinkers were more likely to have higher risk-taking behaviors against the stay-at-home policy, compared to light-or-no-risk drinkers.

COVID-19 Impact on Australian Patients with Substance Use Disorders: Emergency Department Admissions in Western Sydney before Vaccine Roll Out.

BACKGROUND: In this study, we determined the impact of the COVID-19 pandemic on Western Sydney patients with substance use disorders (SUD) by comparing emergency department (ED) admission rates before and after the onset of the COVID-19 pandemic and before the rollout of COVID-19 vaccination. METHODS: ED admission data for patients with SUD were retrieved from the local electronic medical record (eMR) on the hospital central database. ED data collected from 25 January to 25 July 2019 (before the COVID-19 pandemic) were compared with data from 25 January to 25 July 2020 (early pandemic). ED admission reasons were categorised based on the presenting complaints and ED diagnoses. RESULTS: Despite an overall reduction in ED admissions during the early pandemic, compared to the pre-pandemic period, admissions for patients with SUD increased significantly (1.7% to 3.4%, p < 0.01). ED admission rates related to infection (0.05% to 0.12%, p < 0.01), local infection (0.02% to 0.05%, p < 0.01), trauma (0.06% to 0.12%, p < 0.01), alcohol (0.01% to 0.03%, p < 0.05), and other issues (0.06% to 0.10%, p < 0.05) increased significantly among Indigenous patients with SUD. ED admission rates related to drugs (0.12% to 0.39%, p < 0.01), infection (0.21% to 0.34%, p < 0.01), local infection (0.07% to 0.18%, p < 0.01), gastrointestinal (0.15% to 0.23%, p < 0.05), trauma (0.14% to 0.25%, p < 0.01), alcohol (0.36% to 0.74%, p < 0.01), and 'other' issues (0.47% to 0.91%, p < 0.01) increased significantly among non-Indigenous patients with SUD. Four cases of COVID-19 were reported among these patients. CONCLUSIONS: There was an increase in ED admissions for patients with SUD in the initial six months of the COVID-19 pandemic (before vaccine rollout), mainly for drugs, systemic infection, local infection, trauma, and alcohol-related reasons. Now that most people in New South Wales have been vaccinated against COVID-19, a further study is needed to quantify the effect of the pandemic on patients with SUD in the post-vaccine era.

Impact of Covid-19 Pandemic on Quality of Life in Persons with Alcohol use Disorder- A Cross-Sectional Study

Introduction: Alcohol use disorder has a chronic relapsing course. Various biological, psychological, environmental, and psychosocial factors play a major role in maintaining abstinence and determining relapse in patients. The COVID-19 pandemic has caused significant changes in every person's life. It is important to assess how this situation has determined alcohol use in the patients who had utilized deaddiction services in the past. Aim: The aim of this study is to assess the pattern of alcohol use, perceived stress, and quality of life (QOL) during COVID-19 in patients who had utilized deaddiction services for alcohol use disorder in the preceding 1 year. Materials and Methods: A cross-sectional design was employed in the study. After obtaining consent, telephonic interviewing of patients who had utilized deaddiction services during January-December 2019 was done, and questionnaires including sociodemographic details, Severity of Alcohol Dependence Questionnaire, Brief Substance Craving Scale, Perceived Stress Scale-10, and WHOQOL-BREF scale were administered to assess the pattern of alcohol use, stress levels, and QOL. Comparisons were carried out on different variables using SPSS version 20. Results: A total of 122 patients were inducted into the study. About 70.5% of the relapsed individuals belonged to joint families. There was a significant association between the poor QOL and relapse status of the individuals. High levels of stress were reported among the individuals who have relapsed compared to nonrelapsed individuals. Conclusion: High rates of relapse and higher stress levels were found in our study. This study has helped us to understand the pattern of alcohol use in individuals during this pandemic. It is important to address the factors contributing to relapse in individuals so as to focus on developing and implementing feasible and accessible interventions to help the individuals.

Alcohol Use Disorders among Slovak and Czech University Students: A Closer Look at Tobacco Use, Cannabis Use and Socio-Demographic Characteristics.

The main objective of the research was to examine the associations between problematic alcohol use, tobacco use and cannabis use among Czech and Slovak university students during the early COVID-19 pandemic. The research sample consisted of 1422 participants from the Czech Republic (CZ) and 1677 from the Slovak Republic (SK). The analyses included university students who drank alcohol in the past year (CZ: 1323 (93%); SK: 1526 (91%)). Regarding the analysed measures, the Alcohol Use Disorders Identification Test (AUDIT) and its subscales, the Glover-Nilsson Smoking Behavioral Questionnaire (GN-SBQ) and the Cannabis Abuse Screening Test (CAST) were selected to identify substance-related behaviour. Age, gender and residence were included in the analyses as socio-demographic variables. Correlation and regression analyses were used to achieve the main objective of the research. The main results revealed that the use of tobacco and cannabis were positively associated with alcohol use disorders among Czech and Slovak university students. Additionally, males were more likely to report alcohol use disorders. In the Czech Republic, it was found that students living in dormitories were characterized by a lower AUDIT score. The opposite situation was found in the Slovak Republic. Czech and Slovak policy-makers are encouraged to develop alcohol use prevention programs for university students in line with these findings.

Acupuncture Combined With Emotional Therapy of Chinese Medicine Treatment for Improving Depressive Symptoms in Elderly Patients With Alcohol Dependence During the COVID-19 Epidemic.

Objective: We aimed to analyze the characteristics and psychological mechanism of depressive symptoms in elderly patients with alcohol dependence under the COVID-19 epidemic and to observe the effect of acupuncture combined with emotional therapy of Chinese medicine treatment on depressive symptoms in elderly patients with alcohol dependence. Methods: Sixty patients were randomly divided into two groups. One group was treated by a set of emotional therapy of Chinese medicine treatment for 12 weeks (control group). One group was treated by a set of acupuncture combined with emotional therapy of Chinese medicine treatment for 12 weeks (treatment group). We compared the curative effect between the control group and the treatment group, the mean alcohol consumption, the SF-36 scores before and after treatment, and the scores of Hamilton Depression Scale before and after treatment of 3, 6, and 9 weeks. Results: Based on the cognitive behavior model, the characteristics and psychological mechanism of depression in elderly patients with alcohol dependence under the COVID-19 epidemic situation were summarized. The total effective rate of the control group was 60%, and that of the treatment group was 100% (p < 0.05). The alcohol consumption of the patients in each group decreased significantly after treatment (p < 0.05), and there was no significant difference in alcohol consumption between the treatment group and the control group (p > 0.05). After 12 weeks of treatment, there were significant differences in PF, RF, physical pain, general health status, energy, and mental health between the treatment group and the control group (p < 0.05). Before and after treatment, there were significant differences in PF, RF, physical pain, general health, energy, emotional function, and mental health (p < 0.05) of the treatment group. The PF, energy, and mental health of the control group were significantly different before and after treatment (p < 0.05). There was no significant difference between the treatment group and the control group in the scores of Hamilton Depression Scale before treatment. There was significant difference between the treatment group and the control group in the scores of Hamilton Depression Scale at 3, 6, and 9 weeks after treatment. Conclusion: Attention, cognition, emotion, behavior, and physical response reinforce each other, creating a vicious cycle that reinforces and sustains the depressive symptoms of elderly alcohol dependence under the COVID-19 epidemic, and acupuncture combined with emotional therapy of Chinese medicine treatment for improving the depressive symptoms of elderly alcohol dependence during the epidemic period of COVID-19 has a brilliant therapeutic effect.

Relationships between Perceived Stress, Depression and Alcohol Use Disorders in University Students during the COVID-19 Pandemic: A Socio-Economic Dimension.

The objective of the study was to examine the effects of perceived stress on depression and subsequently to examine the effects of depression on alcohol use disorders. The data were obtained by an electronic questionnaire survey during the coronavirus disease 2019 (COVID-19) pandemic (n = 1523 Slovak university students). Descriptive, regression, and correlation analysis were used in the analytical processing, while the analyses included students' scores in three diagnostic tools (Perceived Stress Scale (PSS), Patient Health Questionnaire for depression (PHQ 9), and Alcohol Use Disorders Identification Test (AUDIT)), as well as gender and income characteristics. The PSS identified an increased level of perceived stress in female students, while in contrast, the AUDIT showed an increased level of alcohol use disorders in male students. Differences in mental and behavioural disorders between the gender and income categories were significant in most of the analysed cases. In terms of gender-income characteristics, it was possible to confirm a significant positive effect of the PSS score on the PHQ 9 score, as well as a significant positive effect of the PHQ 9 score on the AUDIT score. As a result, efforts to reduce stress will be reflected in a reduction of depressive disorders as well as a reduction of excessive alcohol consumption among students.