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[...]of the significant cost of development, companies seek to recoup finances through data exclusivity and patent protection of intellectual property, such as the drug product's formulation. Bio/pharma companies reformulate existing therapies for a whole host of reasons, such as treating underserved or neglected disease areas, improving patient adherence (particularly for target patient groups, such as paediatrics), reducing the potential of drug abuse, and providing alternative options in crisis situations-as has been apparent during the COVID-19 pandemic. Pentamidine is an anti-infective agent that can be used to treat an earlier stage of the disease;however, it is unable to penetrate the blood-brain barrier sufficiently to treat the secondary stage of HAT. [...]it was hypothesized that a combined pentamidine-Pluronic formulation may be a suitable approach to provide patients with a single therapeutic option for treatment of all stages of HAT. [...]it was concluded that the pharmacokinetic data attained supports the use of safety and tolerability data from the conventional risperidone formulation for further testing of VAL401 (4).
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Sharp rises in overdose deaths nationally coincided with the arrival of the COVID-19 pandemic. Rural Appalachia, known for high rates of substance use and barriers to health care in general, was suspected to be disproportionately impacted in terms of recovery supports such as 12-step recovery meetings. This study investigated the availability of recovery meetings in South Central Appalachia before and after COVID-19 lockdowns. The number of confirmed recovery meetings was compared before and after COVID-19 lockdowns by geographic location (i.e., rural/nonrural and medium metro/small metro/micropolitan/noncore). Recovery meeting data were systematically collected through interviews with community contacts, reviewing social media and websites, making phone calls, and sending emails and surveys and updated longitudinally. There was no significant change in the number of meetings from pre- (n = 189) to post-COVID-19 (n = 178). There was no significant shift in meeting location when dichotomizing by rural/nonrural classification, chi2(1) = 2.76, p = .097, pi = -0.087. Chi-square test of independence did reveal a significant change in number of recovery meetings by location when using four location classifications, chi2(3) = 7.97, p = .047, Cramer's V = 0.147. There was a noteworthy rise in the meetings in small metro (36.5%-51.1%), with all other locations declining. The establishment and reestablishment of recovery meetings in rural communities should be prioritized to address the longstanding scarcity of recovery resources in rural locations, recent decline in such support, and the rise in overdose deaths. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement This study highlights a significant barrier to recovery from problematic substance use in rural areas. Strategically establishing recovery meetings in areas with few or no meetings and facilitating access through addressing transportation is critical. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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The onset of COVID-19 introduced unprecedented changes to how U.S. public health services were delivered. Many public and private agencies faced mandatory closures, social distancing mandates, and rapid transitions to telehealth interventions and treatment. Mental health clinicians witnessed disruptions in continuity of care and an increase in mental health risks overall. Although some studies have been conducted to survey clinicians' perceptions of the usefulness and ease of use of technology-based interventions, knowledge about mental health clinicians' experiences and perceptions in Virginia was sparse. The purpose of this generic qualitative study was to explore how mental health clinicians in Virginia described their experiences and perceptions of using telehealth in providing services to clients during the COVID-19 pandemic. The social-ecological systems and technology acceptance models were used to explore the experiences and perceptions of clinicians. Data analysis led to the identification of themes: (a) pre-COVID-19 treatment and services (b) adjustments to rapid implementation of telehealth, (c) convenience and flexibility to providing services following acclimation, (d) technological barriers to providing telehealth services, (e) challenges with limited understanding and exposure to technology, (f) protocols and managing expectations, (g) acceptance and aversion to telehealth service, and (h) lessons learned for future practice. The findings of this study have potential implications for positive social change by providing insight into the ease of use of telehealth models, encouraging ongoing training for clinical professionals, and informing future research and practice in the mental health field. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Background: Despite concerns on mental health problems related to lockdowns, recent reports revealed a reduction in psychiatric admissions in Emergency Departments (ED) during the lockdown period compared with the previous year in several countries. Most of the existing studies focused on the first lockdown not considering the different phases of the COVID-19 crisis. The present study aimed to analyse differences in ED admissions for psychiatric consultation during three different phases of the COVID-19 in Italy. Method(s): Information on ED admission the Santo Spirito Hospital in Rome for psychiatric consultations were retrospectively collected. The lockdown(March-June 2020) and the post-lockdown period (June 2020-June 2021) were compared to the pre-lockdown period(January 2019-March 2020). Multinomial logistic regression(MLR) was used to assess the risk of accessing ED for psychiatric consultation during the three periods. Result(s): 3871 ED psychiatric consultations were collected. A significant reduction of psychiatric consultations in ED during the lockdown period and the post-lockdown (H 762.45;p < .001) was documented. MLR showed that compared to pre-lockdown during the lockdown and post-lockdown patients were more likely to be men (RRR 1.52;95% CI 1.10-2.12) and more often diagnosed with non-severe mental illnesses (nSMI) (relative risk ratio [RRR] 1.53, 95% CI 1.10-2.15;and 1.72, 95% CI 1.42-2.08);during the lockdown, patients were also more often diagnosed with alcohol/substance abuse(RRR 1.70;95% CI 1.10-2.65). Conclusion(s): Several changes in the clinical characteristics of psychiatric consultations during and after the lockdown emerged;these may inform clinicians and future preventive strategies among community mental health services.
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BACKGROUND: Changes in injury patterns during the COVID pandemic have been reported in other states. The objective was to explore changes to trauma service volume and admission characteristics at a trauma center in northeast Ohio during a stay-at-home order (SAHO) and compare the 2020 data to historic trauma census data. METHODS: Retrospective chart review of adult trauma patients admitted to a level I trauma center in northeast Ohio. Trauma admissions from January 21 to July 21, 2020 (COVID period) were compared to date-matched cohorts of trauma admissions from 2018 to 2019 (historic period). The COVID period was further categorized as pre-SAHO, active-SAHO, and post-SAHO. RESULTS: The SAHO was associated with a reduction in trauma center admissions that increased after the SAHO (P = .0033). Only outdoor recreational vehicle (ORV) injuries (P = .0221) and self-inflicted hanging (P = .0028) mechanisms were increased during the COVID period and had substantial effect sizes. Glasgow Coma Scores were lower during the COVID period (P = .0286) with a negligible effect size. Violence-related injuries, injury severity, mortality, and admission characteristics including alcohol and drug testing and positivity were similar in the COVID and historic periods. DISCUSSION: The SAHO resulted in a temporary decrease in trauma center admissions. Although ORV and hanging mechanisms were increased, other mechanisms such as alcohol and toxicology proportions, injury severity, length of stay, and mortality were unchanged.
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This is a title only record which contains no .
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Background. The hepatitis C virus (HCV) is often associated with people who inject drugs, and with a reduction in quality of life. While earlier forms of HCV treatment had low treatment uptake, newer HCV treatment integrated with opioid maintenance treatment appears to increase treatment uptake among those who inject drugs. The aim was to explore how people who inject drugs perceive changes in quality of life after treatment of HCV infection. Methods. Four focus group discussions, and 19 individual interviews were conducted with people who inject drugs or who had previously injected drugs and received opioid agonist therapy. All participants were successfully treated for and "cured” for HCV. Data were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Results. The HCV treatment helped participants to let go of negative thoughts and break destructive patterns of interaction. This facilitated the restoration of social relationships with family and others. Furthermore, some participants reported a general improvement in their health. Feeling healthy meant fewer worries such as infecting others. Also, interactions with health professionals were experienced as less stigmatizing. These physical, social, and psychological improvements led to a form of "awakening” and being treated for HCV gave participants hope for the future. Conclusion. HCV treatment improves the mental and physical health in addition to play an important social function. Successful HCV treatment was associated with a greater sense of hope for the future, reconnection with significant others, and reduced feeling of stigma. Overall, improved health and social relationships contributed to improved quality of life.
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INTRODUCTION: The COVID-19 pandemic has had a significant impact on substance abuse patterns in recent times. Many people have experienced increased stress, anxiety, and social isolation, which has led to higher rates of substance abuse and addiction. It impacts on the orofacial region, particularly temporomandibular joint (TMJ). This review was undertaken to assess the association between substance abuse and temporomandibular disorders. (TMDs). MATERIALS AND METHODS: The databases of PubMed, Google Scholar, Web of Science and Cochrane were searched for articles based of set PECO criteria. A comprehensive search using keywords of "Psychoactive substances", "Illegal substances", "substance abuse", "narcotics", "temporomandibular joint" and "temporomandibular joint disorders" yielded a total of 1405 articles. Modified Newcastle-Ottawa Scale for observational studies assessed the risk of bias of included studies. RESULTS: Two studies were reviewed. Samples recruited were either from rehabilitation centres or prisoners and fell in the second to fourth decade. A definite association was noted between psychoactive substance and TMDs. Moderate to low risk of bias was noted in all the studies evaluated. CONCLUSION: Further research is needed to better understand the nature of this relationship and the underlying mechanisms involved. It is important for healthcare providers to be aware of this potential association and to screen for substance abuse in patients with TMD symptoms.
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Background: The COVID-19 pandemic resulted in disruptions to health care services. Vulnerable populations, including people living with HIV (PLHIV), may have experienced unique challenges when accessing medical care. The objective of this study was to evaluate the impact of social disruptions on health care visits among Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study (MWCCS) participants. Method(s): A survey collecting data on missed health care visits and social disruptions (i.e., disruptions in employment, childcare, financial support, housing, and health insurance) during the pandemic was administered via telephone to MWCCS participants 1-3 times from March and September 2020. Logistic regression models adjusted for sociodemographics and HIV-status were used to test the association between social disruptions and three medical care interruption outcomes (i.e., missed healthcare appointment, interruption of mental health care, and interruption of substance use care). Result(s): Surveys (n=10,076) were conducted among 2238 PLHIV (61% women) and 1427 people living without HIV (PLWoH) (41% women). Overall, 42% of participants reported disruptions in health care with no significant difference by HIV status. Among participants receiving mental health care services and substance use treatment, 52% and 36% reported interruptions of care, respectively. Participants reporting >= 2 social disruptions were more likely to report missed health care appointments (adjusted odds ratio [aOR]: 1.81, 95% confidence interval [CI]: 1.54-2.13), and interruptions in mental health care [aOR: 2.42, 95%CI: 1.85-3.17) or substance use treatment (aOR: 1.97, 95%CI: 1.26-3.09), compared to those reporting no disruptions. Participants who were unemployed were more likely to miss health care appointments (aOR:1.46, 95% CI: 1.25-1.71) and report disruptions in mental health care (aOR: 2.02, 95% CI: 1.54-2.66) compared to those who were employed. PLHIV reporting >= 2 social disruptions were at increased risk for missed health care appointments (aOR 1.92, 95%CI: 1.56-2.36) and disruptions in mental health care (aOR: 2.54, 95%CI: 1.83-3.53 (Table 1). Conclusion(s): Social disruptions as a result of the COVID-19 pandemic have adversely impacted the receipt of health care among PLHIV and PLWoH, including the receipt of treatment for mental health and substance abuse. Providing childcare, financial support, housing, and health insurance may reduce disruptions in care and improve health outcomes.
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Data from a unique survey of court-involved New Yorkers collected during the COVID-19 pandemic in 2020 provides evidence for a cycle of disadvantage involving penal control, material hardship, and health risk. We find evidence of chaotic jail conditions from March to May 2020 in the early phase of the pandemic, and high levels of housing and food insecurity, and joblessness for those leaving jail or with current criminal cases. The highest levels of material hardship—measured by housing insecurity, unemployment, shelter stays, and poor self-reported health—were experienced by those with mental illness and substance use problems who had been incarcerated.
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According to this framework, the pandemic is a two-part problem: one part virus, one part social resistance to the cure for the disease. [...]we hear that medical scientists have developed "gold standard" treatments for addiction, but that for reasons of bureaucratic lethargy, public skepticism, or sheer hopelessness among those suffering from addiction, the treatments are not adequately made available and sought out. The stories in the book are drawn from oral-history interviews that the author conducted with family members of people with addictions, doctors, community organizers, and treatment-center directors over a period of four years. Chapter Two reconstructs the life of a single man from the memories of his surviving family members, from the moment of his first exposure to opioids through fourteen separate rounds of addiction treatment and up to the moment of his fatal fentanyl overdose.
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The COVID-19 pandemic of 2020 transformed daily life worldwide. To minimize the spread of the virus, many governments imposed a lockdown and physical distancing measures. Schools, universities, restaurants, shops, and businesses all closed. Research has shown that the mandatory stay-at-home orders associated with the COVID-19 pandemic adversely affected the mental health of parents, children, and youth. This chapter considers how the COVID-19 pandemic has affected the mental health of youth behind bars in the United States and in other countries. The longstanding impression of prisons is that the people in custody are violent, dangerous, and deserve to be incarcerated. Even incarcerated youth are viewed by many in society as super-predators. Most incarcerated youth have significant mental health needs. Incarcerated youth often suffer from a variety of mental health conditions including anxiety, depression, Post Traumatic Stress Disorder, substance abuse, and suicidal ideation. When incarcerated youth show symptoms of COVID-19 or are diagnosed with it, juvenile correctional facilities are faced with few options for quarantine that do not resemble solitary confinement. Because of concern regarding the high transmissibility of COVID-19 in juvenile prisons, most prison administrators suspend visitors or greatly restrict the number of people entering the facilities. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Background: Nearly 26% of adults in the U.S. live with disability and are more likely to experience chronic health conditions, barriers to healthcare, and severe COVID-19 illness. Therefore, COVID-19 testing of adults living with disability is important to consider. The purpose of this study was to explore relationships between disability and COVID-19 testing, infection, and related challenges. Method(s): A Rapid Acceleration of Diagnostics-Underserved Population (RADx-UP) project in Miami, FL determined disability with a modified version of the Washington Group General Disability Measure. HIV serostatus and COVID-19 vaccination were confirmed with medical records. COVID-19 testing and infection history were self-reported. Statistical analyses included chi-squared tests and multiple binary logistic regression;variance inflation factors were calculated to ensure absence of collinearity. Result(s): A total of 1,689 RADx-UP participants with an average age of 55+/-12.3, 51% male, 49% Black non-Hispanic, 23% living with HIV (86% virally suppressed), and 76% received at least one dose of a COVID-19 vaccine. Nearly 40% were disabled, 37% reported employment disability, and 21% were functionally disabled (disability that interferes with performance of daily activities). Despite recruitment from the same sources, PLWH, compared to those without HIV, were more likely to be disabled (52% vs 36%;p< 0.0001), report employment disability (63% vs 30%;p< 0.0001), and report functional disability (29% vs 18%;p< 0.0001). Those with employment disability were less likely to have ever been tested for COVID-19 compared to those without (81% vs 85%;p=0.026). Employment disability was also associated with lower odds of having ever tested positive for COVID-19 after adjustment for demographics, health insurance, HIV, COVID-19 vaccination, smoking, and lung disease (aOR, 0.62;95% CI, 0.43-0.90;p=0.013). Disability was associated with greater odds of transportation challenges (aOR, 2.33;95% CI, 1.76-3.08;p< 0.0001), illicit drug use (aOR, 1.92;95% CI, 1.49-2.47;p< 0.0001), and smoking (aOR, 1.74;95% CI, 1.39-2.17;p< 0.0001). Compared to those without, those with transportation challenges (14% vs 40%;p< 0.0001) and illicit drug use (18% vs 30%;p=0.001) were more likely to postpone medical care. Conclusion(s): Lower COVID-19 testing rates may contribute to underestimated COVID-19 positivity rates in adults living with disability. Challenges with transportation and substance abuse contribute to less engagement in care.
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BACKGROUND: Telehealth has the potential to improve health care access for patients but it has been underused and understudied for examining patients with substance use disorders (SUD). VA began distributing video-enabled tablets to veterans with access barriers in 2016 to facilitate participation in home-based telehealth and expanded this program in 2020 due to the coronavirus COVID-19 pandemic. OBJECTIVE: Examine the impact of VA's video-enabled telehealth tablets on mental health services for patients diagnosed with SUD. METHODS: This study included VA patients who had ≥1 mental health visit in the calendar year 2019 and a documented diagnosis of SUD. Using difference-in-differences and event study designs, we compared outcomes for SUD-diagnosed patients who received a video-enabled tablet from VA between March 15th, 2020 and December 31st, 2021 and SUD-diagnosed patients who never received VA tablets, 10 months before and after tablet-issuance. Outcomes included monthly frequency of SUD psychotherapy visits, SUD specialty group therapy visits and SUD specialty individual outpatient visits. We examined changes in video visits and changes in visits across all modalities of care (video, phone, and in-person). Regression models adjusted for several covariates such as age, sex, rurality, race, ethnicity, physical and mental health chronic conditions, and broadband coverage in patients' residential zip-code. RESULTS: The cohort included 21,684 SUD-diagnosed tablet-recipients and 267,873 SUD-diagnosed non-recipients. VA's video-enabled tablets were associated with increases in video visits for SUD psychotherapy (+3.5 visits/year), SUD group therapy (+2.1 visits/year) and SUD individual outpatient visits (+1 visit/year), translating to increases in visits across all modalities (in-person, phone and video): increase of 18 % for SUD psychotherapy (+1.9 visits/year), 10 % for SUD specialty group therapy (+0.5 visit/year), and 4 % for SUD specialty individual outpatient treatment (+0.5 visit/year). CONCLUSIONS: VA's distribution of video-enabled tablets during the COVID-19 pandemic were associated with higher engagement with video-based services for SUD care among patients diagnosed with SUD, translating to modest increases in total visits across in-person, phone and video modalities. Distribution of video-enabled devices can offer patients critical continuity of SUD therapy, particularly in scenarios where they have heightened barriers to in-person care.
Subject(s)
COVID-19 , Substance-Related Disorders , Telemedicine , Humans , COVID-19/epidemiology , Pandemics , Substance-Related Disorders/epidemiology , TabletsABSTRACT
In a recent editorial, the Lancet reported that one of the consequences of pandemics is the detrimental impact "on the mental health of affected populations," and the current COVID-19 one is no different. Since its out-break at the end of 2019, "depressed mood, anxiety, impaired memory, and insomnia" are constant companions of people around the world. Many even experience "stress, burnout, depression, and post-traumatic stress disorder." Amongst its concerns, the Lancet notes the rising "misuse of substances" as a consequence of these mental health problems.1 One of the reasons for this global mental health crisis is the way the pandemic affects peoples' practices of community building and rituals of belonging. Having to wear masks, being required to keep at least 1.5 meters apart, not being able to meet (vulnerable) friends and family members, and even more drastic measures like weeklong lockdowns fundamentally disrupted everyday lives and reduced opportunities to socialize. What is normally taken for granted is being challenged. Around the world, these measures have been met by increasing demonstrations, often based on conspiracy theories and against commonsense precautions for preventing a potentially lethal disease. This conflict between reasonable precaution and emotional stress and pressure suggests disruptions of common narratives of belonging.
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The first HAH programs in the United States were developed at Johns Hopkins Hospital in the late 1990s and were initially targeted toward geriatric patients with chronic medical problems.2 Follow-up studies focused on medical patients have been performed in multiple patient populations and health systems.3-9 These studies have demonstrated that for medically ill patients, admission to HAH offers significant benefits compared with inpatient admission, including fewer iatrogenic complications such as delirium, improved patient and caregiver satisfaction, decreased readmission rates, and, in some studies, decreased mortality. [...]diverting postoperative readmissions to at-home care has the unique benefit of freeing surgical beds, which can increase procedural capacity and therefore surgical access and hospital revenue. [...]we estimated the margin from new inpatient capacity that could be generated if the hospital avoided HAH-eligible readmissions and backfilled these beds with new medical-surgical admissions. [...]we estimated the potential financial impact on hospital margin of diverting surgical readmissions to an HAH program.
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Am J Manag Care. 2021;27(3):123-128. https://doi.org/10.37765/ajmc.2021.88511 _____ Takeaway Points Robust population health management integrates analytics and agile clinical programs and is adaptable to optimize outcomes and reduce risk during population-level crises. * The coronavirus disease 2019 pandemic revealed the tenuousness of care delivery based on fee-for-service reimbursement models. * Population-level data and care management facilitate identification of demographic-based disparities and community outreach. * Telemedicine and integrated behavioral health have ensured primary care and specialty access, and mobile health and postacute interventions shifted site of care and optimized hospital utilization. * Beyond the pandemic, population health is a cornerstone of a resilient health system and can improve public health while mitigating risk in a value-based paradigm. _____ Prior to the coronavirus disease 2019 (COVID-19) pandemic, the US health care system was in the midst of major transformation—shifting away from the inefficiencies of fee-for-service toward value and patient-centeredness. [...]registries for hypertension, diabetes, and chronic kidney disease identified the highest-risk patients to receive laboratory monitoring or medical procedures, prioritizing those who were likely to need dialysis in the near future.5,6 Similarly, a registry of patients with frailty, defined by the Johns Hopkins ACG System, was used to identify patients for augmented home-based care and goals of care outreach.7,8 Care Management: Delivering Public Health to High-risk Patients and Addressing Disparities For the last decade, the integrated care management program (iCMP) has been an essential component of PHS population health to coordinate care, improve outcomes, and reduce cost for high-risk patients by leveraging a dedicated nurse, social worker, or community health worker.9,10 This team was utilized as a public health workforce to provide outreach to patients at increased risk for adverse outcomes, including elderly patients, frail patients, and those with complex health conditions. The Home Hospital program provides inpatient level of care to low-acuity patients in their homes, and the Mobile Integrated Health (MIH) program uses paramedics to further support home-based care delivery.12 During the pandemic, these programs expanded capacity to prevent potential COVID-19 exposure in patients requiring hospital care and to monitor patients with COVID-19 who were recovering at home, reducing inpatient utilization and preserving higher-acuity resources.13 Within the first 46 days of MIH expansion, teams evaluated 102 patients with confirmed or suspected COVID-19, with 92.2% of patients able to continue care at home. Postacute care is critical to identify safe locations for patients with and without COVID-19 to recover and to maintain inpatient hospital capacity.14 PHS mobilized an existing collaborative of long-term acute care hospitals and skilled nursing facilities (SNFs) to address the surge in postacute capacity by creating unified admission plans, creating COVID-19–specific SNFs, and supporting personal protective equipment (PPE) provision to facilities.15 This team's expertise was extended to support the creation of a 1000-bed field facility called Boston Hope Medical Center, with a dual focus on respite care for homeless populations and postacute care for those recovering from COVID-19.16 The University of Washington also collaborated with postacute partners to develop a comprehensive strategy for COVID-19, which included establishing clear criteria for facility admission, providing PPE training, equipping testing supplies, and developing isolation plans.17 Population-based postacute strategies during the pandemic helped prevent delays in discharge, spread of infection, and overwhelmed facilities to mitigate the effects of the public health crisis.14,18 Behavioral Health: Providing Psychological Support at a Time of Great Need COVID-19 has brought numerous mental health challenges due to elevated stress, financial insecurity, and exposure to traumatic events.19 To address these needs, we adapted existing programs in behavioral health management, substance use disorders, and digital health.
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[...]increase access to care by reimbursing virtual visits. [...]leverage data to identify and intervene when patients are at risk for recurrence or overdose. In practice, expanded access to buprenorphine reduces diversion and misuse because they occur commonly among individuals seeking relief from withdrawal.2 Compared with buprenorphine monotherapy, buprenorphine-naloxone is associated with lower rates of misuse.2 Mark et al demonstrate that among Medicare beneficiaries, removal of prior authorization for buprenorphine-naloxone doubled treatment rates and significantly reduced emergency department (ED) visits and hospitalizations.4 Ultimately, the lifesaving benefits of expanded access to buprenorphine far outweigh the associated risks. In a time of social distancing, limited personal protective equipment, and transportation barriers, payment and delivery of telehealth is imperative to ensuring access to care. Because many patients do not have reliable access to broadband connection or smartphones, audio-only visits must be reimbursed as well.
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The Americans with Disabilities Act (ADA) is sweeping civil rights legislation that affords people with disabilities equality of opportunity, economic self-sufficiency, independent living, and full participation in daily life. The protections of the ADA extend to individuals with alcohol and substance abuse disorders who are in recovery.The objective of this article is to understand the ADA's definition of disability and how it applies to addiction and recovery. The reader will recognize how the ADA applies to people with addiction to alcohol and those in recovery from substance abuse. The article will describe the rights and responsibilities employers and employees have in the three stages of employment.The material in this presentation was developed based on the authors' research, training, education, knowledge, and skill of the ADA.Individuals in recovery are often unaware of their civil rights under the ADA. The ADA ensures that people with disabilities, including those with alcohol use disorder and substance use disorders, have the same rights and opportunities in the workplace.The COVID-19 pandemic has resulted in an increase in increased rates of alcoholism and substance abuse. Individuals living with addiction are unaware of the employment protections they may have under the ADA. Title I of the ADA guarantees employment protections to ensure equality in the workplace for people with disabilities. A clearer understanding of the law will ensure that job seekers and employees are treated in an ethical, valued, and courteous way when disclosing disability and the need for accommodation. [ FROM AUTHOR] Copyright of Journal of Vocational Rehabilitation is the property of IOS Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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One of the biggest global public health crisis began in Wuhan, China at the end of 2019. That emergency was the emergence of SARS-CoV-2 and the disease COVID-19, a highly transmissible acute respiratory syndrome. The pandemic declaration by the WHO in March 2020 caused the world to take on several measures to combat and contain the virus. Initially, social isolation and lockdown were the main initiatives, as there were no forms of treatment or prevention of the disease. These restrictive measures generate a change in the habit of the population that triggered serious physical and psychological impairments. One of the consequences was the increase in the use of substances of abuse and, consequently, substance use disorder, including tobacco. During the pandemic, cigarette consumption increased from 10 to 30% worldwide, whereas smoking is the main cause of preventable death and a risk factor for several diseases. Along with alcohol, nicotine has a greater addictive power than illicit drugs. Substance use disorders and COVID-19 have a synergistic effect, in this way, we seek to integrate neurochemical, cognitive and behavioral aspects that led to increased consumption and/or relapse in nicotine consumption and the used therapy.