Changes in substance supply and use characteristics among people who use drugs (PWUD) during the COVID-19 global pandemic: A national qualitative assessment in Canada

Ali, Farihah; Russell, Cayley; Nafeh, Frishta; Rehm, Jürgen; LeBlanc, Sean; Elton‐Marshall, Tara

doi:10.1016/j.drugpo.2021.103237

Cited by 102 publications

(104 citation statements)

References 23 publications

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“…17 These changes may impact PWUD in several ways including reduced tolerance due to an inability to access opioids or using unregulated fentanyl that also contains nonprescription benzodiazepines. 29,37 A strong evidence base for injectable OAT exists and programs are currently available in three provinces. 32,38 High dose injectable hydromorphone is currently not covered by the Ontario Drug Benefit, and adding it to the formulary would increase available treatment options.…”

Section: Facilitate Adaptive Harm Reduction Strategiesmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Opioid-Related Harm in Ontario

Friesen¹,

Kurdyak²,

Gomes³

et al. 2021

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The Ontario COVID-19 Science Advisory Table is a group of scientific experts and health system leaders who evaluate and report on emerging evidence relevant to the COVID-19 pandemic, to inform Ontario's response. Our mandate is to provide weekly summaries of relevant scientific evidence for the COVID-19 Health Coordination Table of the Province of Ontario, integrating information from existing scientific tables, Ontario's universities and agencies, and the best global evidence. The Science Table summarizes its findings for the Health Coordination Table and the public in Science Briefs.The Mental Health Working Group comprises scientific experts and public health leaders with specific expertise in mental health. Their expertise spans mental health of children and youth, adults and geriatric populations, mental health of health care providers, women's health, mental health among LGBTQ persons, mental health among Black, Indigenous, and other racialized populations, and COVID-19. The Working Group evaluates emerging scientific evidence related to maintaining mental health during COVID-19, the mental health burden of disease and public health interventions on individuals across the lifespan, including children and adolescents, and the older adult population, as well as the need for assessment and recommendations

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Section: Facilitate Adaptive Harm Reduction Strategiesmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Opioid-Related Harm in Ontario

Friesen¹,

Kurdyak²,

Gomes³

et al. 2021

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“…According to a recent study, among 196 participants, 47% reported an increase in substance use since COVID-19 related to loss of employment, fear of catching the virus, social distancing and isolation. Some people reported substance use as a coping mechanism to deal with the negative physical, mental and social impacts of COVID-19 [46].…”

Section: Discussionmentioning

confidence: 99%

Benzodiazepine Misuse: An Epidemic Within a Pandemic

Sarangi¹,

McMahon²,

Gude³

2021

Cureus

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Coronavirus disease 2019 (COVID-19) had deleterious effects on patients with mental health problems and several studies have shown a spike in the rates of depression, insomnia, and post-traumatic stress disorder. Anxiety and insomnia rates have also increased among both the general public and health care professionals. Benzodiazepines are some of the most commonly used drugs in the treatment of anxiety and insomnia. However, benzodiazepines are also misused, abused alone, or abused in combination with other drugs. Lockdowns and social distancing have also had negative consequences on patients with mental health problems. We assessed the extent of benzodiazepine use during the pandemic and interpreted its effects in the future. We conducted a literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol and eight articles reviewed specifically reported worrying fluctuations in benzodiazepine use during the pandemic. We observed varied trends in the usage of benzodiazepines in various parts of the world. Some studies showed an increase in the consumption of benzodiazepine while others demonstrated a decrease in the prescription refills of benzodiazepine, which may be a result of gaps in mental health care. At this time, we can conclude that the current trend with benzodiazepine use is fluctuating and mental health professionals must continue to exercise caution before prescribing benzodiazepines. Future research is also warranted to be aware of the changing patterns and to avoid misuse and/or abuse at an epidemic level.

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“…These studies raise concerning issues that also require further research but if either of these key findings are replicated elsewhere then the consequences for PWUD and the ongoing public health emergency of drug-related deaths will continue to escalate. One large scale qualitative study of the experiences of PWUD in Canada suggests that the risk of fatal and non-fatal overdose may have been elevated in part because of PWUD being compelled to use drugs other than their usual drug(s) of choice because of the disruptions to routes of drug supply in the pandemic [81]. In essence, switching to different types of drug use can lead to a reduction in drug tolerance and put people at greater risk of overdose [81].…”

Section: Drug Related Deathsmentioning

confidence: 99%

“…One large scale qualitative study of the experiences of PWUD in Canada suggests that the risk of fatal and non-fatal overdose may have been elevated in part because of PWUD being compelled to use drugs other than their usual drug(s) of choice because of the disruptions to routes of drug supply in the pandemic [81]. In essence, switching to different types of drug use can lead to a reduction in drug tolerance and put people at greater risk of overdose [81]. Further investigation of what might explain the causes of increases in drug overdoses, and how best to mitigate them, during the pandemic is also required as a matter of urgency.…”

Section: Drug Related Deathsmentioning

confidence: 99%

Understanding the Impacts of Novel Coronavirus Outbreaks on People Who Use Drugs: A Systematic Review to Inform Practice and Drug Policy Responses to COVID-19

Munro

Booth

Gray

et al. 2021

IJERPH

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People who use drugs (PWUD) experience many social and health harms and are considered at greater risk of acquiring COVID-19. Little research has examined the impact of coronaviruses either on PWUD, or on services targeted to PWUD. We report the findings of a systematic review of empirical evidence from studies which have examined the impact of coronaviruses (Severe Acute Respiratory Syndrome (SARS-CoV-1) and Middle Eastern Respiratory Syndrome (MERS-CoV) and COVID-19) on PWUD or on service responses to them. Five databases were searched (MEDLINE, PsycINFO, CINAHL, ASSIA and EMBASE) as well as COVID-19 specific databases. Inclusion criteria were studies reporting any impact of SARS, MERS or COVID-19 or any service responses to those, published between January 2000 and October 2020. Weight of Evidence judgements and quality assessment were undertaken. In total, 27 primary studies were included and grouped by seven main themes: treatment/recovery services; emergency medical settings; low-threshold services; prison setting, PWUD/substance use disorder (SUD) diagnosis; people with SUD and HIV; ‘Sexual minority’ men. Overall, research in the area was scant, and of average/poor quality. More robust research is required to inform on-going and future responses to coronavirus epidemics for PWUD.

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Changes in substance supply and use characteristics among people who use drugs (PWUD) during the COVID-19 global pandemic: A national qualitative assessment in Canada

Cited by 102 publications

References 23 publications

The Impact of the COVID-19 Pandemic on Opioid-Related Harm in Ontario

The Impact of the COVID-19 Pandemic on Opioid-Related Harm in Ontario

Benzodiazepine Misuse: An Epidemic Within a Pandemic

Understanding the Impacts of Novel Coronavirus Outbreaks on People Who Use Drugs: A Systematic Review to Inform Practice and Drug Policy Responses to COVID-19

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