Effect of Coronavirus Disease 2019 on the Psychology and Behavior of Patients on Methadone Maintenance Treatment in Wuhan, China: A Clinical Observational Study

Abstract

Methadone maintenance treatment (MMT) is a national strategy adopted for the treatment of heroin dependency in China. The sudden outbreak of coronavirus disease 2019 (COVID-19) and the resultant social isolation in Wuhan have also had a significant negative impact on local patients undertaking MMT. In this study, 76 patients on MMT from the Wuhan First Health Clinic were selected as the research objects to investigate the effect of COVID-19 on the levels of stress, anxiety, and depression, as well as the withdrawal symptoms and craving and substance use. Our results revealed that, during the outbreak, the Perceived Stress Scale (PSS) score, HAMA score, HAMD score, and craving in the included patients was significantly higher than that at the baseline and post-epidemic (p < 0.01, p < 0.01, p < 0.01, p < 0.01, respectively); the positive rate of morphine and methamphetamine urine test was significantly lower than that the post-epidemic (p = 0.01, p < 0.01, respectively); the amount of tobacco used during the outbreak and the post-epidemic period was significantly higher than that at the baseline (p < 0.01, p < 0.01, respectively), while the amount of alcohol consumed at the outbreak was significantly higher than at the baseline and the post-epidemic (p < 0.01, p < 0.01, respectively). The negative emotions aroused by the COVID-19 outbreak and the accompanying social isolation to patients on MMT are an important factor of negative reinforcement that adversely affected the patients' craving for drugs and the consumption of legal substances. This finding suggests the need to strengthen the psychological counseling for patients on MMT during severe epidemic, actively alleviating the negative emotions, reducing the risk of substance abuse, and strengthening drug management after the epidemic to prevent the rise of substance (legal or illegal) abuse.

Exploration of the Potential Link, Hub Genes, and Potential Drugs for Coronavirus Disease 2019 and Lung Cancer Based on Bioinformatics Analysis

“…Another drug identified was sertraline, which is used to treat depression [ 60 ]. Anxiety and depressive symptoms increase during the COVID-19 outbreak [ 61 ]. Studies have shown that in vitro stimulation with 8-bromo-cAMP activates the cAMP/PKA pathway [ 62 ].…”

Factors of Negative Affect in Elderly Patients With Substance Use Disorders During COVID-19 Pandemic

“…COVID-19 and the subsequent social isolation have triggered NA such as stress, depression, and anxiety, which increased the cravings and consumption of addictive drugs. Therefore, during the severe period of the pandemic, it is necessary to provide psychological counseling for elderly patients with SUDs, proactively treat their NA, and improve drug management after the pandemic to prevent drug (legal or illegal) abuse ( 22 ). In addition, taking a break from the news and social media can indirectly help treatment and prevent relapse ( 13 ).…”

“…However, for the elderlies with substance use disorders (SUDs), it is obvious that their mental and psychological problems are rarely considered by clinicians and researchers before their physical symptoms are addressed. However, studies have shown that the mental and psychological problems of patients with SUDs might relapse or be exacerbated by social isolation and lockdown during a pandemic (20)(21)(22). Patients with previous SUDs are at greater risk of adverse consequences after contracting COVID-19 (23).…”

A narrative systematic review of changes in mental health symptoms from before to during the COVID-19 pandemic

“…Another study found an increase in 147 healthy adult controls, but not 345 adults with bipolar disorder (Yocum et al, 2021). Two smaller studies also found an increase in anxiety; the first in 76 Chinese participants receiving methadone maintenance treatment for substance use disorder (Liu et al, 2021); and the next in 46 American older adults with PTSD, but not 30 traumaexposed older adults without PTSD (Rutherford et al, 2021). A third study found no change in a sample of 35 adults with autism spectrum disorder in Spain (Lugo-Marín et al, 2021).…”