Impact of the COVID-19 Pandemic on Patients With Alcohol Use Disorder and Associated Risk Factors for Relapse

Abstract

Background: The impact of the ongoing COVID-19 pandemic on vulnerable groups like patients suffering from substance use disorders is expected to be tremendous, and corresponding concerns were raised early on by many experts around the world. Psychosocial distress, financial insecurities and physiological problems associated with the COVID-19 crisis could be especially challenging for this group of patients.Methods: In the current study data was collected from a clinical sample of patients with alcohol use disorder (AUD; N = 127) during the initial stage of the pandemic. The impact of various COVID-19 related factors (physiological, psychosocial, economic and others) on patients' personal life was evaluated. Alcohol consumption, craving, and potential posttraumatic stress disorder (PTSD) symptoms were assessed using different scales and their associations were analyzed. Furthermore, differences regarding these variables between comparably sized groups of patients who remained abstinent (N = 37), relapsed (N = 41), or reported unaltered drinking behavior (consuming subgroup, N = 49) were investigated. The impact of sociodemographic and COVID-19 factors on relapse (in comparison to abstinence) was evaluated using binary logistic regression analysis.Results: Our results confirmed the expected positive associations between alcohol consumption, craving, and PTSD symptoms, respectively, among patients with AUD. Furthermore, group differences indicate significantly lower levels on all three scales for abstinent patients. Although generally low PTSD scores were observed, 8% of our participants were found to be at risk of PTSD. Results of a binary logistic regression analysis indicated the presence of psychosocial COVID-19 factors (e.g., isolation, anxiety, and depression) as well as living alone as two major risk factors for relapse.Discussion: Our findings based on actual patient data support the anticipated negative consequences of the pandemic on persons with AUD. Crucially, our results regarding relapse emphasized psychosocial COVID-19 factors and isolation as especially challenging circumstances for persons with AUD, whereas economic and physiological health aspects seemed of minor impact on relapse. Our results reflect the initial stage of the pandemic, whereas long-term developments should be closely monitored.

Factors Associated with COVID-19 Infection among a National Population of Individuals with Schizophrenia in the United States

“…In contrast, a diagnosis of either alcohol use disorder or post-traumatic stress disorder (PTSD) was associated with lower odds of COVID-19 infection. These results are consistent with those of Yazdi et al [22], who reported that 43% of alcohol use disorder patients lived alone during the pandemic, which likely reduced social interactions, leading to a decreased infection risk. Further, in a Veterans Health Administration study, Haderlein et al [23] reported that veterans with clinically diagnosed PTSD were more likely to receive a COVID-19 test than those without a PTSD diagnosis; these patients were also less likely to test positive for COVID-19.…”

Impact of COVID-19 lockdown on individuals under treatment for substance use disorders: Risk factors for adverse mental health outcomes

“…A binary logistic regression was subsequently carried out in order to assess the impact of the predictors on the likelihood of subjects experiencing adverse mental health outcomes due to lockdown. The model initially included variables that were previously identified in literature ( González-Sanguino et al, 2020 ; A. W. Kim et al, 2020 ; Yazdi et al, 2020 )as potential risk factors during the pandemic, as previously mentioned. Other variables that were identified as significant in prior comparisons between the two groups were also introduced to the model in a blockwise manner and only significant contributors were held in the final model.…”

“…However, these results were contradicted by another study, which found an increase in alcohol use, especially in women, during lockdown ( Boschuetz et al, 2020 ). Another study that investigated risk factors for relapse to alcohol use disorder, showed that patients with higher depression and anxiety levels as well as patients who felt isolated during lockdown had a higher chance to relapse ( Yazdi et al, 2020 ).…”

Socioeconomic and Environmental Factors Associated With Increased Alcohol Purchase and Consumption in 38 Countries During the Covid-19 Pandemic

“…It is also important that ongoing support is available for people with alcohol use disorder during the pandemic. Previous research has found that family or professional support helped prevent relapse (17,56). A previous study has suggested that people drinking more during lockdown are less likely to reduce their alcohol intake after lockdown (30).…”