Research on substance use disorders during the COVID-19 pandemic

Abstract

The COVID-19 pandemic has triggered changes in the substance use disorder (SUD) treatment delivery system, in the availability of legal and illicit drugs, and in other social and economic factors. As such, these changes necessitate that the field re-evaluate research approaches to SUDs, including in epidemiology, clinical trials, health services, implementation and policy research, as well as basic and translational neuroscience. COVID-19 has reduced researchers' access to target populations and made it difficult for them to obtain timely data to monitor changes in patterns of drug use and overdoses. These changes have increased researchers' interest in virtual technologies to expand and accelerate access to populations; increased modifications in the design, conduct, and analysis of clinical trials; and increased emphasis on implementation. Similarly, as researchers better understand the biology of COVID-19, they will better understand potential effects of COVID-19 on neurotransmitter receptors and signaling pathways, mechanisms underlying COVID-19 associated neurological and psychiatric sequelae, and interactions between COVID-19 treatments and psychoactive substances. The pandemic has also revealed the need for research that addresses health disparities. Overall, the COVID-19 pandemic has challenged several aspects of current research on SUD. Responding to these challenges provides opportunities to develop robust research approaches that align with the goals of improving patient outcomes and public health and are resilient to the challenges of future crises.

Substance, use in relation to COVID-19: A scoping review

“…For people who consumed alcohol or recreational drugs prior to the COVID-19 pandemic, consumption has increased substantially in the U.S. and Canada during the pandemic. More- over, COVID-19 has further reduced access to target populations and increased difficulty in obtaining timely data to monitor changes in patterns of drug use and overdoses [108] . Pa- tients who engaged in substance use were also at increased risk for COVID-19, an effect that was strongest for individuals who used opioids, followed by individuals using tobacco [108] .…”

“…More- over, COVID-19 has further reduced access to target populations and increased difficulty in obtaining timely data to monitor changes in patterns of drug use and overdoses [108] . Pa- tients who engaged in substance use were also at increased risk for COVID-19, an effect that was strongest for individuals who used opioids, followed by individuals using tobacco [108] . While the scope of substance use and COVID-19 research was broad, we noted lim- ited work on substances other than tobacco and alcohol.…”

The Impact of COVID-19 on Self-Reported Substance Use, Well-Being, and Functioning Among United States Veterans: A Cross-Sectional Study

“…There is also a continued and growing need to understand more precisely COVID-19 health, stressors, and infection-control behaviors, which have occurred in very particular contexts for individuals as they balance maintaining their quality of life and staying safe. For example, social distancing can increase safety from COVID-19 infection; however, loneliness is a risk factor for relapse ( Volkow, 2020 ) because it triggers irritability, anxiety, fear, sadness, anger, or boredom ( Ornell et al, 2020 ). These specific COVID-19 experiences for veterans are essential to consider when investigating the impact of COVID-19, substance use concerns, and health outcomes.…”

Heroin Self-Administration Induces Altered Dopamine Terminal Dynamics in the Nucleus Accumbens

“…This overdose epidemic has been exacerbated by the social isolation and instability experienced during the COVID-19 pandemic, with preliminary reports from the CDC suggesting a 30% increase in opioid-related deaths in 2020 [2]. Furthermore, disruptions in access to clinical providers and treatment as a result of COVID-19 restrictions have led to significant complications in opioid agonist treatment availability and distribution [3][4][5], highlighting the need for re-evaluation of current treatment options and expansion of preclinical research into the neurobiology of OUD to identify new treatment targets [4,[6][7][8][9].…”