A study of 160 people in the United States finds associations between worries around COVID-19 and substance use. The authors warn that the pandemic may increase the risk of substance abuse in some people and advocate for specific interventions to protect mental health.

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Beyond the physical effects of the novel coronavirus, the onset and continuation of the COVID-19 pandemic have dramatically affected people’s mental health in the United States and worldwide.

A recent study highlighted how levels of depression in the U.S. have tripled during the pandemic. Symptoms of anxiety may also be on the rise, according to recent trends in Google searches.

Understandably, the pandemic generates fear in many people, as the world finds itself in an unprecedented situation filled with uncertainty.

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People manage uncertainties in different ways, but there is a risk that the stress the pandemic causes may trigger an ongoing mental health problem in some people.

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A recent study led by the University of Houston, TX, finds that worry about COVID-19 may be a risk factor for substance use, which could, in turn, lead to misuse in some people.

The findings, which appear in Psychiatry Research, suggest the pandemic could adversely affect mental health for years to come.

This study explored worries and fears about COVID-19 among three groups of people: those who do not use substances, people who were substance users before the pandemic, and people who started to use substances during the pandemic.

The substances in question included alcohol, cigarettes, cannabis, e-cigarettes, stimulants, opioids, and other drugs. According to the National Institute of Drug Abuse, these are among the most commonly used substances in the U.S.

In total, 160 people took part in the online study between April and May 2020.

The survey took around 30 minutes to complete and included questions about COVID-19 exposure and diagnosis, fears and worries about the pandemic, and a series of questions about substance use, including when and how people used substances and why they did so.

Almost 6% of the participants said they had received a diagnosis of COVID-19, and around half reported having pre-existing medical conditions.

Many of the participants also reported changing their substance use since the start of the pandemic.

Some participants reported starting using the following substances since the beginning of the pandemic:

  • alcohol (8.8%)
  • cigarettes (6.9%)
  • stimulants (5.6%)
  • opioids (5.6%)
  • cannabis (5%)
  • e-cigarettes (4.4%).

The results also found that worrying about the pandemic had associations with using substances to cope. Substance users reported worrying about COVID-19 more than non-users, and people who started using substances during the pandemic (excluding opioids) had the highest levels of worry.

“Results generally suggest the persons using substance experience the highest levels of COVID-19-related worry and fear,” the authors explain in their paper. “Additionally, worry about COVID-19 is related to coping motives for substance use.”

The authors say that doctors could find their findings useful. They suggest that doctors assessing levels of worry about COVID-19 help identify people at greatest risk for substance use, and ultimately substance abuse.

With this knowledge, doctors might prevent such problems from developing, for example, by recommending therapy or helping the person develop healthy coping mechanisms. The authors write:

“These results provide preliminary evidence that COVID-19-related worry and fear may be putative risk factors for substance use initiation in the face of COVID-19, and these results may provide critical clinical information for helping individuals cope with this pandemic.”

The authors state the importance of developing specialist interventions for COVID-19-specific mental health problems, including addictions, as the pandemic continues to evolve.

It is crucial to roll out such initiatives early to prevent a wave of mental health problems in the future, says Prof. Michael Zvolensky, senior author of the study.

“The impact of COVID-19 on psychological symptoms and disorders, addiction, and health behavior is substantial and ongoing and will negatively impact people’s mental health and put them at greater risk for chronic illness and drug addiction. It will not equally impact all of society. Those at greater risk are those that have mental health vulnerabilities or disorders,” he closes.

The Centers for Disease Control and Prevention (CDC) offers advice and helplines on managing stress during the pandemic.

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