Chiappini, S., Guirguis, A., John, A., Corkery, J. M., & Schifano, F. (2020). COVID-19: The Hidden Impact on Mental Health and Drug Addiction. Frontiers in Psychiatry, 11, 767. https://doi.org/10.3389/fpsyt.2020.00767
Corrigan, P. W., Qin, S., Davidson, L., Schomerus, G., Shuman, V., & Smelson, D. (2020). Recovery from mental illness versus substance use disorder. Advances in Dual Diagnosis, 13(3), 101‑110. https://doi.org/10.1108/ADD-10-2019-0012
Purpose While serious mental illness (SMI) and substance use disorders (SUD) are common, less research has focused on causal beliefs across conditions. This is an important question when trying to understand the experience of dual diagnosis. The purpose of this paper is to examine how three factors representing causal beliefs (biogenetic, psychosocial or childhood adversity) differ by SMI and SUD. This study also examined how causal beliefs were associated with overall, process and outcome beliefs about recovery. Design/methodology/approach Using Mechanical Turks online panel, 195 research participants from the general public completed measures of recovery – overall, outcome and process – for SMI and SUD. Participants also completed the Causal Beliefs Scale yielding three causal factors for SMI and separately for SUD: biogenetic, psychosocial and childhood adversity. Findings Results indicated participants endorsed biogenetic cause more for SMI and SUD. Moreover, research participants endorsed biogenetic causes more than the other two for SMI. Results also showed the psychosocial cause was positively associated with recovery for SMI. Biogenetic causes were not. Almost none of the causal indicators was significantly associated with recovery for SUD. Originality/value Implications of these findings for future research and public efforts to enhance attitudes about recovery are discussed.
Czeisler, M. É., Lane, R. I., Petrosky, E., Wiley, J. F., Christensen, A., Njai, R., … Rajaratnam, S. M. W. (2020). Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic - United States, June 24-30, 2020. MMWR. Morbidity and Mortality Weekly Report, 69(32), 1049‑1057. https://doi.org/10.15585/mmwr.mm6932a1
The coronavirus disease 2019 (COVID-19) pandemic has been associated with mental health challenges related to the morbidity and mortality caused by the disease and to mitigation activities, including the impact of physical distancing and stay-at-home orders.* Symptoms of anxiety disorder and depressive disorder increased considerably in the United States during April-June of 2020, compared with the same period in 2019 (1,2). To assess mental health, substance use, and suicidal ideation during the pandemic, representative panel surveys were conducted among adults aged ≥18 years across the United States during June 24-30, 2020. Overall, 40.9% of respondents reported at least one adverse mental or behavioral health condition, including symptoms of anxiety disorder or depressive disorder (30.9%), symptoms of a trauma- and stressor-related disorder (TSRD) related to the pandemic† (26.3%), and having started or increased substance use to cope with stress or emotions related to COVID-19 (13.3%). The percentage of respondents who reported having seriously considered suicide in the 30 days before completing the survey (10.7%) was significantly higher among respondents aged 18-24 years (25.5%), minority racial/ethnic groups (Hispanic respondents [18.6%], non-Hispanic black [black] respondents [15.1%]), self-reported unpaid caregivers for adults§ (30.7%), and essential workers¶ (21.7%). Community-level intervention and prevention efforts, including health communication strategies, designed to reach these groups could help address various mental health conditions associated with the COVID-19 pandemic.
Gimelfarb, Y., Shamir, E. Z., Ness Dabush, K., & Ben Tzarfati, M. (2020). Methadone maintenance treatment and survival of schizophrenic patients with a lifetime comorbid substance use disorders: a long-term follow-up study. Journal of Addictive Diseases, 1‑7. https://doi.org/10.1080/10550887.2020.1782558
Background Methadone maintenance treatment (MMT) remains the most widely used effective therapeutic approach for opioid use disorders. However, there is paucity of empirical data regarding the relationship between the MMT and survival of subjects with schizophrenia.Aim The aim of this study was to examine the effect of MMT on the long-term survival of subjects with schizophrenia and a lifetime comorbid substance use disorders.Methods The charts of 277 consecutive subjects admitted in our center during a period from January 1, 2002 to February 1, 2007 were assessed. Psychiatric diagnoses have been established according to international classification of diseases and health related problems-10th edition (ICD-10). The risk of all-cause mortality was assessed by Cox proportional-hazards regression models, including time-dependent covariates.Results Out of MMT subjects, 31 (11.2%) had mental and behavioral disorders due to multiple psychoactive substance use, 5 (1.8%) had mental and behavioral disorders due to use of opioids. All of 13 (4.7%) subjects with opioid use disorders were treated. MMT has been found to be predictive of lower long-term survival, in time-independent (hazard ration [HR] = 1.88; 95%CI: 1.06-3.37; p<.05) and in time-dependent adjusted models (HR = 2.01; 95%CI: 1.21-3.60; p<.05). MMT daily dose of <120 mg (adjusted HR = 1.83; 95%CI: .95-3.54) and MMT daily dose of ≥120 mg (adjusted HR = 2.70; 95%CI: .97-7.54) were associated with less long-term survival, all compared with no lifetime MMT (p<.046).Conclusions Among subjects with schizophrenia and a lifetime comorbid substance use disorders, overall mortality was higher in those who received lifetime MMT, then in patients without MMT.
Heimer, R., McNeil, R., & Vlahov, D. (2020). A Community Responds to the COVID-19 Pandemic: a Case Study in Protecting the Health and Human Rights of People Who Use Drugs. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 97(4), 448‑456. https://doi.org/10.1007/s11524-020-00465-3
Effective responses to a global pandemic require local action. In the face of a pandemic or similar emergencies, communities of people who use drugs face risks that result from their ongoing drug use, reduced ability to secure treatment for drug use and correlated maladies, lack of access to preventive hygiene, and the realities of homelessness, street-level policing, and criminal justice involvement. Herein, we document the efforts of a coalition of people who use drugs, advocates, service providers, and academics to implement solutions to reduce these risks at a municipal and state level focusing on New Haven and the State of Connecticut. This coalition identified the communities at risk: active users needing access to harm reduction services, persons in treatment needing access to their medications, the homeless and marginally housed needing improved hygiene, people engaged in sex work, and the incarcerated needing release from custody. The section describing each of the risks demonstrates how the coalition acted preemptively at early stages of the pandemic, ahead of official initiatives, to develop ameliorative risk reduction solutions. Outcomes discussed include instances in which obstacles were overcome or still remain.
Keepers, G. A., Fochtmann, L. J., Anzia, J. M., Benjamin, S., Lyness, J. M., Mojtabai, R., … Hong, S.-H. (2020). The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. American Journal of Psychiatry, 177(9), 868‑872. https://doi.org/10.1176/appi.ajp.2020.177901
López-Pelayo, H., Aubin, H.-J., Drummond, C., Dom, G., Pascual, F., Rehm, J., … Gual, A. (2020). « The post-COVID era »: challenges in the treatment of substance use disorder (SUD) after the pandemic. BMC Medicine, 18(1), 241. https://doi.org/10.1186/s12916-020-01693-9
BACKGROUND: Citizens affected by substance use disorders are high-risk populations for both SARS-CoV-2 infection and COVID-19-related mortality. Relevant vulnerabilities to COVID-19 in people who suffer substance use disorders are described in previous communications. The COVID-19 pandemic offers a unique opportunity to reshape and update addiction treatment networks. MAIN BODY: Renewed treatment systems should be based on these seven pillars: (1) telemedicine and digital solutions, (2) hospitalization at home, (3) consultation-liaison psychiatric and addiction services, (4) harm-reduction facilities, (5) person-centered care, (6) promote paid work to improve quality of life in people with substance use disorders, and (7) integrated addiction care. The three « best buys » of the World Health Organization (reduce availability, increase prices, and a ban on advertising) are still valid. Additionally, new strategies must be implemented to systematically deal with (a) fake news concerning legal and illegal drugs and (b) controversial scientific information. CONCLUSION: The heroin pandemic four decades ago was the last time that addiction treatment systems were updated in many western countries. A revised and modernized addiction treatment network must include improved access to care, facilitated where appropriate by technology; more integrated care with addiction specialists supporting non-specialists; and reducing the stigma experienced by people with SUDs.
Melamed, O. C., Hauck, T. S., Buckley, L., Selby, P., & Mulsant, B. H. (2020). COVID-19 and persons with substance use disorders: Inequities and mitigation strategies. Substance Abuse, 41(3), 286‑291. https://doi.org/10.1080/08897077.2020.1784363
The COVID-19 pandemic disproportionately disrupts the daily lives of marginalized populations. Persons with substance use disorders are a particularly vulnerable population because of their unique social and health care needs. They face significant harm from both the pandemic itself and its social and economic consequences, including marginalization in health care and social systems. Hence, we discuss: (1) why persons with substance use disorders are at increased risk for infection with COVID-19 and a severe illness course; (2) anticipated adverse consequences of COVID-19 in persons with substance use disorders; (3) challenges to health care delivery and substance use treatment programs during and after the COVID-19 pandemic; and (4) the potential impact on clinical research in substance use disorders. We offer recommendations for clinical, public health, and social policies to mitigate these challenges and to prevent negative outcomes.
Ogundipe, E., Sælør, K. T., Dybdahl, K., Davidson, L., & Biong, S. (2020). “Come together”: a thematic analysis of experiences with belonging. Advances in Dual Diagnosis, 13(3), 123‑134. https://doi.org/10.1108/ADD-03-2020-0002
Purpose The purpose of this paper is to explore, describe and interpret two research questions: How do persons with co-occurring mental health and substance abuse problems, living in supportive housing, experience belonging? How do residential support staff experience promoting a sense of belonging for persons with co-occurring mental health and substance abuse problems, living in a supportive housing? Design/methodology/approach Individual semi-structured interviews were conducted with five persons with co-occurring mental health and substance abuse problems living in supportive housing in a Norwegian district. In addition, one semi-structured focus group was conducted with nine residential support staff. All interviews were transcribed verbatim and analyzed using thematic analysis. Findings Analysis resulted in three main themes: “I do not go to sleep in my pajamas”, “Do I have a choice?” and “Be kind to each other”. Research limitations/implications More research on how inclusive practices that are commonly described in guidelines actually affect the experience of residents and residential support staff is needed. Practical implications Practices that incorporate a communal and contextual understanding when assigning supportive housing are warranted. Originality/value By paying attention to the components of social recovery, this paper provides a nuanced understanding of how persons with co-occurring mental health and substance abuse problems, living in supportive housing, experience belonging. In addition, residential support staffs’ experiences with promoting a sense of belonging for this group are explored.
Richert, T., Anderberg, M., & Dahlberg, M. (2020). Mental health problems among young people in substance abuse treatment in Sweden. Substance Abuse Treatment, Prevention, and Policy, 15(1), 43. https://doi.org/10.1186/s13011-020-00282-6 Young people with substance use problems face a high risk of co-occurring mental health problems, something that may involve a more difficult life situation, social problems as well as worse treatment outcomes. The aim of this study is to analyse self-reported mental health problems among young people receiving outpatient treatment for substance use problems in Sweden. We explore what types of mental health problems are more or less predominant, and whether there are significant differences between boys and girls. In addition, we analyse how various mental health problems covary with indicators of substance abuse severity.
Simart, S. (2020). [Identify psychotraumatisms in people with addictive problems]. Soins. Psychiatrie, 41(326), 24‑29. https://doi.org/10.1016/S0241-6972(20)30017-7
Frequently overlooked during the patient’s treatment, psychological trauma can constitute a significant part of the addiction problem. Clinical data reveal a high incidence of post-traumatic stress disorder for which addictive behaviours may be a way of repressing the anxiety caused by the trauma. Systematic screening for trauma would help to ensure an appropriate treatment plan is put in place.
Wicki, M., Marmet, S., Studer, J., Epaulard, O., & Gmel, G. (2020). Curvilinear associations between sexual orientation and problematic substance use, behavioural addictions and mental health among young Swiss men. Addictive Behaviors, 112, 106609. https://doi.org/10.1016/j.addbeh.2020.106609
BACKGROUND AND AIMS: It is well documented that individuals with a minority sexual orientation face greater risks of problematic substance use (e.g. heavy episodic drinking, alcohol use disorder) and mental health problems. Far less is known about how that risk varies within this population and their risk of behavioural addictions. This study estimated the risks of problematic substance use, behavioural addiction and poor mental health across the spectrum of sexual orientation. SAMPLE AND METHOD: A sample of young Swiss men (N = 5294; mean age = 25.5, SD = 1.25; representative of 21 of Switzerland’s 26 cantons) completed a self-reporting questionnaire on sexual orientation (attraction, 5-point scale) and criterion variables: problematic substance use (e.g. alcohol, cigarettes, cannabis and other illegal drugs), behavioural addictions (gambling, gaming, cybersex, internet, smartphone, work, exercise) and indicators of mental health (e.g. depression, stress). Curvilinear associations between sexual orientation (heterosexual, mostly-heterosexual, bisexual, mostly-homosexual or homosexual individuals) and criterion variables were explored using fractional polynomial regressions. RESULTS: Although there were differences across criterion variables, in general, the highest risks of problematic substance use, behavioural addictions and mental health problems were estimated for mostly-heterosexual, bisexual or mostly-homosexual men, followed by homosexual men, and with heterosexual men facing the lowest risk. DISCUSSION AND CONCLUSION: Aggregating the spectrum of sexual orientations into two or three distinct groups blurs important internal group differences. Outcome-specific explanations beyond minority stress and biphobia are necessary to understand the pathways between sexual orientation and risky behaviours. Considering sexual orientation is important to provide targeted healthcare prevention and interventions.
