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Substance abuse and alcohol consumption
What does the evidence say about substance abuse and alcohol consumption?
Recent literature has explored the impact of the COVID-19 response on addiction or substance
abuse disorders. Overall, findings show the impact of COVID-19 on people with alcohol and
other drug problems has been largely indirect as they evolve from risk factors such as social
isolation, housing, incarceration, employment and reduced access to recovery or health
services62. The increased use of substances in combination with the above risk factors is linked
to suicide, which is why the research recommends a multidisciplinary approach to substance
abuse63,64. Such an approach provides flexible access to services and reduces risk of relapse
and suicide.
Those who suffer from underlying health conditions such as diabetes, cancer, heart and
respiratory diseases, related to the prolonged use of substances such as alcohol, cigarettes and
other illicit substances, are severely at-risk for COVID-19. This is primarily due to the
immunocompromised state of persons who suffer from the former, as well as damage to lung
tissue inhibiting their ability to respond to infection65. Literature suggests that opioid use, which
has already increased in recent times would be compounded by the outbreak of COVID-19 66.
Often those with opioid use disorder, experience co-morbidities that make them more
susceptible to other health issues. Stimulant use is linked to inflammation and damage to lung
tissue, which also increases susceptibility 67.
Social distancing measures and restrictions may hinder the ability of persons with substance
abuse disorders to access recovery services or attend syringe service programs such as
methadone clinics 68. This may lead to reduced supervision or assistance to administer
We interviewed Wesley Mission’s emergency relief management, who informed
us that a lack of physical support for people struggling with substance abuse
may increase their rates of use. This is especially the case where the client is
also experiencing social isolation.
medications and increases risk of opioid overdoses or fatalities. There is also the risk of
individuals relapsing on opioids if support services are limited or not easily accessible. Divulging
in substance use to alleviate exceptional fears, stresses and grief associated with being isolated
and living through a pandemic is known to occur 69. The disruption of community access to illicit
substances may cause a surge in treatment seekers. This has consequences for potential
overdose risk, as well as the extremely high pressure and demand for community, rehabilitation
and health services.
The societal stigma that exists around people with substance abuse issues may also be
worsened by hospital resources being at capacity and prioritising allocation of resources
towards COVID-19 70. People with substance abuse disorders may not be prioritised if they
present with COVID-19 symptoms, due to existing stigmas. Such stigmas include the flawed
perception that ‘weak character and poor choices’ are causes of addiction 71.
Substance abuse and alcohol consumption in relation to suicide prevention and mental
health
Social isolation is highlighted as one of the key risk factors for both substance abuse and
suicidality 72. An interview with senior management from Wesley Mission providing support in
emergency relief, suggests that a lack of physical support for persons struggling with substance
abuse may increase levels of use, particularly when social isolation is also a factor involved 73.
The significant stresses on both mental health and general wellbeing caused by COVID-19,
Reducing distress in the community following the COVID-19 pandemic
June 2020
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