Changes in Drug Use Patterns During the COVID-19 Pandemic in Italy: Monitoring a Vulnerable Group by Hair Analysis

Abstract Background From March 22 until May 18, 2020, a complete lockdown in Italy was ordered by the government as a drastic and unprecedented countermeasure against the COVID-19 pandemic. Social isolation measures affect some populations more than others, and people with mental and drug and/or alcohol disorders are more likely to be adversely affected by home confinement. The literature on substance use during the COVID-19 pandemic is still nascent, but past research on other large-scale disasters suggests a modification in drug use patterns. This study presents for the first time experimental laboratory data on the use of alcohol and drugs in a high-risk population during Italy's first wave of the COVID-19 pandemic. Methods Thirty subjects with substance use disorders were monitored for the use of traditional drugs and alcohol every 3 months before, during and after lockdown by the analysis of hair, a biological matrix that permits retrospective evaluations. Results There was a general decrease in the use of traditional drugs during the lockdown: the number of samples positive for heroin, cocaine, MDMA and cannabis fell considerably and then resumed to pre-lockdown levels when the period of confinement was over. Interestingly, the consumption of benzodiazepines and alcohol followed the opposite trend. The number of benzodiazepine-positive samples increased and remained high even at the end of the lockdown. Similarly, alcohol consumption underwent a significant increase during the period of confinement and remained high even after the lockdown restrictions were lifted. Conclusions Confinement measures produced significant changes in drug/alcohol use patterns with a shift towards the use of substances that are more easily accessible and used for the self-medication of stress, anxiety, irritability, depressive symptoms and insomnia. Furthermore, the combined use of alcohol and benzodiazepines can alleviate the negative effects of abstinence from drugs that are no longer easily available. It is concerning that the levels of alcohol and benzodiazepine consumption have remained high even after the lockdown. Mixing benzodiazepines and alcohol can result in a number of serious short-term and long-term effects, which inevitably place further pressure on drug addiction and health services during and after the pandemic.

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Changes in Drug Use Patterns during the COVID-19 Pandemic in Italy: Monitoring a Vulnerable Group by Hair Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041967 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1967

Author(s):

Alessio Gili ◽

Mauro Bacci ◽

Kyriaki Aroni ◽

Alessia Nicoletti ◽

Angela Gambelunghe ◽

...

Keyword(s):

Illicit Drugs ◽

Hair Analysis ◽

Laboratory Data ◽

High Risk Population ◽

Self Medication ◽

Alcohol Disorders ◽

Use Patterns ◽

Alcohol And Drugs ◽

Drug Use Patterns ◽

Negative Feelings

From 22 March until 18 May 2020, a complete lockdown in Italy was ordered as a countermeasure against the COVID-19 pandemic. Social isolation measures affect some populations more than others, and people with drug and/or alcohol disorders (SUDs) are more likely to be adversely affected. This study presents, for the first time, laboratory data on the use of alcohol and drugs in a high-risk population during Italy’s first wave of the COVID-19 pandemic. Thirty subjects with SUDs were monitored for the use of illicit drugs and alcohol every 3 months before, during and after the lockdown, by hair analysis. The number of samples positive for heroin, cocaine, MDMA and cannabis fell considerably during the lockdown and then resumed to pre-lockdown levels when the period of confinement was over. Interestingly, the consumption of benzodiazepines and alcohol followed the opposite trend; both the number of benzodiazepine-positive samples and the level of alcohol consumption increased and remained high, even at the end of the lockdown. The confinement measures produced significant changes in drug/alcohol use patterns, with a shift toward the use of substances that were more easily accessible, used as self-medication for negative feelings, and used to alleviate the effects of abstinence from drugs that were no longer readily available.

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Patterns of Substance use in an Immgrant Population in Spain

European Psychiatry ◽

10.1016/s0924-9338(09)70683-2 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

A. Qureshi ◽

N. Rutow ◽

C. Visiers ◽

E. Pedrini ◽

H.W. Revollo ◽

...

Keyword(s):

Substance Use ◽

Drug Use ◽

Social Factors ◽

Social Stress ◽

Drug Users ◽

Service Access ◽

Foreign Born ◽

Use Patterns ◽

Drug Use Patterns ◽

Migratory Process

Aims:The relationship between immigration and drug abuse and its treatment is complex and poorly understood. The objective of this study is to gain insight into patterns of drug use and service access and how they are influenced by social factors and the migratory process in a population of foreign born drug users in Barcelona, Spain.Methods:An interview protocol was developed for the study which examined drug use patterns, social and health factors, and treatment, and was administered to 118 foreign born users in harm reduction centers. 92% were male and 8% were female. 42% were from Eastern Europe, 35% were from the Magreb, 14% from the European Community, 6% from Subsaharan Africa and 3% from Latin America.Results:With migration opium use decreased whereas cocaine, heroin, and speedball increased, which also constitute the primary drug used by this sample. Social support was correlated with greater consumption of heroin, cocaine, and alcohol, whereas lower social stress was predictive of higher cannabis use. Hard drug use was predicted by illegal status and a lack of stable housing. Acculturation and acclturative stress were not found to be related to substance use. Treatment was positively evaluated, with no perception of lower quality of care.Discussion:Drug use patterns shift with the migratory process, and, it would appear, adapt to the dominant local ones. The unexpecting findings regarding social factors and acculturation and acculturative stress may indicate differences in the Spanish drug use context, and as such warrant further research.

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Improved drug-use patterns at 6 months post-discharge from inpatient substance use disorder treatment: results from compulsorily and voluntarily admitted patients

BMC Health Services Research ◽

10.1186/s12913-016-1548-6 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 11

Author(s):

Adrian R. Pasareanu ◽

John-Kåre Vederhus ◽

Anne Opsal ◽

Øistein Kristensen ◽

Thomas Clausen

Keyword(s):

Substance Use ◽

Drug Use ◽

Substance Use Disorder ◽

Treatment Results ◽

Post Discharge ◽

Substance Use Disorder Treatment ◽

Use Patterns ◽

Drug Use Patterns ◽

Disorder Treatment

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Drug Use Patterns and Demographics of Employed Drug Users: Data from the 1988 National Household Survey on Drug Abuse

PsycEXTRA Dataset ◽

10.1037/e496352006-002 ◽

1990 ◽

Cited By ~ 1

Author(s):

Andrea Kopstein ◽

◽

Joseph Gfroerer

Keyword(s):

Drug Abuse ◽

Drug Use ◽

Drug Users ◽

Household Survey ◽

Use Patterns ◽

Drug Use Patterns ◽

National Household Survey

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Drug Use Patterns and Premenstrual Dysphoria

PsycEXTRA Dataset ◽

10.1037/e496882006-006 ◽

1986 ◽

Author(s):

Nancy K. Mello ◽

Keyword(s):

Drug Use ◽

Use Patterns ◽

Drug Use Patterns

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Review of Drug Utilization Studies in Neonatal Units: A Global Perspective

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165669 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5669 ◽

Cited By ~ 1

Author(s):

Asma Al-Turkait ◽

Lisa Szatkowski ◽

Imti Choonara ◽

Shalini Ojha

Keyword(s):

Drug Use ◽

Drug Utilization ◽

Antibiotic Use ◽

Global Perspective ◽

Use Patterns ◽

Rational Prescribing ◽

Drug Use Patterns ◽

General Drug ◽

The Usa ◽

Drug Utilization Studies

Rational prescribing is challenging in neonatology. Drug utilization studies help identify and define the problem. We performed a review of the literature on drug use in neonatal units and describe global variations. We searched databases (EMBASE, CINAHL and Medline) from inception to July 2020, screened studies and extracted relevant data (two reviewers). The search revealed 573 studies of which 84 were included. India (n = 14) and the USA (n = 13) reported the most. Data collection was prospective (n = 56) and retrospective (n = 26), mostly (n = 52) from one center only. Sixty studies described general drug use in 34 to 450,386 infants (median (IQR) 190 (91–767)) over a median (IQR) of 6 (3–18) months. Of the participants, 20–87% were preterm. The mean number of drugs per infant (range 11.1 to 1.7, pooled mean (SD) 4 (2.4)) was high with some reporting very high burden (≥30 drugs per infant in 8 studies). This was not associated with the proportion of preterm infants included. Antibiotics were the most frequently used drug. Drug use patterns were generally uniform with some variation in antibiotic use and more use of phenobarbitone in Asia. This study provides a global perspective on drug utilization in neonates and highlights the need for better quality information to assess rational prescribing.

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Personality, Motivation, and Adolescent Drug Use Patterns

School Psychology Review ◽

10.1080/02796015.1976.12086364 ◽

1976 ◽

Vol 5 (2) ◽

pp. 17-23

Author(s):

Samuel E. Krug ◽

Thomas J. Henry

Keyword(s):

Drug Use ◽

Adolescent Drug Use ◽

Use Patterns ◽

Drug Use Patterns

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The Relationship between Self-Reported Religiosity and Drug Use by College Students

Journal of Drug Education ◽

10.2190/4u8t-yrwt-2349-21mj ◽

1979 ◽

Vol 9 (1) ◽

pp. 67-78 ◽

Cited By ~ 17

Author(s):

Carol J. Turner ◽

Robert J. Willis

Keyword(s):

College Students ◽

Drug Use ◽

Private College ◽

Drug Usage ◽

College Counselors ◽

Use Patterns ◽

Current Drug ◽

Drug Use Patterns ◽

Drug Problems ◽

The Relationship

As part of an extensive questionnaire on student drug use patterns at a small private college, this study was completed to determine the relationship between self-reported religiosity of college students and 1) the nature and incidence of current drug usage, 2) reasons for abstaining from drug use, 3) acceptable sources for referral in case of drug problems, and 4) persons with whom students would discuss their attitudes toward drugs. Statistically significant differences between religious and non-religious students at the 0.01 level were found in the current use of alcohol and marijuana, in reasons for abstaining from marijuana, amphetamines, barbiturates, and hallucinogens; in referral of drug problems to drug wise friends; and in discussing drug attitudes with parents and with college counselors.

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