Illicit Substance Use and the COVID-19 Pandemic in the United States: A Scoping Review and Characterization of Research Evidence in Unprecedented Times
- PMID: 35886734
- PMCID: PMC9317093
- DOI: 10.3390/ijerph19148883
Illicit Substance Use and the COVID-19 Pandemic in the United States: A Scoping Review and Characterization of Research Evidence in Unprecedented Times
Abstract
We carried out a scoping review to characterize the primary quantitative evidence addressing changes in key individual/structural determinants of substance use risks and health outcomes over the first two waves of the COVID-19 pandemic in the United States (US). We systematically queried the LitCovid database for US-only studies without date restrictions (up to 6 August 2021). We extracted quantitative data from articles addressing changes in: (a) illicit substance use frequency/contexts/behaviors, (b) illicit drug market dynamics, (c) access to treatment and harm reduction services, and (d) illicit substance use-related health outcomes/harms. The majority of 37 selected articles were conducted within metropolitan locations and leveraged historical timeseries medical records data. Limited available evidence supported changes in frequency/behaviors/contexts of substance use. Few studies point to increases in fentanyl and reductions in heroin availability. Policy-driven interventions to lower drug use treatment thresholds conferred increased access within localized settings but did not seem to significantly prevent broader disruptions nationwide. Substance use-related emergency medical services' presentations and fatal overdose data showed a worsening situation. Improved study designs/data sources, backed by enhanced routine monitoring of illicit substance use trends, are needed to characterize substance use-related risks and inform effective responses during public health emergencies.
Keywords: COVID-19; harm reduction; illicit drugs; scoping review; substance use.
Conflict of interest statement
The funders had no role in the study design, conduct, and reporting of this review. A.P. has received untied educational funds from Seqirus and Mundipharma for post-marketing surveillance of pharmaceutical opioids; these organizations had no role in study design, conduct and reporting, and funding was for work not presented here.
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References
-
- United Nations Office on Drugs and Crime . World Drug Report 2021. United Nations Office on Drugs and Crime; Vienna, Austria: 2021.
-
- Wang H., Paulson K.R., Pease S.A., Watson S., Comfort H., Zheng P., Aravkin A.Y., Bisignano C., Barber R.M., Alam T., et al. Estimating Excess Mortality Due to the COVID-19 Pandemic: A Systematic Analysis of COVID-19-Related Mortality, 2020–2021. Lancet. 2022;399:1513–1536. doi: 10.1016/S0140-6736(21)02796-3. - DOI - PMC - PubMed
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