key: cord-315963-hs70zo48
authors: Kar, Sujita Kumar; Arafat, S.M. Yasir; Sharma, Pawan; Dixit, Ayushi; Marthoenis, Marthoenis; Kabir, Russell
title: COVID-19 pandemic and addiction: Current problems and future concerns
date: 2020-04-10
journal: Asian J Psychiatr
DOI: 10.1016/j.ajp.2020.102064
sha: 
doc_id: 315963
cord_uid: hs70zo48

nan

To the Editor, COVID-19 pandemic is a global public health emergency. It affected more than 512,000 people with 23,495 confirmed deaths in 202 countries by 28th March 2020 (Organization, 2020) . The disease spread rapidly across the globe due to the unique properties of the virus (extraordinary genetic diversity, highly contagious, easy mode of spread, relatively unaffected by climatic variations) (Mackenzie and Smith, 2020) . People around the globe, during this crisis period, are expected to encounter several mental health challenges ranging from panic, phobia, health anxiety, sleep disturbances to dissociative like symptoms (Banerjee, 2020) . Along with these, addictive behaviors could be potential reasons for nuisance during the locked-down period and subsequently, newer behavioral addictions could emerge especially for the teens.

People are advised to stay at home, maintaining social distancing and avoiding travel. Schools, restaurants, pubs, offices, shops have been closed resulting in inaccessibility to substances. Staying at home setting and isolating from the society, also reduces the risk of substance consumption. Social celebrations and partying are restricted. These situations are conducive to substance use. To reduce the spread of COVID-19, social distancing technique is often promoted; the morality behind it is not to limit socialization but to enhance physical distancing to prevent the spread of infection. An individual is free to socialize online, rather than offline; however, online socialization is unlikely to build peer pressure to that extent, which expected to happen in direct socialization. Social distancing and limited socialization also reduce the possibility of peer pressure for substance use. Hence, people who were addicted to any kind of substance use independence pattern are expected to experience withdrawal symptoms. The above factors convey that the social restriction and locked down states in most parts of the world can be a risky affair in the short-run, as many of the individuals can have severe withdrawal symptoms, which can be life-threatening at times (for example-alcohol withdrawal seizures and delirium tremens).

On the other hand, as the sources of pleasure are limited to indoor activities, people spend a substantial period watching television and their electronic gadgets. As the impact of pandemic lasting for a long time, the binge-watching of television and electronic gadgets are also likely to persist; which may later result in behavioral addiction. There are higher chances for the young generation to develop behavioral addictions, especially in developing countries.

Another important area to look at would be the patients with opioid dependence and undergoing daily dispensing agonist treatment. Missing a single dosage at the time of lockdown would lead to relapse. When the whole world is preparing to fight the pandemic they could be missed (Russell, 2010) . Also, it is an accepted truth that the patients with substance use problems are vulnerable populations during the time of pandemic both for being infected or regarding complications (O'Sullivan and Bourgoin, 2010) . Furthermore, those who are addicted to specific drugs and could not obtain any supply due to the lockdown period, they might try to make home-made alcoholic spirits. The spirits might have a high risk of alcohol toxicity and can cause poisoning and fatality.

There is an urgent need to address the mental health issues of people during this pandemic. Most of the countries in the world are adapting lockdown measure to reduce the spread of the infection, the health services are struggling to deal with the daily rise of infected cases hence little attention is provided to the substance user during this pandemic so proper measures and support services should be established to help this vulnerable community. It is highly important to address mental health emergencies like severe and complicated withdrawal symptoms of substance use. Milder symptoms can be addressed through online psychiatric consultation (Yao et al., 2020) . There is a need to sensitize people about the addiction-related issues during this pandemic. A mental health helpline may be useful to address specific queries. A special focus for the young person to prevent them from developing the behavioral addictions could be thought as they are more prone to develop it.

The COVID-19 outbreak: crucial role the psychiatrists can play

COVID-19: a novel zoonotic disease caused by a coronavirus from China: what we know and what we don't

Vulnerability in an influenza pandemic: looking beyond medical risk

Coronavirus disease (COVID-19) outbreak situation. Coronavirus Dis. COVID-19 Pandemic

Influenza pandemic, mental illnesses, addictions

Rethinking online mental health services in China during the COVID-19 epidemic

Yasir Arafat b , Pawan Sharma c , Ayushi Dixit d , Marthoenis Marthoenis e

None.
