A multicentric survey among patients with substance use disorders during the COVID-19 lockdown in India

The unprecedented first wave of the COVID-19 pandemic severely impacted mental health services globally. However, the negative impact of such disruptions on people with substance use disorders (SUD) seeking treatment remains unclear. We aim to explore the behaviors adopted by these individuals to overcome the service disruptions.

We explored the changes related to substance use behavior (quit attempts, withdrawal experienced, treatment-seeking, and risky behaviors), and behavioral changes in response to COVID-19 lockdown. A cross-sectional survey was conducted among 404 people with SUD seeking treatment from seven centers across India. They were assessed by a specially designed structured questionnaire during the first wave (June-September) of the pandemic.

An overwhelming majority experienced withdrawal symptoms, with close to half making quit attempts and seeking treatment during the lockdown. Three-fourth of the sample reported difficulty in accessing treatment services and medications. Patients with opioid use were significantly more likely to think about quitting (χ² = 20.408, P = 0.000), make attempts (χ² = 12.436, P = 0.000), seek treatment (χ ² = 7.536, P = 0.006), and self-medicate for withdrawal symptoms (χ² = 5.885, P = 0.015). In turn, those with alcohol use were more likely to use telepsychiatry services (χ² = 35.143, P = 0.000) and experience stigma by family members (χ² = 29.951, P = 0.000) and neighbors (χ² = 17.725, P = 0.000). Among COVID-19 safety precautions, majority practised wearing masks and social distancing but not others.

COVID-19 lockdown led a significant proportion of substance users, especially opioid users, to make quit attempts and seek help. However, these could not be sustained due to difficulty in accessing treatment services. Further, significant proportion failed to adhere to COVID-19 safety precautions.