{"doi":"10.1111/add.15080","title":"Mitigating and learning from the impact of COVID‐19 infection on addictive disorders","abstract":"The COVID-19 pandemic and the measures required to address it are cutting a swathe through people's lives and the global economy. People with addictive disorders are particularly badly affected as a result of poverty, physical and mental health vulnerabilities and disruption of access to services. The pandemic may well increase the extent and severity of some addictive disorders. Current research is suffering from the termination of face-to-face data collection and other restrictions. There is an urgent need to coordinate efforts nationally and internationally to mitigate these problems and to find innovative ways of continuing to provide clinical and public health services to help people with addictive disorders. In recent years, many countries have experienced sharp increases in opioid use disorder (OUD) and fatal opioid poisonings [1, 2]. COVID-19 is likely to compound this. People with OUD have a high prevalence of coexisting health problems, including chronic obstructive pulmonary disease [3]. Many live in geographical areas characterized by social deprivation, high population densities, poor-quality housing and homelessness [4, 5]. Together, these conditions make it more likely that people with OUD will have elevated rates of COVID-19 infection and transmission. Social distancing and treatment, staff sickness and absences are straining the ability of OUD clinics to operate effectively, although many have stayed open, at least in some countries. It is essential that patients can continue to access medication for OUD. In the United Kingdom, new government advice asks services to transfer as many patients as possible from supervised consumption to take-home doses, with a 14-day supply for self-administration. More flexibility is recommended for patients opting for buprenorphine over methadone. Patients self-isolating are advised to nominate someone to collect the dispensed medicine on their behalf [6]. While this social distancing response targets reduced COVID-19 exposure, it may inadvertently increase medication diversion and fatal opioid poisoning. In the community, disruption to the supply of illicit opioids and increases in price could have several effects, including a surge in treatment seekers, more cases of overdose from the consumption of other opioids and increased harms associated with the substitution of opioids with other more readily available substances, such as alcohol, cocaine and benzodiazepines. People who smoke crack cocaine may be likely to experience more severe COVID-19 disease because they already have greater inflammation of, and damage to, lung tissue [7]. Stimulant use more generally puts people at greater risk of cardiovascular disease, and this is a major risk factor for mortality with COVID-19 infection [8]. Much of the debate concerning alcohol during the early phases of the pandemic has focused on the restrictions placed on sales, either through the enforced closure of on-trade venues—such as pubs, bars and restaurants—or the decisions taken by public bodies on whether off-trade sales can continue through shops and supermarkets [9]. In places where all alcohol sales outlets are closed drinking can be expected to decrease significantly [10], although this effect may be moderated if stockpiling behaviour occurred immediately before the imposition of restrictions. The closure of all alcohol outlets may improve health and reduce intimate partner violence, as well as other violence. However, social isolation may heighten domestic tensions negating or reversing this possible benefit. In jurisdictions where off-trade outlets remain open, the overall changes in levels and patterns of alcohol consumption are difficult to predict, but there is evidence already of a significant increase in alcohol sales [11]. The closure of on-trade premises will probably affect how people drink (e.g. the emergence of new social practices involving alcohol consumption, such as online pub quizzes, dinner dates and partie","journal":"Addiction","year":2020,"id":49649,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":241,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9582,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":240669,"name":"Shane Darke","orcid":"0000-0001-8718-7055","position":1,"is_corresponding":false},{"id":68407,"name":"Wayne Hall","orcid":"0000-0003-1984-0096","position":2,"is_corresponding":false},{"id":240670,"name":"Matthew Hickman","orcid":"0000-0001-9864-459X","position":3,"is_corresponding":false},{"id":240671,"name":"John Holmes","orcid":"0000-0001-9283-2151","position":4,"is_corresponding":false},{"id":240672,"name":"Keith Humphreys","orcid":"0000-0003-0694-5761","position":5,"is_corresponding":false},{"id":240673,"name":"Joanne Neale","orcid":"0000-0003-1502-5983","position":6,"is_corresponding":false},{"id":240674,"name":"Jalie A. Tucker","orcid":"0000-0003-1055-9038","position":7,"is_corresponding":false},{"id":240675,"name":"Robert West","orcid":"0000-0002-0291-5760","position":8,"is_corresponding":false},{"id":240668,"name":"John Marsden","orcid":"0000-0002-1307-2498","position":0,"is_corresponding":true}],"reference_count":9,"raw_metadata":null,"created_at":"2026-07-18T20:37:28.027635Z","pmid":"32250482","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}