COVID-19 Pandemic Results in Increased Substance Use Among Regular Drug Users


Sudden disruptions in the supply of street drugs when the COVID-19 pandemic began were associated with an increase in overdose deaths and other harms.

Individuals who regularly use psychoactive substances report experiencing various negative impacts since the beginning of the COVID-19 pandemic, including increased usage and fear of relapse or overdose, according to a survey published in the International Journal of Drug Policy.

“People who use drugs have been negatively impacted by the pandemic in ways that put them at greater risk for experiencing substance and health-related harms, including overdoses and a decreased ability to mitigate risk behaviors,” said lead study author Dr. Farihah Ali in a press release. “These findings warrant the need for increased accessibility of safe supply programs, take-home naloxone and drug-testing kits, as well as novel approaches to help ensure they have the necessary tools available to make informed choices and mitigate risk.”

Forty-seven percent of respondents indicated their substance use had increased during COVID-19, and 38% said they believed they were at higher risk of overdose due to supply disruptions that made drugs more expensive, harder to get, and of unknown origin. Among those using syringes or other paraphernalia, 47% responded that they started re-using or sharing for the first time after the beginning of the pandemic due to COVID-19-related restrictions decreasing access to harm reduction or needle exchange programs.

Seven percent of survey respondents indicated they had relapsed during the COVID-19 pandemic.

“One of the potential factors in relapse is all the time spent alone and isolated with all the pandemic restrictions,” said Tara Elton-Marshall, PhD, independent scientist at the Centre for Addiction and Mental Health Institute for Mental Health Policy Research, in the release. “Using alone itself was a real concern. We know that people who use alone are more likely to die of an overdose, in part because there is nobody there to administer naloxone or call emergency services.”

The researchers said that sudden disruptions in the supply of street drugs when the pandemic began were associated with an increase in overdose deaths and other harms. In British Columbia, where the survey was conducted, the number of illicit drug overdose deaths increased by 72% during the first 4 months of the pandemic compared to the previous year.

“We need everything from good treatment and harm reduction measures to realizing that we are in an environment where everything is different during COVID and we need different solutions,” said Jürgen Rehm, PhD, in the release. “We need to consider now how to decriminalize drug use. This survey lends strong support for the need for an integrated drug policy strategy including harm reduction.”


Large numbers of regular drug users report increased substance use during COVID-19 [news release]. EurekAlert; April 20, 2021. Accessed April 22, 2021.

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