Substance use and related harms in the context of COVID-19: a conceptual model

Health Promot Chronic Dis Prev Can. 2020 Dec 9;40(11-12):342-349. doi: 10.24095/hpcdp.40.11/12.03. Epub 2020 Sep 16.
[Article in English, French]

Abstract

As the effects of COVID-19 have been unfolding, growing attention has been paid to the intersection of COVID-19 and substance use and the related harms. However, there are few theories and little empirical evidence to guide investigations in this area. To advance this emerging area of inquiry, we present a conceptual model that synthesizes evidence, information and knowledge on substance use and related harms in the context of the pandemic. The conceptual model offers a visual representation of the connections between the pandemic and substance use and related harms, and can be used to identify areas for future research.

À mesure que les effets de la COVID-19 se sont manifestés, une attention croissante a été accordée à la relation entre la COVID-19 et la consommation de substances et les méfaits connexes. Cependant, il existe peu de théories et de preuves empiriques pour orienter les travaux de recherche dans ce domaine. Pour faire progresser ce nouveau champ de recherche, nous présentons un modèle conceptuel qui résume les données probantes, l’information et les connaissances sur la consommation de substances et les méfaits connexes dans le contexte de la pandémie. Le modèle conceptuel offre une représentation visuelle des liens entre la pandémie et la consommation de substances et les méfaits connexes. Il peut être utilisé pour déterminer les futurs domaines de recherche.

Keywords: COVID-19; conceptual model; coronavirus; opioids; substance use; substance-related harms.

Plain language summary

As of June 2020, substance use and related harms in the context of a pandemic remained largely uninvestigated. The COVID-19 pandemic may impact how Canadians use substances and may present specific challenges and harms among people who use substances. The conceptual model in this paper offers a synthesis of evidence, information and knowledge of the concepts and associations relevant to substance use and harms in the context of the pandemic. Relevant concepts were synthesized into five interrelated domains that can be used to identify areas for future research into substance use and related harms in the context of COVID-19: substance use as a means of coping; changes in social support and networks; availability and accessibility of services; increased risk of COVID-19 transmission among people who use substances; and increased risk of severe outcomes.

MeSH terms

  • Adaptation, Psychological
  • COVID-19 / complications
  • COVID-19 / epidemiology*
  • COVID-19 / psychology*
  • COVID-19 / transmission
  • Health Services Accessibility
  • Humans
  • Mental Health
  • Mental Health Services
  • Models, Theoretical*
  • Pandemics*
  • Risk Factors
  • SARS-CoV-2
  • Social Stigma
  • Social Support
  • Substance-Related Disorders / complications*
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy