Lessons learnt from alcoholism and substance use disorders (SUDs) during the COVID-19 pandemic in India.: Alcoholism and substance use disorders (SUDs) during the COVID-19 pandemic

Abstract

Substance use disorder (SUD) is a widespread non-communicable disease (NCD) with biological, social, or psychological foundations, policymakers, stakeholders, and doctors have given it less attention during the COVID-19 pandemic. On similar lines, in India, alcohol consumption and mental health problems are two major illnesses that have a significant impact on people, individually. When both come together, it adds to the burden of disease and creates a vicious cycle involving healthcare providers, consumers, and the patient itself. The correlation between alcohol and drug dependence with mental health and its associated illnesses is difficult to conclude and establish, making it even difficult to provide effective treatment options. The abrupt surge in patients with SUD (primarily alcohol) related disorders (e.g., withdrawal) was noticed because of the sudden non-availability of alcohol or opioid distribution during the countrywide Covid-19 lockdowns. It resembled a pandemic’s emotional epidemic curve. Around 40 people have died because of SUD-related withdrawal and suicide, as per the media reportings. Methanol intoxication has been reported in several parts of the country. Similar to Indian trends, 700 people reportedly died because of methanol intoxication in Iran. Unfortunately, de-addiction services in India were not adequately equipped for the SUD pandemic, and as a result, most services could not cope with lockdown problems. To our surprise, some jurisdictions have opted to make alcohol available to those who cannot live without it regularly, in order to treat alcohol withdrawal. Though this method may be effective in the short term or in delaying the SUD epidemic, it will have a long-term impact on de-addiction efforts and treatments delivered in hospitals or community settings. If we dive deep to find the answer to these questions, we can easily determine many factors responsible, especially the socio-economic crisis which led to the job loss, closure of small businesses, factory units, etc. The government had to ensure supplies of essential drugs and other amenities to the people for free of cost while the people had to sit back at home to help the government prevent the spread of the Infection. Not only this, but the developing tension within homes also gave rise to the battlefield between couples and doubled the rates of domestic violence and/or divorces exaggerating the already prevailing social issues like SUD and alcoholism in the community.