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.
2. Sarkar S, Ghosh A. The magnitude and vicissitudes of substance use disorders in India. Indian J Soc Psychiatry. 2019 Apr 1;35(2):99–101.
3. WHO. Alcohol and COVID-19: what you need to know [Internet]. 2020 [cited 2020 Apr 18]. Available from: http://www.euro.who.int/__data/assets/pdf_file/0006/437604/COVID-19-alcohol-consumption.pdf
4. WHO. WHO EMRO | Tobacco and waterpipe use increase the risk of suffering from COVID-19 | Know the truth | TFI [Internet]. 2020 [cited 2020 Apr 18]. Available from: http://www.emro.who.int/tfi/know-the-truth/tobacco-and-waterpipe-users-are-at-increased-risk-of-covid-19-infection.html
5. Arya S, Gupta R. COVID-19 outbreak: Challenges for Addiction services in India. Asian J Psychiatry. 2020 Jun 1;51:102086.
6. Rehm J, Sempos CT, Trevisan M. Alcohol and cardiovascular disease--more than one paradox to consider. Average volume of alcohol consumption, patterns of drinking and risk of coronary heart disease--a review. J Cardiovasc Risk. 2003;10(1):15-20. doi:10.1097/01.hjr.0000051961.68260.30
7. Mukherjee S. Alcoholism and its effects on the central nervous system. Curr Neurovasc Res. 2013;10(3):256-262. doi:10.2174/15672026113109990004
8. Alcohol Use Disorder | National Health Portal Of India [Internet]. [cited 2021 May 28]. Available from: https://www.nhp.gov.in/healthlyliving/alcohol-use-disorder
9. Brennan, S.E., McDonald, S., Page, M.J. et al. Long-term effects of alcohol consumption on cognitive function: a systematic review and dose-response analysis of evidence published between 2007 and 2018. Syst Rev 9, 33 (2020). https://doi.org/10.1186/s13643-019-1220-4
10. Petrakis IL, Gerardo G, Robert R, Krystal JH. Comorbidity of Alcoholism and Psychiatric Disorders. Natl Inst Alcohol Abus Alcohol [Internet]. 2002 [cited 2021 May 28];81–90. Available from: https://pubs.niaaa.nih.gov/publications/arh26-2/81-89.htm
11. Pulla P. Covid-19: India imposes lockdown for 21 days and cases rise. BMJ [Internet]. 2020 Mar 26 [cited 2020 Apr 5];368. Available from: https://www.bmj.com/content/368/bmj.m1251
12. NEWS18. Amid Coronavirus Lockdown, States Across India Witness Surge in Suicide Cases Due to Alcohol Withdrawal Symptoms - News18 [Internet]. 2020 [cited 2020 Apr 19]. Available from: https://www.news18.com/news/india/amid-coronavirus-lockdown-states-across-india-witness-surge-in-deaths-due-to-alcohol-withdrawal-symptoms-2561191.html
13. The human cost of India’s coronavirus lockdown: Deaths by hunger, starvation, suicide and more | India – Gulf News [Internet]. [cited 2020 May 2]. Available from: https://gulfnews.com/world/asia/india/the-human-cost-of-indias-coronavirus-lockdown-deaths-by-hunger-starvation-suicide-and-more-1.1586956637547
14. False Belief That Poisons Cures COVID Kills Over 700 Iranians | Time [Internet]. [cited 2020 May 2]. Available from: https://time.com/5828047/methanol-poisoning-iran/
15. Deccanherald. From alcohol bath to “no cabbage”: Here are the COVID-19 fake news | Deccan Herald [Internet]. 2020 [cited 2020 Apr 18]. Available from: https://www.deccanherald.com/national/from-alcohol-bath-to-no-cabbage-here-are-the-covid-19-fake-news-818383.html
16. The Hindu. CM: liquor allowed on doctor’s prescription [Internet]. The Hindu. 2020 [cited 2020 Apr 18]. Available from: https://www.thehindu.com/news/national/kerala/cm-liquor-allowed-on-doctors-prescription/article31194899.ece
17. Huremović D. Quarantine and Isolation: Effects on Healthcare Workers [Internet]. 2020 [cited 2020 Apr 18]. Available from: https://link.springer.com/chapter/10.1007/978-3-030-15346-5_10
18. Sohrabi C., Alsafi Z., O'Neill N., Khan M., Kerwan A., Al-Jabir A., Iosifidis C., Agha R. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19) Int. J. Surg. 2020;76:71–76. doi: 10.1016/j.ijsu.2020.02.034.
19. Alpers SE, Skogen JC, Mæland S, et al. Alcohol Consumption during a Pandemic Lockdown Period and Change in Alcohol Consumption Related to Worries and Pandemic Measures. Int J Environ Res Public Health. 2021;18(3):1220. Published 2021 Jan 29. doi:10.3390/ijerph18031220
20. Krishnakumar, A., Verma, S. Understanding Domestic Violence in India During COVID-19: a Routine Activity Approach. Asian J Criminol 16, 19–35 (2021). https://doi.org/10.1007/s11417-020-09340-1
21. COVID-19: ILO Monitor – 7th edition: ILO: Uncertain and uneven recovery expected following unprecedented labour market crisis [Internet]. [cited 2021 Jul 9]. Available from: https://www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_766949/lang--en/index.htm
22. MSME Day 2020: the COVID -19 pandemic and its impact on small business [Internet]. [cited 2021 Jul 9]. Available from: https://www.ilo.org/empent/whatsnew/WCMS_749275/lang--en/index.htm
23. India’s unemployment rate rises to 27.11% amid COVID-19 crisis: CMIE - The Hindu [Internet]. [cited 2021 Jul 9]. Available from: https://www.thehindu.com/business/indias-unemployment-rate-rises-to-2711-amid-covid-19-crisis-cmie/article31511006.ece
24. Inamdar N. Coronavirus lockdown: India jobless numbers cross 120 million in April [Internet]. BBC News. 2020 [cited 2021 Jul 9]. Available from: https://www.bbc.com/news/world-asia-india-52559324
25. Covid Impact on SME: Dun & Bradstreet: Over 82% of SMEs had negative impact during Covid-19 - The Economic Times [Internet]. [cited 2021 Jul 9]. Available from: https://economictimes.indiatimes.com/small-biz/sme-sector/dun-bradstreet-over-82-of-smes-had-negative-impact-during-covid-19/articleshow/82197779.cms?from=mdr
26. Salari, N., Hosseinian-Far, A., Jalali, R. et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Global Health 16, 57 (2020). https://doi.org/10.1186/s12992-020-00589-w
27. Zhao N, Zhou G. Social Media Use and Mental Health during the COVID-19 Pandemic: Moderator Role of Disaster Stressor and Mediator Role of Negative Affect. Appl Psychol Health Well Being. 2020;12(4):1019-1038. doi:10.1111/aphw.12226
28. Pathare, S., Vijayakumar, L., Fernandes, T. et al. Analysis of news media reports of suicides and attempted suicides during the COVID-19 lockdown in India. Int J Ment Health Syst 14, 88 (2020). https://doi.org/10.1186/s13033-020-00422-2
29. Ransing R, Adiukwu F, Pereira-Sanchez V, Ramalho R, Orsolini L, Schuh Teixeira AL, et al. Early career psychiatrists’ perspectives on the mental health impact and care of the COVID-19 pandemic across the world. Asian J Psychiatry. 2020 Apr 14;102085.
30. Medical Council of India. Medical Council of India: Modification in medicine list in telemedicine practice guidelines [Internet]. 2020 [cited 2020 Apr 18]. Available from: https://mciindia.org/MCIRest/open/getDocument?path=/Documents/Public/Portal/LatestNews/Modification%20in%20Medicine%20lists%20in%20Telemedicine%20Practice%20Guidelin.pdf