Treatment Disruption and Childcare Responsibility as Risk Factors for Drug and Alcohol Use in Persons in Treatment for Substance Use Disorders During the COVID-19 Crisis.
Treatment Disruption and Childcare Responsibility as Risk Factors for Drug and Alcohol Use in Persons in Treatment for Substance Use Disorders During the COVID-19 Crisis.
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DOI：
10.1097/adm.0000000000000813
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发表时间：
2022-01-01
影响因子：
5.5
通讯作者：
Dunn KE
中科院分区：
文献类型：
--
作者：
Huhn AS;Strain EC;Jardot J;Turner G;Bergeria CL;Nayak S;Dunn KE
2019年新型冠状病毒（COVID-19）危机给美国医疗保健系统带来了巨大动荡。目前的研究调查了COVID-19危机早期阶段患者报告的物质使用障碍（SUD）治疗经历。SUD治疗的参与者于2020年4月14日至2020年5月26日在COVID-19危机的早期阶段通过在线众包招募。参与者报告SUD治疗中断，在0-100分视觉模拟量表（VAS）上由这些中断引起的压力和焦虑，在0-100 VAS上与育儿责任相关的压力，在感知压力量表（PSS）上的当前压力，在贝克焦虑量表（BAI）上的焦虑症状，在失眠严重程度指数（ISI）上的睡眠障碍，以及他们在COVID-19危机期间是否使用药物或酒精。参与者（N = 240）赞同至少有1项SUD治疗转为远程医疗（63.7%），取消了一些预约（37.5%），或因COVID-19而中断（29.6%）。 接受药物/酒精使用与不接受药物/酒精使用的参与者报告难以获得治疗SUD的药物（OR = 2.47，95% CI，1.17-5.22，χ2 = 5.98，P = 0.016），VAS治疗相关应激评分更高（F1，197 = 5.70，P =.018）和焦虑（F1，197= 4.07，P = 0.045），与育儿相关的VAS压力更大（F1，107 = 10.24，P =.002），PSS评分更高（F1，235 = 19.27，P <.001）、BAI（F1，235 = 28.59，P <.001）和ISI（F1，235= 14.41，P <.001）。 在COVID-19危机期间，提供者和公共卫生官员应努力提高护理的连续性和质量，特别注意解决儿童保育困难，并提供远程方法来改善SUD治疗人员的压力，焦虑和睡眠。
The novel 2019 coronavirus (COVID-19) crisis has caused considerable upheaval in the U.S. healthcare system. The current study examined patient-reported experiences in substance use disorder (SUD) treatment during the early stages of the COVID-19 crisis. Participants in SUD treatment were recruited via online crowdsourcing from April 14, 2020 to May 26, 2020, during the early stages of the COVID-19 crisis. Participants reported disruptions in SUD treatment, stress and anxiety caused by these disruptions on a 0-100 point visual analogue scale (VAS), stress associated with childcare responsibilities on a 0–100 VAS, current stress on the Perceived Stress Scale (PSS), anxiety symptoms on the Beck Anxiety Inventory (BAI), sleep disturbances on the Insomnia Severity Index (ISI), and whether they used drugs or alcohol during the COVID-19 crisis. Participants (N = 240) endorsed that at least 1 SUD treatment was switched to telemedicine (63.7%), had some appointments cancelled (37.5%), or was discontinued due to COVID-19 (29.6%). Participants who did versus did not endorse drug/alcohol use reported difficulty obtaining medications to treat their SUD (OR = 2.47, 95% CI, 1.17–5.22, χ2 = 5.98, P = .016), greater scores on VAS treatment-related stress (F1,197 = 5.70, P = .018) and anxiety (F1,197 = 4.07, P = .045), greater VAS stress related to childcare (F1,107 = 10.24, P = .002), and greater scores on the PSS (F1,235 = 19.27, P < .001), BAI (F1,235 = 28.59, P < .001), and ISI (F1,235 = 14.41, P < .001). Providers and public health officials should work to improve continuity and quality of care during the COVID-19 crisis, with special attention on addressing childcare difficulties and providing remote methods to improve stress, anxiety, and sleep for persons in SUD treatment.