New Realities: Understanding addiction during the pandemic
In March 2020, the provincial government made the difficult decision to temporarily close many businesses that were deemed non-essential. The introduction of infection control protocols and reduced capacities allowed essential businesses – food retailers, pharmacies, etc. – to continue operating. Naturally, public debate over which businesses should be deemed “essential” ensued.
To the surprise of many, LCBO stores were allowed to remain open. Surely Ontarians could go without liquor for a short period. After all, alcohol is Canada’s most commonly abused addictive substance, causing hospitalizations at a rate comparable to heart attacks. So why were these Crown-operated liquor stores deemed essential?
Researchers at the Peter Boris Centre for Addictions Research (PBCAR) are helping to understand the effects of the COVID-19 pandemic in relation to addiction
The decision may have seemed counterintuitive to those unaware of the realities of alcohol dependence. With bars and restaurants temporarily shuttered, an LCBO closure would have increased the risk to those suffering from alcoholism, leading to a rise in withdrawal-related hospitalizations. This was already a crucial time for hospitals, which were busy preparing for a surge in COVID-19 patients. Even though keeping LCBO stores open meant a slightly increased risk of community spread, effective safety measures like physical distancing, masking, and hand sanitizing addressed those risks.
Ultimately, when public policy is guided by science, society is better able to understand and address the nuances of many key issues. Without an evidence-based approach, unintentional harms can be introduced, even with the best of intentions.
The Peter Boris Centre for Addictions Research (PBCAR) at St. Joseph’s Healthcare Hamilton conducts state-of-the-art research on the causes, consequences, and treatment of addiction. Researchers conduct empirical investigations across four broad domains: psychological science, cognitive neuroscience, behavioural genetics, and clinical research. Their work impacts the development of addiction interventions as well as public policy.
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Without proper medical supervision, alcohol withdrawal can lead to symptoms that include anxiety, nausea, high blood pressure, fever, hallucinations, and much more. A medically supervised detox program can help reduce and manage side effects during recovery from alcohol dependence.
Since the pandemic began, researchers at the PBCAR have paid close attention to its effects on mental health and addiction.
“The most troubling impact of the pandemic is the spike in opioid overdose deaths. This is because public health measures like physical distancing and quarantining lead to social isolation and solitary drug use,” explains Dr. James MacKillop, Director of the PBCAR and Professor in the Department of Psychology and Behavioural Neurosciences at McMaster University. “Using alone is a major risk factor for overdose because the rescue medication naloxone can’t be used. Unfortunately, what’s happening is that the existing problem with highly toxic opioids being present in the drug supply is being significantly exacerbated by the pandemic.”
Researchers at the PBCAR have been busy developing and adapting studies to incorporate the effects of COVID-19 across a broad range of addictions. For example, prior to the pandemic Dr. MacKillop began conducting a longitudinal study called PATH Cann, which aims to characterize patterns of change in a number of different areas over the course of cannabis legalization. In June 2020, the PATH Cann team was awarded over $400,000 from the Canadian Institutes of Health Research to expand the study, allowing supplementary data collection related to the impacts of COVID-19. Researchers have recently completed their third follow-up as part of this study, which will help them develop pandemic-related insights.
Researchers at the PBCAR make use of state-of-the-art imaging in some of their research to better understand physiological aspects of addiction
“It is critical that we systematically examine pandemic impacts on substance use because so much of what we are hearing is based on anecdote,” says Dr. MacKillop.
It has been nearly a year since Ontario was first hit by the coronavirus pandemic, and individuals across the board have been affected to varying degrees, both mentally and physically. Surprisingly, some aspects of the pandemic and accompanying social restrictions have had unexpected effects on some populations typically affected by addictive substances.
“One of the things we are learning in Peter Boris Centre studies is that not all news is bad,” adds Dr. MacKillop. “Although it is certainly the case that some people are increasing their alcohol or cannabis use, in other cases, such as in heavy drinking young adults, levels are going down. In addition, among people in recovery, we are also seeing reports of stories of resilience and unanticipated coping strategies.”
The complex social aspects that are intertwined with addiction have become even more enigmatic as the constantly evolving pandemic continues to run its course. Fortunately, researchers at the PBCAR are expediting their work – identifying risk factors and effective coping strategies with the goal of helping patients weather the challenges of the pandemic as successfully as possible.