COVID-19 and Substance Use Disorders: Syndemic Responses to a Global Pandemic

As this chapter is being written, the COVID-19 pandemic is having enormous impact upon the world. This is not only from direct mortality and morbidity due to the infection itself but also from its impact upon existing health services capacity which has been reoriented to cope. Worldwide infection control measures are causing socioeconomic upheaval. Deep emotional trauma and prolonged anxiety over facing the unseen and unknown are predicted to have lasting effects on individuals and communities. This includes an increase in drug and alcohol use, mental health conditions such as posttraumatic stress disorder, depression, somatisation and anxiety, lowered perceived health and reduced resilience to adversity.Alongside this however are also huge advancements in medical science and unprecedented access to information and methods of communication through an ever-expanding digital infrastructure. Furthermore, there has been an increased understanding of the inter-relatedness of various aspects of life, the so-called determinants of health, and an explosion of multidisciplinary research approaches.This chapter proffers to the reader a framework to understand the complexities of the COVID-19 pandemic in relation to the field of addiction medicine. The proposed syndemic response requires us to see addictions and substance use disorders as existing within multiple synergistic systems of social, economic, political and cultural contexts. It opens up opportunities for more effective and responsive multidisciplinary research, interventions and programmatic evaluations. Indeed, it is a good fit for current calls for research and programmes that enable society to prepare for the psychosocial and physiological challenges that lie ahead.