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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">COVID-19 pandemic and addiction: Current problems and future concerns</title>
<author><name sortKey="Kar, Sujita Kumar" sort="Kar, Sujita Kumar" uniqKey="Kar S" first="Sujita Kumar" last="Kar">Sujita Kumar Kar</name>
<affiliation><nlm:aff id="aff0005">Department of Psychiatry, King George's Medical University, Lucknow 226003, U.P., India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Arafat, S M Yasir" sort="Arafat, S M Yasir" uniqKey="Arafat S" first="S. M. Yasir" last="Arafat">S. M. Yasir Arafat</name>
<affiliation><nlm:aff id="aff0010">Department of Psychiatry, Enam Medical College and Hospital, Dhaka 1340, Bangladesh</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sharma, Pawan" sort="Sharma, Pawan" uniqKey="Sharma P" first="Pawan" last="Sharma">Pawan Sharma</name>
<affiliation><nlm:aff id="aff0015">Department of Psychiatry, Patan Academy of Health Sciences & Medical Director, Arogin Health Care and Research Center, Nepal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dixit, Ayushi" sort="Dixit, Ayushi" uniqKey="Dixit A" first="Ayushi" last="Dixit">Ayushi Dixit</name>
<affiliation><nlm:aff id="aff0020">Clinical Psychologist, Shafa Home, Deaddiction and Rehabilitation Centre, Kotdwara, Uttarakhand, India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Marthoenis, Marthoenis" sort="Marthoenis, Marthoenis" uniqKey="Marthoenis M" first="Marthoenis" last="Marthoenis">Marthoenis Marthoenis</name>
<affiliation><nlm:aff id="aff0025">Department of Psychiatry and Mental Health Nursing, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kabir, Russell" sort="Kabir, Russell" uniqKey="Kabir R" first="Russell" last="Kabir">Russell Kabir</name>
<affiliation><nlm:aff id="aff0030">School of Allied Health, Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom</nlm:aff>
</affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">COVID-19 pandemic and addiction: Current problems and future concerns</title>
<author><name sortKey="Kar, Sujita Kumar" sort="Kar, Sujita Kumar" uniqKey="Kar S" first="Sujita Kumar" last="Kar">Sujita Kumar Kar</name>
<affiliation><nlm:aff id="aff0005">Department of Psychiatry, King George's Medical University, Lucknow 226003, U.P., India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Arafat, S M Yasir" sort="Arafat, S M Yasir" uniqKey="Arafat S" first="S. M. Yasir" last="Arafat">S. M. Yasir Arafat</name>
<affiliation><nlm:aff id="aff0010">Department of Psychiatry, Enam Medical College and Hospital, Dhaka 1340, Bangladesh</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sharma, Pawan" sort="Sharma, Pawan" uniqKey="Sharma P" first="Pawan" last="Sharma">Pawan Sharma</name>
<affiliation><nlm:aff id="aff0015">Department of Psychiatry, Patan Academy of Health Sciences & Medical Director, Arogin Health Care and Research Center, Nepal</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dixit, Ayushi" sort="Dixit, Ayushi" uniqKey="Dixit A" first="Ayushi" last="Dixit">Ayushi Dixit</name>
<affiliation><nlm:aff id="aff0020">Clinical Psychologist, Shafa Home, Deaddiction and Rehabilitation Centre, Kotdwara, Uttarakhand, India</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Marthoenis, Marthoenis" sort="Marthoenis, Marthoenis" uniqKey="Marthoenis M" first="Marthoenis" last="Marthoenis">Marthoenis Marthoenis</name>
<affiliation><nlm:aff id="aff0025">Department of Psychiatry and Mental Health Nursing, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kabir, Russell" sort="Kabir, Russell" uniqKey="Kabir R" first="Russell" last="Kabir">Russell Kabir</name>
<affiliation><nlm:aff id="aff0030">School of Allied Health, Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Asian Journal of Psychiatry</title>
<idno type="ISSN">1876-2018</idno>
<idno type="eISSN">1876-2026</idno>
<imprint><date when="2020">2020</date>
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<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Banerjee, D" uniqKey="Banerjee D">D. Banerjee</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mackenzie, J S" uniqKey="Mackenzie J">J.S. Mackenzie</name>
</author>
<author><name sortKey="Smith, D W" uniqKey="Smith D">D.W. Smith</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="O Ullivan, T" uniqKey="O Ullivan T">T. O’Sullivan</name>
</author>
<author><name sortKey="Bourgoin, M" uniqKey="Bourgoin M">M. Bourgoin</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Organization, W H" uniqKey="Organization W">W.H. Organization</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Russell, B" uniqKey="Russell B">B. Russell</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Yao, H" uniqKey="Yao H">H. Yao</name>
</author>
<author><name sortKey="Chen, J H" uniqKey="Chen J">J.-H. Chen</name>
</author>
<author><name sortKey="Xu, Y F" uniqKey="Xu Y">Y.-F. Xu</name>
</author>
</analytic>
</biblStruct>
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<pmc article-type="letter"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Asian J Psychiatr</journal-id>
<journal-id journal-id-type="iso-abbrev">Asian J Psychiatr</journal-id>
<journal-title-group><journal-title>Asian Journal of Psychiatry</journal-title>
</journal-title-group>
<issn pub-type="ppub">1876-2018</issn>
<issn pub-type="epub">1876-2026</issn>
<publisher><publisher-name>Elsevier B.V.</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">32305033</article-id>
<article-id pub-id-type="pmc">7151310</article-id>
<article-id pub-id-type="publisher-id">S1876-2018(20)30175-1</article-id>
<article-id pub-id-type="doi">10.1016/j.ajp.2020.102064</article-id>
<article-id pub-id-type="publisher-id">102064</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>COVID-19 pandemic and addiction: Current problems and future concerns</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Kar</surname>
<given-names>Sujita Kumar</given-names>
</name>
<email>drsujita@gmail.com</email>
<xref rid="aff0005" ref-type="aff">a</xref>
<xref rid="cor0005" ref-type="corresp">*</xref>
</contrib>
<contrib contrib-type="author" id="aut0010"><name><surname>Arafat</surname>
<given-names>S.M. Yasir</given-names>
</name>
<email>arafatdmc62@gmail.com</email>
<xref rid="aff0010" ref-type="aff">b</xref>
</contrib>
<contrib contrib-type="author" id="aut0015"><name><surname>Sharma</surname>
<given-names>Pawan</given-names>
</name>
<email>pawan60@gmail.com</email>
<xref rid="aff0015" ref-type="aff">c</xref>
</contrib>
<contrib contrib-type="author" id="aut0020"><name><surname>Dixit</surname>
<given-names>Ayushi</given-names>
</name>
<email>ayushid287@gmail.com</email>
<xref rid="aff0020" ref-type="aff">d</xref>
</contrib>
<contrib contrib-type="author" id="aut0025"><name><surname>Marthoenis</surname>
<given-names>Marthoenis</given-names>
</name>
<email>marthoenis@hotmail.com</email>
<xref rid="aff0025" ref-type="aff">e</xref>
</contrib>
<contrib contrib-type="author" id="aut0030"><name><surname>Kabir</surname>
<given-names>Russell</given-names>
</name>
<email>russellkabir@live.co.uk</email>
<xref rid="aff0030" ref-type="aff">f</xref>
</contrib>
</contrib-group>
<aff id="aff0005"><label>a</label>
Department of Psychiatry, King George's Medical University, Lucknow 226003, U.P., India</aff>
<aff id="aff0010"><label>b</label>
Department of Psychiatry, Enam Medical College and Hospital, Dhaka 1340, Bangladesh</aff>
<aff id="aff0015"><label>c</label>
Department of Psychiatry, Patan Academy of Health Sciences & Medical Director, Arogin Health Care and Research Center, Nepal</aff>
<aff id="aff0020"><label>d</label>
Clinical Psychologist, Shafa Home, Deaddiction and Rehabilitation Centre, Kotdwara, Uttarakhand, India</aff>
<aff id="aff0025"><label>e</label>
Department of Psychiatry and Mental Health Nursing, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia</aff>
<aff id="aff0030"><label>f</label>
School of Allied Health, Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom</aff>
<author-notes><corresp id="cor0005"><label>⁎</label>
Corresponding author. <email>drsujita@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="pmc-release"><day>10</day>
<month>4</month>
<year>2020</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>6</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub"><day>10</day>
<month>4</month>
<year>2020</year>
</pub-date>
<volume>51</volume>
<fpage>102064</fpage>
<lpage>102064</lpage>
<history><date date-type="received"><day>29</day>
<month>3</month>
<year>2020</year>
</date>
<date date-type="accepted"><day>31</day>
<month>3</month>
<year>2020</year>
</date>
</history>
<permissions><copyright-statement>© 2020 Elsevier B.V. All rights reserved.</copyright-statement>
<copyright-year>2020</copyright-year>
<copyright-holder>Elsevier B.V.</copyright-holder>
<license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p>
</license>
</permissions>
<kwd-group id="kwd0005"><title>Keywords</title>
<kwd>COVID-19</kwd>
<kwd>Pandemic</kwd>
<kwd>Addiction</kwd>
</kwd-group>
</article-meta>
</front>
<body><p content-type="salutation">To the Editor,</p>
<p id="par0005">COVID-19 pandemic is a global public health emergency. It affected more than 512,000 people with 23,495 confirmed deaths in 202 countries by 28th March 2020 (<xref rid="bib0020" ref-type="bibr">Organization, 2020</xref>
). The disease spread rapidly across the globe due to the unique properties of the virus (extraordinary genetic diversity, highly contagious, easy mode of spread, relatively unaffected by climatic variations) (<xref rid="bib0010" ref-type="bibr">Mackenzie and Smith, 2020</xref>
). People around the globe, during this crisis period, are expected to encounter several mental health challenges ranging from panic, phobia, health anxiety, sleep disturbances to dissociative like symptoms (<xref rid="bib0005" ref-type="bibr">Banerjee, 2020</xref>
). Along with these, addictive behaviors could be potential reasons for nuisance during the locked-down period and subsequently, newer behavioral addictions could emerge especially for the teens.</p>
<p id="par0010">People are advised to stay at home, maintaining social distancing and avoiding travel. Schools, restaurants, pubs, offices, shops have been closed resulting in inaccessibility to substances. Staying at home setting and isolating from the society, also reduces the risk of substance consumption. Social celebrations and partying are restricted. These situations are conducive to substance use. To reduce the spread of COVID-19, social distancing technique is often promoted; the morality behind it is not to limit socialization but to enhance physical distancing to prevent the spread of infection. An individual is free to socialize online, rather than offline; however, online socialization is unlikely to build peer pressure to that extent, which expected to happen in direct socialization. Social distancing and limited socialization also reduce the possibility of peer pressure for substance use. Hence, people who were addicted to any kind of substance use independence pattern are expected to experience withdrawal symptoms. The above factors convey that the social restriction and locked down states in most parts of the world can be a risky affair in the short-run, as many of the individuals can have severe withdrawal symptoms, which can be life-threatening at times (for example- alcohol withdrawal seizures and delirium tremens).</p>
<p id="par0015">On the other hand, as the sources of pleasure are limited to indoor activities, people spend a substantial period watching television and their electronic gadgets. As the impact of pandemic lasting for a long time, the binge-watching of television and electronic gadgets are also likely to persist; which may later result in behavioral addiction. There are higher chances for the young generation to develop behavioral addictions, especially in developing countries.</p>
<p id="par0020">Another important area to look at would be the patients with opioid dependence and undergoing daily dispensing agonist treatment. Missing a single dosage at the time of lockdown would lead to relapse. When the whole world is preparing to fight the pandemic they could be missed (<xref rid="bib0025" ref-type="bibr">Russell, 2010</xref>
). Also, it is an accepted truth that the patients with substance use problems are vulnerable populations during the time of pandemic both for being infected or regarding complications (<xref rid="bib0015" ref-type="bibr">O’Sullivan and Bourgoin, 2010</xref>
). Furthermore, those who are addicted to specific drugs and could not obtain any supply due to the lockdown period, they might try to make home-made alcoholic spirits. The spirits might have a high risk of alcohol toxicity and can cause poisoning and fatality.</p>
<p id="par0025">There is an urgent need to address the mental health issues of people during this pandemic. Most of the countries in the world are adapting lockdown measure to reduce the spread of the infection, the health services are struggling to deal with the daily rise of infected cases hence little attention is provided to the substance user during this pandemic so proper measures and support services should be established to help this vulnerable community. It is highly important to address mental health emergencies like severe and complicated withdrawal symptoms of substance use. Milder symptoms can be addressed through online psychiatric consultation (<xref rid="bib0030" ref-type="bibr">Yao et al., 2020</xref>
). There is a need to sensitize people about the addiction-related issues during this pandemic. A mental health helpline may be useful to address specific queries. A special focus for the young person to prevent them from developing the behavioral addictions could be thought as they are more prone to develop it.</p>
<sec id="sec0005"><title>Authors’ contributions</title>
<p id="par0030">Conception & Design: SK Kar, Ayushi Dixit</p>
<p id="par0035">Drafting of the manuscript: SK Kar, SMY Arafat, Pawan Sharma, M Marthoenis, R Kabir</p>
<p id="par0040">Critical revision of the manuscript: All authors</p>
<p id="par0045">Final Approval of the manuscript: All authors</p>
</sec>
<sec id="sec0010"><title>Funding</title>
<p id="par0050">None</p>
</sec>
<sec sec-type="COI-statement"><title>Declaration of Competing Interest</title>
<p id="par0055">None.</p>
</sec>
</body>
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<ack id="ack0005"><title>Acknowledgement</title>
<p>None.</p>
</ack>
</back>
</pmc>
</record>
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