Grup Recerca Addiccions Clínic (GRAC-GRE), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona, Spain.
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Alcohol Clin Exp Res. 2021 Apr;45(4):802-807. doi: 10.1111/acer.14555. Epub 2021 Mar 5.
Patients with alcohol use disorder (AUD) are likely to suffer disproportionate harms related to the COVID-19 pandemic and related policy measures. While many surveys have been conducted, most are focused on drinking changes in the general population and validation with biological markers is lacking.
We performed a retrospective cohort study among patients with AUD attending a urine drug screening program. With mixed-effects logistic regression models, we assessed the probability of screening positive for ethyl glucuronide according to patients' main clinical characteristics and time of analysis (either prior to or after a lockdown was implemented in Spain).
A total of 362 patients provided 2,040 urine samples (1,295 prior to lockdown, 745 during lockdown). The mean age of participants was 52.0 years (SD 12.6), and 69.2% were men. Of the 43% of patients tested for other drugs 22% screened positive. After adjusting for all covariates, the odds of screening positive for ethyl glucuronide during lockdown almost doubled (OR = 1.99, 95% CI 1.20 to 3.33, p = 0.008). Other significant covariates included testing positive for other drugs (OR = 10.79, 95% CI 4.60 to 26.97) and length of treatment (OR = 0.59, 95% CI 0.47 to 0.74).
Our data support an association between the lockdown due to COVID-19 and increased alcohol use in patients with AUD. Thus, addiction healthcare systems could face significant challenges ahead. In light of these findings, it is essential to evaluate prospectively how patients with AUD are affected by the pandemic and how health systems respond to their needs.
患有酒精使用障碍（AUD）的患者可能会因 COVID-19 大流行及其相关政策措施而遭受不成比例的伤害。虽然已经进行了许多调查，但大多数调查都集中在普通人群的饮酒变化上，并且缺乏与生物标志物的验证。
我们对参加尿液药物筛查计划的 AUD 患者进行了回顾性队列研究。使用混合效应逻辑回归模型，我们根据患者的主要临床特征和分析时间（在西班牙实施封锁之前或之后）评估了乙基葡萄糖醛酸苷筛查阳性的概率。
共有 362 名患者提供了 2040 个尿液样本（1295 个在封锁前，745 个在封锁期间）。参与者的平均年龄为 52.0 岁（SD 12.6），69.2%为男性。在接受其他药物检测的 43%的患者中，有 22%筛查呈阳性。在调整了所有协变量后，在封锁期间乙基葡萄糖醛酸苷筛查阳性的几率几乎翻了一番（OR=1.99，95%CI 1.20 至 3.33，p=0.008）。其他重要的协变量包括检测出其他药物阳性（OR=10.79，95%CI 4.60 至 26.97）和治疗时间（OR=0.59，95%CI 0.47 至 0.74）。
我们的数据支持 COVID-19 导致的封锁与 AUD 患者饮酒量增加之间的关联。因此，成瘾医疗保健系统可能会面临重大挑战。鉴于这些发现，有必要前瞻性地评估 AUD 患者如何受到大流行的影响以及卫生系统如何满足他们的需求。
