University hospital of Bordeaux, Centre d'addictovigilance de Bordeaux, Department of medical pharmacology, Bordeaux F-33000, France; Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux F-33000, France; CHU de Bordeaux, Bordeaux, France.
Unité de Coordination et d'Analyse de l'Information Médicale, Département d'Information Médicale (Ucaim-DIM), Service D'information Médicale, Chu De Bordeaux, FR, France.
Int J Drug Policy. 2023 Aug;118:104082. doi: 10.1016/j.drugpo.2023.104082. Epub 2023 Jun 8.
The Covid-19 pandemic offered a unique opportunity to investigate trends in hospitalizations related to psychoactive substance intoxication, since the usual health burden of social use at parties and gatherings was likely to be decreased during lockdowns and curfew periods. Since young adults are the main users of psychoactive substances for experimental and recreational purposes, this study identified and compared hospitalization trends in young adults and adults over 30 years old.
This national cohort study was conducted using the French hospital discharge database. An interrupted time-series analysis for the period between 2014 and 2020 was performed in two groups: young (age 18-29) and other adults (30+) to ascertain the trends in the monthly incidence of hospitalization related to psychoactive substance intoxication (opiates, cocaine, benzodiazepines, psychostimulants, alcohol and cannabis). Hospitalization characteristics during the first and second lockdown and the period between them were compared to the reference period (from 01/01/2014 to 29/02/2020).
Among 1,358,007 stays associated with psychoactive substance intoxication, 215,430 concerned young adults. Compared with adults 30+, hospitalization trends in young adults showed a greater decrease in the number of stays during lockdown, with a maximum decrease of -39% during the first lockdown (1,566 vs. 2,576; CI95%: 2,285-2,868) versus -20% (10,212 vs. 12,894; CI95%: 12,001-13,787) in the second lockdown. Presentations for alcohol intoxication decreased throughout the pandemic, particularly during the second lockdown, while admissions for benzodiazepine intoxication increased during both lockdowns. Admissions for cannabis intoxication increased throughout the entire period.
Lockdowns were associated with fewer hospitalizations related to psychoactive substance intoxication in both age groups, especially among young adults, which might reflect a decrease in social use. Recreational use might therefore be an important target for prevention and risk minimization.
Covid-19 大流行提供了一个独特的机会，可以研究与精神活性物质中毒相关的住院趋势，因为在封锁和宵禁期间，社交聚会中通常的社会使用带来的健康负担可能会减少。由于年轻人是出于实验和娱乐目的使用精神活性物质的主要人群，因此本研究确定并比较了年轻人和 30 岁以上成年人的住院趋势。
本项全国性队列研究使用了法国住院数据库。在两组（18-29 岁的年轻人和 30 岁以上的其他成年人）中进行了 2014 年至 2020 年期间的中断时间序列分析，以确定与精神活性物质中毒（阿片类药物、可卡因、苯二氮䓬类、兴奋剂、酒精和大麻）相关的每月住院人数的趋势。与参考期（2014 年 1 月 1 日至 2020 年 2 月 29 日）相比，比较了第一次和第二次封锁期间以及其间的住院特征。
在 1358007 例与精神活性物质中毒相关的住院中，有 215430 例涉及年轻人。与 30 岁以上的成年人相比，年轻人的住院趋势显示在封锁期间住院人数减少幅度更大，第一次封锁期间最大减少 39%（1566 例 vs. 2576 例；95%CI：2285-2868），而第二次封锁期间减少 20%（10212 例 vs. 12894 例；95%CI：12001-13787）。整个大流行期间，酒精中毒的住院人数都在减少，特别是在第二次封锁期间，而苯二氮䓬类中毒的住院人数在两次封锁期间都有所增加。大麻中毒的住院人数在整个期间都有所增加。
封锁与两个年龄段与精神活性物质中毒相关的住院人数减少有关，尤其是年轻人，这可能反映了社交使用的减少。因此，娱乐性使用可能是预防和降低风险的一个重要目标。
