Effect of Covid-19 pandemic period on pattern of substance usage among people who use drugs (PWUD) receiving treatment at University Malaya Medical Centre (UMMC) in Malaysia / Amir Zulhilmi Yahaya

Amir Zulhilmi, Yahaya (2022) Effect of Covid-19 pandemic period on pattern of substance usage among people who use drugs (PWUD) receiving treatment at University Malaya Medical Centre (UMMC) in Malaysia / Amir Zulhilmi Yahaya. Masters thesis, Universiti Malaya.

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Abstract

COVID-19 (Coronavirus Disease 2019) was announced by World Health Organization (WHO) as a global pandemic and is rising in the number of infections around the globe. This pandemic virus causes a certain vulnerable population to have higher morbidities and mortalities, for example; Substance Use Disorder patients or people who use alcohol/illicit substances which in turn, causes a change of pattern of substance usage among them during this COVID-19 pandemic period. This study aims to determine the effects of the Covid-19 Pandemic Period on the Pattern of Substance Usage Among People Who Use Drugs ( PWUD) Receiving Treatment in the University Malaya Medical Centre (UMMC) as well as levels of anxiety and depression among them together with their coping mechanism as well as other associating factors that affected it. This is a cross sectional study among 130 peoples who use drugs/alcohol (PWUD), receiving treatment in University Malaya Medical Centre and convenient sampling was used for recruitment. The participants who agreed to participate in this study will answer an online questionnaire which include socio – demographic questionnaire, The Mini – European Web Survey On Drugs (EWSD) : COVID 19, Hospital Anxiety and Depression Scale (HADS) and Brief COPE Scale (both validated Malay and English version). The data collection took place from 6 July 2020 – 31 October 2021. The prevalence and pattern of each of the substance/alcohol use was determined. Univariate and multivariate analysis were done to determine the association between different change in the pattern of substance use with isolation status during COVID-19, depression, anxiety, and coping skills. 130 people who use drugs/alcohol (PWUD) completed the online survey. There were 36.2% of PWUDs had not used/stop the usage of illicit drugs/alcohol, 26.2% increased their usage, 20% of them decreased, and 14.6% of them used the same amount of illicit substances/alcohol during the COVID-19 Pandemic Period/ Restrictions. Most of the PWUD in UMMC used multiple substances (14.6%), followed by heroin, alcohol, and amphetamine-type stimulant (12.3% for each of them), and lastly cannabis (6.9%). Most of the PWUD increased their illicit substances/alcohol usage during the COVID-19 Pandemic Period/restrictions because of boredom (23.1%) and anxiety to cope with COVID-19 (11.6%). Around 48.5% of the PWUDs experienced physical and home isolation, 26.6% had physical isolation and 6.2% of them had physical and home isolation as well as being quarantined. There were 28.5% of PWUDs had an increased intention to seek professional support for drug counseling/treatment during the COVID-19 Pandemic Period. The prevalence of PWUD who had anxiety and depression symptoms in HADS were 33% and 41.5% respectively, with depression being associated with an increase in alcohol/illicit substance use. PWUD who experienced isolation during the COVID-19 pandemic have significantly higher odds of increasing their alcohol/illicit substances usage. There were also noted increased odds of maintaining the alcohol/illicit substance usage during the COVID-19 Pandemic Period among PWUDs who practices dysfunctional coping. PWUDs who has to increase their intention to seek professional support does have significantly higher odds of reducing their alcohol/illicit substances usage during the COVID-19 Pandemic Period. COVID-19 Pandemic does significantly affect the population of substance users in Malaysia. Our study highlighted that anxiety and depression were prevalent among PWUD. Depression, isolation status, dysfunctional coping, and intention to seek professional support does affect the pattern of alcohol/illicit substance use during the COVID-19 Pandemic Period. A more vast prospective longitudinal study is imminent to highlight these associating factors and causal relationships among them.

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