Illicit Drug Use Patterns among Hospitalized Patients after the COVID-19 Pandemic and Economic Crisis

Year 2024, Volume: 25 Issue: 3, 254 - 261, 30.09.2024

Ali Baran Tanrıkulu Onur Koçhan

https://doi.org/10.51982/bagimli.1381269

Abstract

Objective: This study aimed to investigate the impact of the COVID-19 pandemic and subsequent economic crisis on illicit drug use patterns in Türkiye.
Method: The study population comprised 1027 patients diagnosed with substance use disorder (SUD). 615 patients who were hospitalized between May 2018-December 2019 and 412 patients who were hospitalized between December 2021-August 2023 at the Alcohol-Drug Addiction Research, Treatment and Training Center in Elazığ Mental Health and Diseases Hospital were recruited to study.
Results: The rate of opioid-positive results was significantly higher in the May 2018-December 2019 group. The rate of methamphetamine-positive results was significantly higher in the December 2021 - August 2023 group. The rate of cannabis-positive results was found to be similar between the two groups. The treatment completion rate was significantly lower in methamphetamine-positive patients when compared with methamphetamine-negative patients. The treatment completion rate was significantly higher in opioid-positive patients when compared with opioid-negative patients.
Discussion: While methamphetamine consumption has significantly increased, opioid consumption has significantly decreased in the wake of the economic crisis in Türkiye and the COVID-19 pandemic. Monitoring changes in illicit drug use patterns could help take appropriate measures.

Keywords

Illicit drug use, methamphetamine, COVID-19, economic crisis

COVID-19 Pandemisi ve Ekonomik Kriz Sonrasında Hastanede Yatan Hastalarda Madde Kullanım Örüntüleri

Abstract

Amaç: Bu çalışma COVID-19 salgınının ve ardından gelen ekonomik krizin Türkiye'deki yasa dışı madde kullanım paternleri üzerindeki etkisini araştırmayı amaçlanmıştır.
Yöntem: DSM-5 kriterlerine göre madde kullanım bozukluğu tanısı alan 1027 hasta çalışmaya dahil edildi. Elazığ Ruh Sağlığı ve Hastalıkları Hastanesi Alkol ve Madde Bağımlılığı Tedavi Eğitim Merkezi'nde Mayıs 2018 - Aralık 2019 tarihleri arasında yatan 615 hasta ve Aralık 2021 - Ağustos 2023 tarihleri arasında yatan 412 hasta çalışmaya alındı.
Bulgular: Ürinaliz testinde pozitif opioid sonuçlarının oranı Mayıs 2018 - Aralık 2019 grubunda anlamlı derecede yüksekti. Ürinaliz testinde pozitif metamfetamin sonuçlarının oranı Aralık 2021 - Ağustos 2023 grubunda anlamlı derecede yüksekti. Pozitif esrar sonuçlarının oranı iki zaman aralığında benzer bulundu. Metamfetamin kullanan hastalarda tedaviyi tamamlama oranı metamfetamin kullanmayan hastalara göre anlamlı derecede düşük bulundu. Opioid kullanan hastalarda tedaviyi tamamlama oranı, opioid kullanmayan hastalara göre anlamlı derecede yüksekti.
Tartışma: Çalışmamız, Türkiye'de yaşanan ekonomik kriz ve COVID-19 salgını sonrasında hastanede yatan hastalarda metamfetamin tüketim oranının anlamlı düzeyde arttığını, opioid tüketiminin ise anlamlı düzeyde azaldığını göstermektedir. Yasa dışı madde kullanım patternlerindeki değişimlerin izlenmesi ve ilişkili faktörlerin takip edilmesi uygun tedbirlerin alınması ve tedavi yaklaşımlarının geliştirilmesine yardımcı olacaktır.

Keywords

Yasa dışı madde kullanımı, metamfetamin, COVİD-19, ekonomik kriz

References

• WHO. Atlas on Substance Use (2010): Resources For The Prevention and Treatment of Substance Use Disorders. Geneva: World Health Organization, 2010.
• Daley DC. Family and social aspects of substance use disorders and treatment. J Food Drug Anal. 2013; 21(4): 73-76.
• Ilhan IÖ, Yıldırım F, Demirbaş H, et al. Prevalence and sociodemographic correlates of substance use in a university-student sample in Turkey. Int J Public Health. 2009; 54: 40-44.
• Ilhan MN, Arikan Z, Kotan Z, et al. Prevalence and socio-demographic determinants of tobacco, alcohol, substance use and drug misuse in general population in Turkey. Noro Psikiyatri Ars 2016; 53(3): 205-212.
• Emniyet Genel Müdürlüğü. Türkiye Genel Nüfusta Tütün, Alkol ve Madde Kullanımına Yönelik Tutum ve Davranış Araştırması Raporu. Ankara: Emniyet Genel Müdürlüğü. 2018: 1-13.
• Ünübol H, Hızlı Sayar G. Prevalence and sociodemographic determinants of substance use in Turkey. Eur Addict Res 2021; 27(6): 447-456.
• Turkish National Police Counter Narcotics Department. 2023 Turkish Drug Report. Ankara: Turkish National Police Counter Narcotics Department, 2023. .
• Turkish National Police Counter Narcotics Department, 2018 Turkish Drug Report. Ankara: Turkish National Police Counter Narcotics Department, 2018.
• Williams SN, Armitage CJ, Tampe T, et al. Public perceptions and experiences of social distancing and social isolation during the COVID-19 pandemic: A UK-based focus group study. BMJ Open. 2020; 10: e039334.
• Nicola M, Alsafi Z, Sohrabi C, et al. The socio-economic implications of the coronavirus pandemic (COVID-19): A review. Int J Surg 2020; 78: 185-193.
• United Nations Office on Drugs and Crime (UNODC). COVID-19 and the Drug Supply Chain: From Production and Trafficking to Use. Vienna: United Nations Office on Drugs and Crime, 2020.
• Gili A, Bacci M, Aroni K, et al. Changes in drug use patterns during the COVID-19 pandemic in Italy: monitoring a vulnerable group by hair analysis. Int J Environ Res Public Health 2021; 18: 1967.
• Price O, Man N, Bruno R, et al. Changes in illicit drug use and markets with the COVID‐19 pandemic and associated restrictions: findings from the Ecstasy and Related Drugs Reporting System, 2016–20. Addiction. 2022; 117(1): 182-194.
• Malczewski A, Kidawa M, Bevz M. The Impact of the COVID-19 Epidemic on Drug Services, Drug Users and Drug Market in Poland: Findings of the Rapid Situation Assessment. Warsaw: Reitox National Focal Point National Bureau for Drug Prevention, 2020.
• Taskinsoy J. COVID-19 could cause bigger cracks in Turkey’s fragile crisis prone economy. SSRN 2020; doi:10.2139/ssrn.3613367.
• Kondilis E, Giannakopoulos S, Gavana M, et al. Economic crisis, restrictive policies, and the population’s health and health care: the Greek case. Am J Public Health. 2013; 103(6): 973-979.
• Colell E, Sánchez‐Niubò A, Delclos GL, et al. Economic crisis and changes in drug use in the Spanish economically active population. Addiction. 2015; 110(7): 1129-1137.
• Storti CC, De Grauwe P and Reuter P. Economic recession, drug use and public health. Int J Drug Policy 2011; 22(5): 321-325.
• Zuccato E, Castiglioni S, Tettamanti M, et al. Changes in illicit drug consumption patterns in 2009 detected by wastewater analysis. Drug Alcohol Depend 2011; 118(2-3): 464-469.
• Apaydin F and Çoban MK. The political consequences of dependent financialization: Capital flows, crisis and the authoritarian turn in Turkey. Rev Int Polit Econ 2023; 30(3): 1046-1072.
• European Monitoring Centre for Drugs and Drug Addiction. Exploring Methamphetamine Trends in Europe, EMCDDA Papers. Luxembourg, Publications Office of the European Union, 2014. .
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Washington, DC: American Psychiatric Association, 2013.
• George D. SPSS for Windows Step By Step: A Simple Study Guide And Reference, 17.0 update, 10/e. London: Pearson Education, 2011.
• TCMB. Turkish Statistical Institute Report Consumer Price Index 2023. Ankara: TCMB, 2023.
• Zolopa C, Hoj S, Bruneau J, et al. A rapid review of the impacts of “Big Events” on risks, harms, and service delivery among people who use drugs: Implications for responding to COVID-19. Int J Drug Policy. 2021; 92: 103127.
• Pavarin RM, Sanchini S, Marani S, et al. Mortality risk among cocaine users before and after the economic recession: results of a longitudinal study. Eur Addict Res 2020; 26(1): 10-19.
• Tarján A, Dudás M, Gyarmathy VA, et al. Emerging risks due to new injecting patterns in Hungary during austerity times. Subst Use Misuse. 2015; 50(7): 848-858.
• Ondocsin J, Holm N, Mars SG, et al. The motives and methods of methamphetamine and ‘heroin’co-use in West Virginia. Harm Reduct J 2023; 20(1): 88.
• Turkish Statistical Institute Report. Consumer-Price-Index-October-2022. Ankara: Turkish Statistical Institute, 2022.
• Fazli S. Narcotics Smuggling in Afghanistan: Links between Afghanistan and Pakistan. SOC ACE Research Paper No. 9. Birmingham, UK: University of Birmingham, 2022.
• United Nations Office on Drugs and Crime. Understanding Illegal Methamphetamine Manufacture in Afghanistan. Vienna: United Nations Office on Drugs and Crime, 2023.
• Campbell ND, Lovell AM. The history of the development of buprenorphine as an addiction therapeutic. Ann N Y Acad Sci 2012; 1248: 124-139.
• Sung S, Conry JM. Role of buprenorphine in the management of heroin addiction. Ann Pharmacother 2006; 40(3): 501-505.
• Evren C. Current status of buprenorphine/naloxone maintenance treatment in Istanbul Turkey. Addicta: The Turkish Journal on Addictions. 2014; 1(1): 48-63.
• Moszczynska A. Current and emerging treatments for methamphetamine use disorder. Curr Neuropharmacol. 2021; 19(12): 2077-2091.
• McGregor C, Srisurapanont M, Jittiwutikarn J, et al. The nature, time course and severity of methamphetamine withdrawal. Addiction. 2005; 100(9): 1320-1329.