Document Type : Letter to Editor

Authors

Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran

Abstract

Corona Virus Disease 2019 (COVID-19), a cluster of acute respiratory illness with unknown causes, occurred in Wuhan, Hubei Province, China since December 2019(1). COVID-19, a contagious disease, has spread all around the globe. It has affected almost every country on the planet (2). COVID-19 was declared as a pandemic on January 30, 2020 by WHO(3). This rapid growth in the number of infected people has enforced every country to take appropriate actions to control this disease(3).
The most effective way to stop COVID-19 that human being had used to battle epidemics for hundreds of years is quarantine or isolation(4). Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick. This definition differs from isolation, which is the separation of sick people with a contagious disease from people who are not sick. The  two  terms  are  often  used  interchangeably,  especially  in  communication  with  the  public(5). In recent outbreak of COVID-19, many countries have taken various kinds of quarantine measures to slow down the explosive spread of COVID-19. Effective and reasonable quarantine appears to be able to slow the spread of the virus until research finds an effective medical treatment(4).The quarantine is proven to be effective against the disease, but there are some side effects which includes the   effect on human psychology and  world economic crisis(6).
Findings of the study  conducted by Nelson et al. indicated that mental health symptoms were currently elevated compared to historical norms, and that variation in these symptoms were associated with COVID-19 concern when compared to epidemiological data signifying objective risk. Loss of employment is associated with greater depressive symptoms and COVID-19 concern, and both anxiety symptoms and psychological concern about COVID-19 were the strongest predictors of self-quarantine behavior(7). Under such circumstances, vulnerable people may turn to ineffective defense mechanisms such as smoking, alcohol, and drugs to relieve their psychological pain(8). Therefore, although the pandemic threatens everyone, it is a particularly high risk to people with alcohol and drug use disorders. In fact, studies show that even the fear of job loss can increase the consumption of alcohol, tobacco and prescription drugs. Those who are unemployed are much likely to use drugs or alcohol and develop substance use disorders. Those in recovery are also more likely to return to substance use, and job loss is a substantial trigger for relapse(9, 10). Also, due to COVID-19 outbreak and quarantine, the psychiatric sessions and counseling of these people may be interrupted.  Therefore, there is an urgent need to address the mental health issues of substance users during the Novel Coronavirus Disease pandemic and it is necessary to consider measures to prevent the occurrence and return of addictive behaviors.
Conflicts of interest:
 Nothing to declare.

Keywords

1.         Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. New England Journal of Medicine. 2020.
2.         World Health Organization. Laboratory testing for coronavirus disease 2019 (COVID-19) in suspected human cases: interim guidance, 2 March 2020. World Health Organization; 2020.
3.         Jones DS. History in a crisis—lessons for Covid-19. New England Journal of Medicine. 2020.
4.         Hu W, Su L, Qiao J, Zhu J, Zhou Y. Countrywide quarantine only mildly increased anxiety level during COVID-19 outbreak in China. medRxiv. 2020.
5.         Centers for Disease Control and Prevention. Quarantine and Isolation  [updated September 29, 2017. Available from: https://www.cdc.gov/quarantine/index.html.
6.         Tahir MB, Masood A. The COVID-19 Outbreak: Other Parallel Problems. Available at SSRN 3572258. 2020.
7.         Nelson B, Pettitt AK, Flannery J, Allen N. Psychological and Epidemiological Predictors of COVID-19 Concern and Health-related Behaviors. 2020.
8.         Bazrafshan MR, Sharif F, Molazem Z, Mani A. Cultural concepts and themes of suicidal attempt among Iranian adolescents. Int J High Risk Behav Addict. 2015;4(1).
9.         Henkel D. Unemployment and substance use: a review of the literature (1990-2010). Current drug abuse reviews. 2011;4(1):4-27.
10.       Alexander GC, Stoller KB, Haffajee RL, Saloner B. An epidemic in the midst of a pandemic: opioid use disorder and COVID-19. American College of Physicians; 2020.