Psychological Impact of the Acute COVID-19 Period on Patients With Substance Use Disorders: We Are All in This Together

DeJong, Cor A. J.; DeJong Verhagen, Janine G.; Pols, Robert; Verbrugge, Cor; Baldacchino, Alexander

doi:10.32598/bcn.11.covid19.2543.1

Volume 11, Issue 2 (March & April - Special Issue on COVID-19 2020) BCN 2020, 11(2): 207-216 | Back to browse issues page

‎ 10.32598/bcn.11.covid19.2543.1

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DeJong C A J, DeJong Verhagen J G, Pols R, Verbrugge C, Baldacchino A. Psychological Impact of the Acute COVID-19 Period on Patients With Substance Use Disorders: We Are All in This Together. BCN 2020; 11 (2) :207-216
URL: http://bcn.iums.ac.ir/article-1-1773-en.html

Psychological Impact of the Acute COVID-19 Period on Patients With Substance Use Disorders: We Are All in This Together

Cor A. J. DeJong ^*

¹, Janine G. DeJong Verhagen²

, Robert Pols³

, Cor Verbrugge⁴

, Alexander Baldacchino⁵

1- Behavioral Science Institute, Radboud Universiteit Nijmegen, The Netherlands.
2- Integral Recovery [Integraal Herstel], Wychen, The Netherlands.
3- Mental Health Organization (MHO) GGZ Oost Brabant, The Netherlands.
4- Novadic-Kentron Addiction Care, Vught, The Netherlands.
5- Division of Population and Health Sciences, University of St Andrews, St Andrews, Fife, Scotland, UK.

Abstract:

^{Introduction:}^{Coronavirus disease 2019 (COVID-19) results from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). it is now a pandemic that affects us all. For patients referring to the addiction care systems, this pandemic can create additional vulnerabilities. A great deal of effort has made to re-organize the care systems for patients with addiction. Our study focuses on the voice of our patients, on clues to adapt treatment, and on the impact of the pandemic on the therapeutic alliance.}

^Methods:^{A qualitative design was used to develop a description and understanding of general and clinically relevant aspects of the impact of the COVID-19 pandemic. Fifteen addicted patients (11 under treatment and 4 in recovery) were interviewed by 4 interviewers according to the COREQ (consolidated criteria for reporting qualitative research).}

^Results:^{COVID-19 has had a serious impact on thoughts, feelings, and behaviors. Interviewees shared their anxieties about their health and the health of their relatives. Frightening thoughts were associated with a range of negative feelings and behaviors, such as stress, anger, avoidance, and isolation. The use of psychoactive substances differed between the patients in treatment with those who are in stable recovery. In the former, all succeeded in staying abstinent. They have experienced that solidarity and connectedness were essential in sustaining their recovery. Those still in treatment were fighting against the temptation to start using again; they felt emotionally isolated and sometimes patronized by health care workers.}

^Conclusion:^{The elaboration of the interviewees on the therapeutic relationship provides promising clues to optimize that relationship. Remembering this common expression, “we are all in this together,” shared decision making could very well be used to shape effective and receptive treatment interventions during the different challenges faced at different stages of the COVID-19 epidemic.}

Keywords: Acute coronavirus epidemic, COVID-19, Therapeutic alliance, Professional patient relations, Psychological stress, Trauma and stressor-related disorders, Shared traumatic stress, Shared decision making

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●^{COVID-19 influenced the lives of addicted patients in a way that is comparable with how we are all affected all by the pandemic.}

● ^{Because of the mostly negative thoughts, feelings and behavior the interviewees in treatment were vulnerable to relapse.}

●^{Thoughts, feelings and behavior forms a good basis for a behavioral therapeutic intervention by making a functional analysis and challenging irrational thoughts and looking together for more rational thoughts that can reduce negative feelings.}

●^{Therapy has changed by necessary rules to mitigate COVID-19 spread, and patient and health care worker both are troubled by it. Just as Shared Decision Making helps to start a treatment, improves the working alliance, the adherence and the efficacy, this method could very well be used to shape effective and receptive treatment interventions during the different challenges faced at different stages of the COVID-19 epidemic.}

^{Plain Language Summary}

^{On several occasions it was suggested that it would be good to make addicted patients' voices heard in this COVID-19 pandemic. Anecdotes are not suitable for this, so we conducted in the second week of April a qualitative study. We were able to develop a description and understanding of general and clinically relevant aspects of the impact of pandemic. Interviewees shared anxieties about their health and the health of their relatives. Frightening thoughts were associated with a range of negative feelings and behaviors such as stress, anger, avoidance and isolation. The use of psychoactive substances differed between the patients in treatment with those who are in stable recovery. In the former all succeeded in staying abstinent. They have experienced that solidarity and connectedness were essential in sustaining their recovery. Those still in treatment were fighting against the temptation to start using again, they felt emotionally isolated and sometimes patronized by health care workers. The elaboration of the interviewees on the therapeutic relationship provides promising clues to optimize that relationship. "We are all in it together!" Shared Decision Making could very well be used to shape effective and receptive treatment interventions during the different challenges faced at different stages of the COVID-19 epidemic.}

Type of Study: Original | Subject: Clinical Neuroscience
Received: 2020/05/4 | Accepted: 2020/05/16 | Published: 2020/07/1

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