Bulgarian Journal of Psychiatry, 2021; 6(1):19-30
SUBSTANCE USE DISORDERS DURING THE CORONAVIRUS PANDEMIC. ALGORITHM FOR INPATIENT TREATMENT OF ADDICTION IN THE GLOBAL CRISIS
Katrin Aryutova1,2, Vladimir Nikolov1,3, Dimitar Radoev1
1State Psychiatric Hospital for Treatment of Drug Addiction and Alcoholism – Sofia
2 Department of Psychiatry and Medical Psychology, Medical University – Plovdiv
3 Department of Psychiatry and Medical Psychology, Medical University – Sofia
Abstract. Substance addiction is biopsychosocial disorder which occurs with health-threatening behaviors that determine the development of co-morbid somatic diseases. The patients are a vulnerable group in pandemic of the Coronavirus disease 2019 (COVID-19) caused by the new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The accompanying somatic problems and the characteristic substance-seeking behavior are a prerequisite for a severe course and poor prognosis of COVID-19 among patients suffering from substance use disorders. Objectives: Due to the social isolation and reduced resource of health services in the context of a pandemic, access to many of the key therapeutic elements in the treatment of addictions has been reduced. This led to an increase in the need for hospital care and necessitated the development of an Inpatient Treatment Algorithm at the State Psychiatric Hospital for Treatment of Drug Addiction and Alcoholism during the COVID-19 pandemic. Materials and methods: For the period from 26.03.2020 to 26.11.2020, 143 patients with substance use disorders were hospitalized in the State Psychiatric Hospital for Treatment of Drug Addiction and Alcoholism. During this process, all the recommendations of the World Health Organization and the restrictive measures imposed by the Ministry of Health were followed. Each patient underwent a PCR test and followed isolation measures were applied until the results were obtained. Cross-education was conducted among the hospital staff and specialized medical teams were formed, providing continuous care for new patients. Results: We have developed 3 Algorithms for inpatient admission, in accordance with the current epidemic conditions and the relevant legal provisions. The three models have proven feasibility and effectiveness, both in meeting the needs of people suffering from substance use disorders and in the prevention of COVID-19 infection among medical staff and already hospitalized patients. Conclusion: In the conditions of a pandemic, it is necessary to introduce innovative strategies to deal with the increased needs for medical care of addicts. We propose the hypothesis that the Algorithms developed by the State Psychiatric Hospital for Treatment of Drug Addiction and Alcoholism have the potential to be applied to any risk contingent of patients in the conditions of global crisis.
Key words: addiction, pandemic, inpatient treatment, COVID-19
Full text (in Bulgarian) here.