Substance use and abuse, COVID-19-related distress, and disregard for social distancing: A network analysis

Addict Behav. 2021 Mar:114:106754. doi: 10.1016/j.addbeh.2020.106754. Epub 2020 Dec 3.


Research shows that there has been a substantial increase in substance use and abuse during the COVID-19 pandemic, and that substance use/abuse is a commonly reported way of coping with anxiety concerning COVID-19. Anxiety about COVID-19 is more than simply worry about infection. Research provides evidence of a COVID Stress Syndrome characterized by (1) worry about the dangers of COVID-19 and worry about coming into contact with coronavirus contaminated objects or surfaces, (2) worry about the personal socioeconomic impact of COVID-19, (3) xenophobic worries that foreigners are spreading COVID-19, (4) COVID-19-related traumatic stress symptoms (e.g., nightmares), and (5) COVID-19-related compulsive checking and reassurance-seeking. These form a network of interrelated nodes. Research also provides evidence of another constellation or "syndrome", characterized by (1) belief that one has robust physical health against COVID-19, (2) belief that the threat of COVID-19 has been exaggerated, and (3) disregard for social distancing. These also form a network of nodes known as a COVID-19 Disregard Syndrome. The present study, based on a population-representative sample of 3075 American and Canadian adults, sought to investigate how these syndromes are related to substance use and abuse. We found substantial COVID-19-related increases in alcohol and drug use. Network analyses indicated that although the two syndromes are negatively correlated with one another, they both have positive links to alcohol and drug abuse. More specifically, COVID-19-related traumatic stress symptoms and the tendency to disregard social distancing were both linked to substance abuse. Clinical and public health implications are discussed.

Keywords: Alcohol abuse; COVID stress syndrome; COVID-19; Drug abuse; Network analysis; Social distancing.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Physical Distancing*
  • Quarantine / psychology*
  • Social Network Analysis*
  • Stress, Psychological / psychology*
  • Substance-Related Disorders / psychology*
  • Young Adult