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LETTER TO EDITOR
Year : 2021  |  Volume : 30  |  Issue : 2  |  Page : 364-365  Table of Contents     

COVID-19 in India: Vulnerable migrant population and an added menace of substance abuse


1 Department of Forensic Medine and Toxicology, AIIMS, Rishikesh, Uttarakhand, India
2 Faculty of Life Sciences and Biotechnology, South Asian University (SAU), New Delhi, India
3 Department of Psychiatry, AIIMS, Bibinagar, Telangana, India

Date of Submission13-Feb-2021
Date of Acceptance18-May-2021
Date of Web Publication29-Jul-2021

Correspondence Address:
Dr. Rishi Sharma
PhD Scholar, Department of Forensic Medicine and Toxicology, AIIMS, Rishikesh - 249 203, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ipj.ipj_168_20

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How to cite this article:
Sharma R, Bisht R, Tikka SK, Bhute AR, Bastia BK. COVID-19 in India: Vulnerable migrant population and an added menace of substance abuse. Ind Psychiatry J 2021;30:364-5

How to cite this URL:
Sharma R, Bisht R, Tikka SK, Bhute AR, Bastia BK. COVID-19 in India: Vulnerable migrant population and an added menace of substance abuse. Ind Psychiatry J [serial online] 2021 [cited 2021 Dec 7];30:364-5. Available from: https://www.industrialpsychiatry.org/text.asp?2021/30/2/364/322647



COVID-19 pandemic has affected more than 10.9 million and killed more than 1.5 lacs people in India (on February 11, 2021). The country resorted to a nationwide lockdown to prevent the spread of COVID-19. Differential impact of COVID-19 and lockdown resulted in mass unemployment, economic fallout, indebtedness, homelessness, poverty, mental health crisis, and substance abuse. COVID-19 has disproportionally affected the poor as lockdown brought immense economic distress causing many workers to lose livelihood and shelter, ultimately resulting in a mass exodus to their native place.

Findings of recently published articles on the mental health of migrant laborers[1] and the industrial impact of COVID-19[2] are quite significant. Apart from the issues raised in these articles, there is an urgent need to address substance abuse and associated risks among India's migrant population. Daily wage seasonal migrant workers are among the most vulnerable, marginalized, and adversely affected community groups who experience social exclusion, discrimination, inequality, and have poor access to education and public schemes, which render them more prone to stress, strain, and mental disorders leading to increased dependency on psychoactive substances (tobacco – 53.9%, alcohol – 46.5%, and cannabis – 8.9%).[3]

COVID-19 has substantially aggravated preexisting psychological conditions and contributed to increased substance use (cannabis – 63% and alcohol – 71.7%) reported by a global survey.[4] Lockdown affected supply-chain of nonessential items (also liquor and tobacco), which lead to a shortage, high demand, and increased cost, thereby reduced access to chronic abusers. A similar shift in drug abuse behavior was observed during the 2008 global financial crisis, prominently because of the affected delivery of services.[5] There is a risk of a similar drug abuse trend due to COVID-19-induced drug supply changes. A recurring cycle of drug availability and shortage can have a catastrophic impact on the mental health of chronic abusers with possible self-harm behaviors and suicide attempts due to sudden withdrawal.[6] Reports suggest a 50% rise in the number of patients reporting to the emergency department for alcohol and drug withdrawal-related issues.[7] In India, studies found a significant surge in substance abuse cases and registrations in de-addiction centers for treatment since the outbreak.[8] Although there are only a few studies in the Indian context, we are closely monitoring the substance abuse (particularly cannabis abuse) cases postlockdown. Our group contacted the patients and private-run rehabilitation clinics to procure data on cannabis use disorder in the general population under an ongoing project, “To determine the impact of lockdown on patients with cannabis use disorder.” We have recorded an increased number of requests for registration in the rehabilitation program and elevated withdrawal symptoms observed among newly enrolled patients.

Due to the grave impact of pandemic restrictions on migrant workers, they are less likely to comply with public guidelines during future restrictions if any and might be at higher risk to substance abuse. For the management of drug abuse, we suggest strategies such as information collection of existing drug users, monitoring distressing cases and suicide attempts, and providing dedicated telepsychiatry services for migrant workers. In addition, the arrangement of mental health-care centers, transportation facilities, counseling, online training module, and training sessions by psychiatrists and psychologists would be beneficial.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Singh O. Mental health of migrant laborers in COVID-19 pandemic and lockdown: Challenges ahead. Ind J Psychiatry 2020;62:233.  Back to cited text no. 1
    
2.
Prakash J, Chatterjee K, Srivastava K. Industrial impact of COVID-19 pandemic: Mental health perspective. Ind Psychiatry J 2020;29:9.  Back to cited text no. 2
  [Full text]  
3.
Ghulam R, Verma K, Sharma P, Razdan M, Razdan RA. Drug abuse in slum population. Ind J Psychiatry 2016;58:83-6.  Back to cited text no. 3
    
4.
Farhoudian A, Ramin Radfar S, Mohaddes Ardabili H, Rafei P, Ebrahimi M, Khojasteh Zonoozi A, et al. A global survey on changes in the supply, price and use of illicit drugs and alcohol, and related complications during the 2020 COVID-19 pandemic. MedRxiv 2020;13:2020.  Back to cited text no. 4
    
5.
Dom G, Samochowiec J, Evans-Lacko S, Wahlbeck K, Van Hal G, McDaid D. The impact of the 2008 economic crisis on substance use patterns in the countries of the European Union. Int J Environ Res Public Health 2016;13:122.  Back to cited text no. 5
    
6.
Center for Substance Abuse Treatment. Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment. US: Substance Abuse and Mental Health Services Administration; 2009.  Back to cited text no. 6
    
7.
During Covid-19 lockdown, Delhi Hospitals see Double the Usual Alcohol Withdrawal Cases-India News-Hindustan Times n.d. Available from: https://www.hindustantimes.com/india-news/covid-19-lockdown-number-of-alcoholics-with-withdrawal-symptoms-doubled-in-hospitals-emergencies/story-OD8QuiDVZwQm8uesxbf8NK.html. [Last accessed on 2020 Jun 06].  Back to cited text no. 7
    
8.
Substance abuse in India rises during Covid-19-Media India Group n.d. Available from: https://mediaindia.eu/society/substance-abuse-in-india-rises-during-covid-19/. [Last accessed on 2020 Aug 14].  Back to cited text no. 8
    




 

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