COVID-19 risk in fully vaccinated individuals with substance use disorders

Co-occurring health disorders appear to contribute to increased risk, NIH study suggests

People with substance use disorders (SUDs) face higher risks for developing COVID-19 and for experiencing serious problems associated with the infection. A recent study in World Psychiatry examined these risks in fully vaccinated individuals with SUDs.

The study included 579,372 people in the United States (30,183 with a diagnosis of SUD and 549,189 without such a diagnosis) who were fully vaccinated between December 2020 and August 2021 and had not contracted COVID-19 prior to vaccination.

The risk for breakthrough COVID-19 infection in vaccinated people with SUDs ranged from 6.8% for tobacco use disorder to 7.8% for cannabis use disorder, all significantly higher than the 3.6% in the vaccinated non-SUD population. After matching for demographics (age, gender, ethnicity) and vaccine types (Pfizer, Moderna, Johnson & Johnson), patients with SUDs—with the exception of those with tobacco use disorder—still had higher risks for breakthrough COVID-19 compared with matched individuals without SUDs, with the highest risks for those with cocaine use disorder and cannabis use disorder.

These excess risks among people with SUDs were largely due to their higher prevalence of comorbidities and adverse socioeconomic determinants of health (such as problems related to education, employment, and housing).

“First and foremost, vaccination is highly effective for people with substance use disorders, and the overall risk of COVID-19 among vaccinated people with substance use disorders is very low,” said NIDA Director Nora D. Volkow, M.D., and one of the lead authors on the study. “We must continue to encourage and facilitate COVID-19 vaccination among people with substance use disorders, while also acknowledging that even after vaccination, this group is at an increased risk and should continue to take protective measures against COVID-19.”

Prof. Afzal Javed, President of World Psychiatric Association (WPA), commented: “This is an important research and World Psychiatry’s role is highly appreciated.”

“We received more than 400 submissions related to COVID-19 pandemic between 2020 and 2021” – said Prof. Mario Maj, Past-President of the WPA and Editor of World Psychiatry – “but we decided to accept for publication only those papers which were likely to have significant clinical or policy implications. This is one of them.”

Author: WPA