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Health Agencies Update
October 27, 2020

Substance Use Disorder Linked to Higher COVID-19 Risk

JAMA. 2020;324(16):1598. doi:10.1001/jama.2020.19686

People with substance use disorder (SUD), particularly those with opioid use disorder (OUD) and Black individuals, are at an increased risk of coronavirus disease 2019 (COVID-19), according to a recent study coauthored by Nora Volkow, MD, director of the National Institute on Drug Abuse (NIDA).

Having a substance use disorder was linked with a higher risk of coronavirus disease 2019 in a recent study.

National Institute of Allergy and Infectious Diseases

Volkow and her coauthors conducted a case-control study of deidentified electronic health records for nearly 73.1 million unique patients, including 12 030 with diagnosed COVID-19.

Patients with an SUD diagnosis within the previous year were significantly more likely (adjusted odds ratio, 8.7) to have been diagnosed with COVID-19 than those without SUD. The association was strongest among those with OUD, followed by those with tobacco use disorder.

Among patients with a recent SUD diagnosis, Black individuals were more than twice as likely as White individuals to have been diagnosed with COVID-19. The racial difference was greatest among people with OUD.

Among patients with COVID-19, those with SUD were more likely to be hospitalized and to die than those without SUD.

Comorbidities associated with a higher risk of severe COVID-19, such as chronic lung diseases, cardiovascular diseases, type 2 diabetes, obesity, and cancer, were more common among patients with SUD than without SUD.

“The lungs and cardiovascular system are often compromised in people with SUD, which may partially explain their heightened susceptibility to COVID-19,” Volkow noted in a statement. “Another contributing factor is the marginalization of people with addiction, which makes it harder for them to access health care services.”