By Dr Dean Murphy, Research Fellow, Kirby Institute, UNSW, Sydney and Alfred Health, Melbourne.

Although there hasn’t been a huge amount of research on trends in drug consumption since the onset of the COVID-19 pandemic, some large international surveys have suggested that  there was at least initially a decrease in consumption in places like Europe (1). It has been suggested that COVID-19 restrictions have made it more difficult for people to access drugs, and economic consequences of the pandemic have made it more difficult for many to afford them (2). Overall, in Australia however, consumption of most drugs (with the exception of opiates) has increased since the beginning of the epidemic (3), and this is especially the case with alcohol (3, 4).

Among gay, bisexual and queer (GBQ) men, the trends have been mixed. One US study conducted early in the pandemic found that most men (73%) reported no change in their use of ‘recreational’ drugs (5). Another US study found that consumption of both marijuana and other illegal drug use have declined significantly (6). No trends have yet been reported for Australia. However, these overall findings, in addition to suggesting different headline trends, also mask significant variations between different subgroups. For example, the earlier US study found that one-tenth of men had increased use of recreational drugs (5). Also, younger men (15–24 years) were more likely to have increased drug and alcohol use due to in the COVID-19 period, with 18% reporting an increase in drug use.

As ever, the focus of drug use in the majority of studies of GBQ men has been in sexual contexts. A large survey of GBQ men in Israel found that men who used drugs before or during sex were more likely to continue meeting casual partners for sex during the period of social distancing [than men who didn’t use drugs] (7). However, among these men, there was also a decrease from the pre-COVID-19 period in the proportion who reported using drugs.

Another US study found that while the proportion of participants reporting drug usedeclined overall during COVID-19, the association between drug use and sexual behaviour was magnified. In fact, while overall there was a slight decrease in casual sex partners reported by men in the study, among men who use drugs, there was an increase in casual sex partners (6).

A notable feature of some of this research is the questionable assumptions being promulgated by some researchers, mostly in relation to compliance with social distancing and other restrictions. Starks and colleagues, for example, suggested that ‘sexual minority men who use drugs may be among the most likely to deviate from distancing guidance through sexual interactions’ (5). Similarly, Carrico and colleagues argued that ‘it is likely that people who use meth will experience greater difficulties with adhering to COVID-19 social distancing guidelines’ (8).

References

1. European Monitoring Centre for Drugs and Drug Addiction. EU Drug Markets— Impact of COVID-19 2020 [Available from: https://www.emcdda.europa.eu/system/files/publications/13130/EMCDDA-Trendspotter-Covid-19-Wave-2_1.pdf.
2. Mota P. Avoiding a new epidemic during a pandemic: the importance of assessing the risk of substance use disorders in the COVID-19 era. Psychiatry Research. 2020.
3. Farhoudian A, Radfar SR, Ardabili HM, Rafei P, Ebrahimy M, Zonoozi AK, 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. 2020.
4. Colbert S, Wilkinson C, Thornton L, Richmond R. COVID-19 and alcohol in Australia: Industry changes and public health impacts. Drug and alcohol review. 2020;39(5):435-40.
5. Sanchez TH, Zlotorzynska M, Rai M, Baral SD. Characterizing the Impact of COVID-19 on Men Who Have Sex with Men Across the United States in April, 2020. AIDS and behavior. 2020;24(7):2024-32.
6. Starks TJ, Jones SS, Sauermilch D, Benedict M, Adebayo T, Cain D, et al. Evaluating the impact of COVID-19: A cohort comparison study of drug use and risky sexual behavior among sexual minority men in the U.S.A. Drug and Alcohol Dependence. 2020;216:108260.
7. Shilo G, Mor Z. COVID-19 and the Changes in the Sexual Behavior of Men Who Have Sex With Men: Results of an Online Survey. The journal of sexual medicine. 2020.
8. Carrico AW, Horvath KJ, Grov C, Moskowitz JT, Pahwa S, Pallikkuth S, et al. Double Jeopardy: Methamphetamine Use and HIV as Risk Factors for COVID-19. AIDS and Behavior. 2020.

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