Impact of COVID-19 on stimulant use disorder treatment: A national cohort study in the Veterans Health Administration

Abstract

ObjectiveRates of stimulant overdose have increased dramatically, which may have been exacerbated by treatment disruptions during the pandemic, but no recent studies have examined use of stimulant use disorder (StUD) treatment. MethodsIn this retrospective cohort study (March 2018 to February 2022) of national Veterans Health Administration patients, we use an interrupted time-series analysis to examine the impact of COVID-19 (starting in March 2020) on treatment use for StUD. ResultsThe number of patients receiving StUD care was increasing pre-COVID (22,640–23,020, February 2018-February 2020) but dropped post-pandemic to 18,578 in February 2022. The monthly number of patients receiving StUD care increased by 34.6 patients per month (95% CI, 1.1–68.0; P=0.04) before March 2020, decreased by 2803.3 patients (95% CI, −3912.3 to −1694.3; P <0.001) in March 2020, and, accounting for pre-COVID trends, further decreased by 85.85 patients per month (95% CI,−148.9.2 to −23.0; P =0.01) after March 2020. ConclusionsCare for StUD drastically declined during the COVID-19 pandemic and has yet to show signs of a return to pre-pandemic levels despite surging rates of stimulant-involved overdose deaths and a critical need to engage people with StUD in care.