Table 1_Changes in drug-use behaviors among people who use drugs with comorbid psychiatric disorders across the COVID-19 pandemic: a three-phase longitudinal cohort study.docx

COVID-19 infection history and vaccination status were verified through centralized electronic health records. Within-person changes in drug-use behaviors across time points and factors associated with these changes were examined using mixed-effects models.</p>Results<p>One hundred and thirty participants (mean age 40.03 years) completed the study. The majority (62.3%) had a comorbid substance-induced psychotic disorder.

Overall, 27.7% had laboratory-confirmed COVID-19 infection during the study period. Across the three phases, participants demonstrated significant reductions in substance use disorder severity and drug-use frequency. Sharing of drug-use equipment also declined and remained lower after the pandemic.

Greater worry about contracting COVID-19 was associated with increased avoidance of drug use with others and reduced sharing of drug-use equipment. Prior COVID-19 infection was associated with lower drug-use frequency. Among individual drugs, cough syrup was uniquely linked to more frequent use, less solitary use, and sustained reductions in equipment sharing.</p>Conclusion<p>Adult PWUD with comorbid psychiatric disorders demonstrated sustained improvements in drug-use behaviors throughout the COVID-19 pandemic and after its official conclusion.

Both prior COVID-19 infection and greater worry about contracting COVID-19 were associated with these positive behavioral changes.</p>