Unfortunately for mariners, the total amount of wave energy in a storm doesn't rise linearly with wind speed, but to its fourth power. The seas generated by a forty-knot wind aren't twice as violent as those from a twenty-knot wind, they're seventeen times as violent.
-from Sebastian Junger, The Perfect Storm: A True Story of Men Against the Sea
The September edition of The American Journal of Psychiatry has a commentary on the effects of alcohol and substance use disorders and susceptibility to COVID-19 infection and its sequelae. The authors point out that a "perfect storm" exists between the combination of COVID-19 factors and alcohol and substance use. These factors include:
- both alcohol and substance use decrease the immune response which increases the risk of lung infections and other complications from COVID-19
- there are reports that COVID-19 infection can involve the brain in some people, which makes it conceivable that neurological changes related to substance use could combine deleteriously in people infected with COVID-19 and and make both disorders worse
- cannabis and nicotine consumption are linked to specific COVID-19 risk factors (i.e. smoking anything is bad for the lungs, especially during COVID-19!)
- inability to purchase alcohol and other substances may lead to withdrawal, as well as risky behaviors to use to counteract withdrawal symptoms
- COVID-19 is a huge stressor, leading to increased fear, anxiety and social isolation. I am seeing this first hand everyday on the inpatient psych unit. Increased stress is related to increased substance craving, consumption, and risk of relapse. The authors make the point that it is crucial to remember that stress-, alcohol-, and drug-related alterations in brain chemistry persist even after the stressor resolves