Since the outbreak of COVID-19 across Europe and subsequent national responses to contain and mitigate the epidemic (self-isolation, quarantine, confinement, lockdowns), information has emerged about unprecedented challenges for services providing care to people who use drugs in the community and in prisons. Anecdotal information also indicates that there may have be changes in drug use patterns and in how people are obtaining their drugs. Understanding and sharing information on the consequences of COVID-19 and national response measures on harms deriving from the lack of access to care and how services have adapted as a response may help services improve their responses.
In order to investigate and rapidly document the current impact of the COVID-19 epidemics and national responses in the EU Member States on changes in patterns of drug use, harms and service provision, the EMCDDA is carried out a study using an adapted version of the trendspotter methodology across EU Member States, of which this survey forms a part. The Mini European Web Survey on Drugs: COVID-19 is part of this snapshot and was conducted across Europe in April-May 2020. The aim was to gather information about how patterns of drug use may have changed in Europe due to COVID-19.
In Bulgaria, the study was carried out with the support of the National Focal Point on Drugs and Drug Addictions, covering 212 drug users (mostly with daily or almost daily use of at least one drug).
Nearly half of respondents (46.2%) said there had been no change in their drug use since the start of the COVID-19 pandemic, one in four used less during the pandemic restrictions, and 5.7 % did not use drugs during the first lockdown. Only 11.8% experienced higher drug use after restrictions were imposed.
No change in drug use occurred to the greatest extent among cocaine users (77.6%), as well as among users of synthetic cannabinoids (71.9%) and opioids other than heroin (68.9%). The greatest change in drug use occurred among users of heroin (35.2%) and amphetamines (33.3%).
Stopping drug use was most common among users of LSD (18.2%) and ecstasy (7.0%). A decrease in the number of cases of use is mainly reported among users of amphetamines (23.7%), heroin (15.9%) and cannabis (12.9%), and a decrease in the amount of drug used – among users of heroin (11.4%) and cannabis (7.2%).
More frequent drug use and in greater quantity is seen primarily among users of opioids (methadone and heroin) and cannabis users.
With the imposed restrictions, drug users are also oriented towards replacing the habitually used drug with another. This applies mostly to users of opioids (heroin and methadone), cannabis and amphetamines who replace their usual use mainly with the use of benzodiazepines and alcohol.
As reasons for the decrease in drug use since the start of the COVID-19 pandemic, users mainly point to a loss of income to buy drugs, reduced ability to collect drugs, due to restrictions on leaving the home or reduced supply, fewer opportunities to use drugs due to closures of clubs/bars, restrictions on gatherings, as well as concern about the health effects of drug use when infected with COVID-19.
As reasons for the increase in drug use since the start of the pandemic, drug users mainly point to anxiety about to cope with the infection, boredom with the restrictions imposed, and the significant stocks of drugs that some users had.
The restrictions imposed in connection with the COVID-19 pandemic have also had an impact on the pattern of drug use in Bulgaria, although for nearly half of the users no change has occurred. However, more than 15% have reduced their injecting drug use, while those who smoke and swallow as a means of their use have increased.