Youth drug-related hospitalisations rose during pandemic, study finds

Seán McCárthaigh

The rate of young people in Ireland being admitted to hospital for drug-related problems increased during hard lockdowns to restrict the spread of Covid-19 compared to periods before and after the pandemic, according to a new study.

Researchers claim their findings suggest that the adverse effects of pandemic restrictions appear to be linked to a rising incidence of acute drug-related issues among youths aged 15-24 years.

The study by HSE healthcare professionals was carried out against the background of raised concerns that the Covid-19 pandemic and associated lockdowns had an impact on the level of substance use among young people.

They sought to investigate potential changes in admission levels to hospital for alcohol and drug-related problems among 15-24-year-olds in the Republic.

They also noted previous studies suggested that the pandemic had exacerbated mental health challenges among young people in a country which already had the fourth highest rate of youth suicide in Europe.

Level 5 restrictions required people to stay at home and only leave for essential reasons and to confine any exercise within a five-kilometre radius.

Schools, colleges and universities were all closed while no social gatherings were permitted and all non-essential retail outlets were closed.

The study analysed data on over 4,000 drug-related hospital admissions among young people between 2017 and 2022 and compared the three periods of “hard lockdowns” between 2020 and 2021, which totalled a combined 29 weeks, with corresponding periods in other years.

The results of the study, which is published in the Irish Journal of Psychological Medicine, found young patients with drug-related problems accounted for 3.81 per cent of all hospital admissions during lockdowns compared to 2.16 per cent at other periods.

They also showed the median rate of drug-related hospital admissions among 15-24-year-olds during the lockdowns was 23.8 per million per week compared to 18.2 per million per week at other times.

However, there was a slightly higher rate of hospital admissions for young people for alcohol-related problems in the control periods compared to the lockdowns.

The study showed the rate of admissions for youths with alcohol issues outside the periods of strict restrictions on movement and gatherings was 17.6 per million per week compared to 15.8 during the hard lockdowns.

However, it contrasted the increase in drug-relation admissions by young people during the pandemic with the notable decrease in the overall level of hospital admissions among the general population at the same time.

Males accounted for 71 per cent of all patients, while the average age on admission was 20.4 years.

The average length of hospital stay for such patients was 3.4 days.

Cannabinoids had been used by 37 per cent of youths admitted to hospital for drug-related problems, with both cocaine and opioids having each been used by 32 per cent of patients.

While the prominence of use of cocaine and opioids by youths requiring hospital admission could have been anticipated, one of the report’s main authors, Bobby Smyth, said the higher number of cannabis-related admissions “might surprise clinicians.”

However, Dr Smyth, a consultant child and adolescent psychiatrist at Cherry Orchard Hospital in Dublin, also observed that the increasing involvement of cannabis in hospital admissions had already been noted across Europe.

“Our findings suggest that pandemic restrictions may have increased acute drug-related problems requiring medical management in youths aged 15 – 24 years,” said Dr Smyth.

The study noted that the pandemic had significantly heightened stress, anxiety, depression and isolation among young people as well as profoundly impacting on some individuals.

“School closures and disrupted routines led to increased unsupervised time, which potentially resulted in greater instances of substance experimentation. Furthermore, the loss of support systems and restricted access to youth services exacerbated these challenges,” said Dr Smyth.

He added: “With many activities cancelled, young adults were left with unstructured time, making them more prone to engaging in risky behaviours.”

The study claimed many families also faced financial and health challenges that increased stress levels which could have led to an increase in substance use.

It observed that parents, who were often dealing with their own struggles, had less capacity to closely monitor their children, while increased online time also exposed children and adolescents to “pro-substance messages.”

While the study’s findings show an association between the lockdowns and a surge in drug-related hospital admissions, the researchers said they could not establish a direct causal relationship due to the study’s limitations in capturing contributory factors.

It recommended that further research should develop targeted strategies to mitigate the negative effects of substance misuse among young people, particularly during periods of social disruption.

The study concluded: “If society faces similar challenges in the future, the potential adverse impacts on youth must be carefully weighed when implementing restrictive measures.”