psychological impact of the acute covid-19 period on patients with substance use disorders: we are all in this together

Introduction: coronavirus disease 2019 (covid-19) results from severe acute respiratory syndrome coronavirus 2 (sars-cov-2). it is now a pandemic that affects us all. for patients referring to the addiction care systems, this pandemic can create additional vulnerabilities. a great deal of effort has made to re-organize the care systems for patients with addiction. our study focuses on the voice of our patients, on clues to adapt treatment, and on the impact of the pandemic on the therapeutic alliance. methods: a qualitative design was used to develop a description and understanding of general and clinically relevant aspects of the impact of the covid-19 pandemic. fifteen addicted patients (11 under treatment and 4 in recovery) were interviewed by 4 interviewers according to the coreq (consolidated criteria for reporting qualitative research). results: covid-19 has had a serious impact on thoughts, feelings, and behaviors. interviewees shared their anxieties about their health and the health of their relatives. frightening thoughts were associated with a range of negative feelings and behaviors, such as stress, anger, avoidance, and isolation. the use of psychoactive substances differed between the patients in treatment with those who are in stable recovery. in the former, all succeeded in staying abstinent. they have experienced that solidarity and connectedness were essential in sustaining their recovery. those still in treatment were fighting against the temptation to start using again; they felt emotionally isolated and sometimes patronized by health care workers. conclusion: the elaboration of the interviewees on the therapeutic relationship provides promising clues to optimize that relationship. remembering this common expression, “we are all in this together,” shared decision making could very well be used to shape effective and receptive treatment interventions during the different challenges faced at different stages of the covid-19 epidemic.