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Official websites use. Share sensitive information only on official, secure websites. Elsevier hereby grants permission to make all its COVIDrelated research that is available on the COVID resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. We aimed to analyse the use patterns of those substances and underlying motivations before and during the pandemic. The reported use of distinct substances and the underlying motivations were ascertained before retrospectively and during the pandemic. Furthermore, associations between drug use as a coping mechanism, pandemic-related stressors, and substance use were examined. Regarding the reported frequency of use during the pandemic, Participants reported that price, quality, and supply were mostly unaffected by the pandemic. The most common motivations before and during the pandemic were mood-related factors, such as a desire to feel exhilarated, euphoric, high, or buzzed. The relevance of social purposes and mood-related motivators declined during the pandemic, whereas dealing with boredom increased. Overall, Those who increased their level of drug use and perceived it as a coping strategy in particular might be targeted with adaptive preventive and therapeutic measures. The influence of the pandemic on substance use was already anticipated at the beginning of the COVID pandemic, and warnings of an increase in use were issued World Health Organization, Stimulants e. Alcohol and cannabis are often consumed in recreational settings as well, but they are not included in the narrower definition of party drugs. Whereas, on average, increases in the consumption of alcohol and cannabis were anticipated and confirmed, research into the use of typical party drugs during the pandemic is lacking and an overall decrease was conjectured due to the relative absence of parties and other recreational events EMCDDA, ; Winstock et al. During the COVID lockdown in spring , wastewater analyses provided insight into objectively measured changes in the consumption of psychoactive substances at the community level EMCDDA, ; Reinstadler et al. The markers for methamphetamine were more than doubled in Austria Reinstadler et al. Quantitative online surveys with subjective self-rating assessments mostly replicated these findings. The use of party drugs in particular decreased according to the international Global Drug Survey Winstock et al. In contrast, alcohol and cannabis showed inverse patterns, with a larger number of increases than reductions and the percentage of risky drinking particulary increased Institute of Alcohol Studies, Furthermore, the pandemic-caused economic downturn has the potential to lead to financial shortages and, therefore, either a reduction in drug use or a shift towards less costly licit substances EMCDDA, or cheaper and potentially more harmful illegal substances similar to findings after the financial crisis of UNODC, An example is the shift to the enhanced use of methamphetamine as a substitute for amphetamine and cocaine during the COVID lockdown in Austria Reinstadler et al. Furthermore, the use of illegal substances was, as a risk factor, cross-sectionally and prospectively associated with stronger pandemic-related anxiety and fears Bendau et al. Mental health issues were a risk factor for the increase in cannabis use as a maladaptive coping strategy Winstock et al. Therefore, it is important to examine the changes and differences in several illegal substances and their associations with the underlying motivations for drug use and the pandemic-related circumstances beyond existing research. This is particularly relevant for identifying vulnerable populations and addressing them with adaptive preventive and therapeutic measures. Most existing studies focus on relative changes and do not ascertain the absolute frequencies of substance use before and during the pandemic EMCDDA, ; Sutherland et al. Our study aims to address these knowledge gaps. Furthermore, we examined exploratory associations between drug use as a coping mechanism, pandemic-related stressors, and substance use. The cross-sectional study data were collected as part of the international online-based Corona Drug Survey with a non-probability self-selected convenience sample of 5, participants. The study was online from 30 April when 3,, cases of COVID infections worldwide, including , deaths, had been confirmed to 4 August 23,, confirmed cases, including , deaths World Health Organization, The survey was carried out online on the secure web-based platform SoSci Survey Leiner, a. Recruitment was done on an international level via articles in online magazines, advertisement on several webpages and social media, electronic postings, and e-mail announcements. Interposed with the link to the survey was the project landing page, which provided detailed information about the survey. All participants gave written informed consent prior to completing the survey, and participation was fully anonymous and voluntary. The inclusion criteria were the ability to complete the survey in one of those languages, the minimum age of 18 years, and the consumption of at least one of the above-named psychoactive substances in or Participants that reported the use of one of those substances in or and provided further information about the usage frequency were included in the analysis. The survey contained questions about sociodemographic information, such as age, gender, country of origin, country of current residence, educational level, and work-related situation before and during the pandemic. Furthermore, we examined how much the participants and their environments were affected by pandemic measures. The degree of limitation in social contact and other restrictions, work-related consequences as well as states of quarantine, and whether the individual had tested positive for SARS-CoV-2 were recorded. Moreover, subjective worries and concerns, as well as the self-efficacy to deal with the situation and adherence to preventive measures were obtained. A change in psychopathologic strain during the pandemic compared to the pre-pandemic state was assessed with a slightly modified version of the self-rating Symptom Checklist short version-9 SCL-K-9 Prinz et al. Furthermore, for the substances that were reportedly consumed, the contextual factors of drug use where, with whom, aspects of quality, price, and supply constraints , and underlying motivations for drug use were examined retrospectively for the state before the pandemic and for the current situation during the last four weeks. Motivational aspects were assessed with 17 items based on Boys, Marsden, and Strang and Betzler et al. Furthermore, it was assessed whether the users experienced those substances as helpful in dealing with the pandemic in general and particularly with regard to social isolation. A total of 17, clicks on the survey questionnaire has been recorded. Furthermore, datasets were excluded if they exhibited more than 40 missing answers, completed less than 10 pages where the substance-related section of the survey started , showed obvious discrepancies e. Missing data were handled by listwise deletion Little's MCAR test was not significant and the data may be assumed to be missing completely at random. Descriptive statistics provided the core of the analysis. Due to the ordinal-scaled indication of the frequency of use, partly small subgroups and the rather exploratory focus of the analysis, we used non-parametric tests for inferential analyses. Spearman's rank correlations were used to test for associations of changes of the frequency of substance use with age for each substance. We did not examine other demographic characteristics e. To analyse changes in the motives relative proportions of substance use from before to during the pandemic, we applied McNemar tests besides the descriptive examination. Furthermore, we carried out spearman's rank correlations with statistical control for the pre-pandemic frequency of drug use to test correlations of the extent to which one perceived substance use as helpful for coping with the pandemic and the changes in the frequency of use for each substance. In the next step, we divided the sample into two groups those who perceived substance use as not helpful for coping with the pandemic vs those evaluating it as slightly, moderately, very or extremely helpful and calculated Spearman's rank correlations of the extent of pandemic stressors with the ordinal-scaled frequency of substance use during the pandemic for each of the two groups and each substance separately. Furthermore, the applied non-parametric tests complicate the inclusion of any confounding variables. Due to the descriptive and exploratory focus of the analysis we did not account for multiple testing. For all analyses, the significance level was set to 0. The final sample consisted of The mean age was In our sample, 2. A majority of The participants lived in 45 different countries: The vast majority reported restrictions such as limitations in social contacts, about one half experienced work-related changes, one third expressed worries about the pandemic, and the majority reported that they adhered to preventive measures. This indicates that, on average, the mental strain was not or only slightly increased during the pandemic compared to before. Nevertheless, some participants felt much less strain in all nine SCL items, whereas others perceived much more strain. Almost half of the participants Large parts of the sample used drugs rather occasionally less than one time per month before the pandemic. During the pandemic, the majority never used drugs in the last four weeks or approximately once. Between MDMA showed comparatively the smallest percentage of constant substance use Difference scores are calculated by the pandemic minus the pre-pandemic frequency; negative values thus indicate a decrease in the frequency of drug use and positive values an increase. The majority reported no substantial changes in price, quality, or supply constraints due to the pandemic. Non-binary individuals showed on average an increased frequency of MDMA use, whereas male and female participants in contrast reported a decrease. Table 2 descriptively displays different motivational aspects for drug use before and during the COVID pandemic. The relative number of users who reported social purposes e. In contrast, dealing with boredom increased substantially as a reason for substance use during the pandemic. Choosing multiple options was possible. The majority The ability to deal with social isolation seemed relatively unaffected by drug use for large percentages of the participants The bars present percentages. The right column displays partial non-parametric Spearman rank correlation coefficients of the extent of drug use as a coping strategy with the difference in frequency controlled for baseline frequency of substance use. The extent to which individuals perceived substance use as helpful in general and particularly as a coping strategy regarding isolation was significantly positively correlated with an increased frequency of substance use from before to during the pandemic for almost all examined substances except isolation in users of methamphetamine and GHB due to small group sizes. Table 3 shows the moderation of the associations of pandemic-related stressors with substance use during the pandemic by the perception of drugs as a coping strategy. For users of amphetamine, stronger pandemic-related restrictions, strains, and concerns were associated with significantly less frequent drug use when they evaluated those substances as not helpful in dealing with the pandemic. In contrast, users that perceived drug use as helpful showed weaker associations or even positive trends. The same pattern was visible for cocaine use, whereas the patterns for the other substance groups were less consistent. Associations with pandemic-related stressors and mechanisms with the consumption frequency during the pandemic — grouped by the evaluation of drug use as helpful coping strategy vs. Non-parametric Spearman rank correlations. Due to the descriptive character of this analysis, we neither accounted for multiple testing, nor compared correlations by inferential statistics. In our study sample, a large percentage of individuals decreased the frequency of or ceased drug use during the pandemic, but a substantial part maintained or even increased the levels of consumption. The majority of active users before and during the pandemic consisted of occasional users that consumed the various substances from a few times per year up to a few times per month. The percentages of reported consumption reduction were higher than in the Global Drug Survey sample with 55, participants from May to June Winstock et al. Those differences might arise, for instance, from methodological factors, the broader time period of assessment in our survey, and regional divergences. In specific populations, e. Thus, the frequency of their use shows, on average, a downturn that parallels the restrictions on recreational settings EMCDDA, ; Palamar et al. This is furthermore underlined by the finding that for MDMA, GHB, cocaine, and amphetamine, clubs were the most common place of substance use before the pandemic. Difficulties in the availability of those substances The examination of factors that are associated with differences in the frequency of substance use is particularly important. While the relative proportion of several motivations e. The most prominent increase was in using stimulants and dissociatives to deal with boredom. This is in line with European and international findings where boredom as well as reducing anxiety were common reasons for using drugs during the pandemic EMCDDA, ; Winstock et al. In a Belgian study, the loss of daily structures, a lack of social contacts, loneliness, a rewarding function, and conviviality were furthermore reported as reasons for peri-pandemic substance use Vanderbruggen et al. Our observation that the reported price and quality increased or decreased in some cases but otherwise remained relatively stable for the different substances is consistent with the findings of Palamar et al. It might be possible that tangible interruptions would become more apparent with a longer persistence of the pandemic and could not be captured by data collected during the early pandemic. Nevertheless, our findings indicate lower effects of the pandemic on the drug market than those reported in the Global Drug Survey Winstock et al. Congruent with the findings from Palamar et al. Considering the small number of users, attention should be paid to the relative elevation in maladaptive coping motivation escaping from problems and negative emotions and a large percentage The more drug use was perceived as a helpful coping strategy, the higher one's relative level of substance use during the pandemic was on average. Furthermore, we examined the moderating role of perceiving drugs as coping mechanisms on the associations of pandemic-related consequences and strains with the frequency of substance use during the pandemic. Overall, the patterns were mixed, but for amphetamine and cocaine, we found a moderating effect of drug use as a coping mechanism. For instance, isolation was negatively correlated with amphetamine use for individuals that did not perceive it as helpful in coping, whereas the association was positive for those who evaluated it as helpful. In light of our findings, it might be relevant to analyse the subjective evaluation of the function of substance use to predict whether isolation results in higher use due to self-medication purposes or in reduced consumption due to fewer opportunities and less peer ties. Those who increase their level of drug use and perceive it as a coping strategy for dealing with the multiple challenges of the pandemic in particular may need consideration and mitigation EMCDDA, Our survey was carried out during a phase of relative relaxation of infection numbers of the 1st wave and preventive restrictions in most countries, and it can be expected that the problematic role of drug use to deal with the pandemic grows in parallel to the increasing duration and severity of the pandemic. For example, online preventive and therapeutic harm reduction interventions e. Besides its strengths, our study has some limitations. Our sample is a self-selected convenience sample. This reduces the generalizability of the results. Furthermore, it cannot be ruled out that demographic characteristics or other confounding variables influence and modify the results. Most changes in drug use are assumably directly or indirectly influenced by national confinement measures EMCDDA, Due to variations in the infection rates and the timing and severity of those measures between different geographical regions and other differences, e. All answers rely on online self-reports, and the information regarding the use before the pandemic was retrospectively obtained and not actually assessed before the pandemic. This increases the risk for memory and answer biases and the possible presence of purposefully wrong responses cannot be ruled out entirely. Due to the rare use of GHB and methamphetamine, the groups of those users were small, which reduced the informative value of group comparisons. Due to the focus on stimulants, dissociatives, and GHB, as well as the design of our study, we did not analyse a potential shift to other substances such as alcohol or cannabis or interactions between different substances. Our study relies on cross-sectional data, which does not allow any causal conclusions; future longitudinal studies are needed to map courses over time. Most analyses of this study provide a rather descriptive and exploratory way of examination to take into account these limitations and to build a solid base for future studies and analyses. Nevertheless, it is important to differentiate between different substances, use frequencies, and underlying motivations rather than grouping them all together. Those who increased the use of substances during the pandemic e. Our study contributes to the examination of the impact of the pandemic on the patterns of use of psychoactive substances and related harms. In the short and long term, with respect to the further progress of the pandemic and implications after the pandemic, potentially harmful use patterns need attention and further research. Supervision, prevention, and education on different dimensions, as well as the provision of professional support to deal with difficulties on personal, social, or economic levels, are of high relevance — both during and after the pandemic Helbig et al. The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of , as revised in The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. As a library, NLM provides access to scientific literature. Int J Drug Policy. No party, no drugs? Find articles by Antonia Bendau. Find articles by Leonard Viohl. Find articles by Moritz Bruno Petzold. Find articles by Jonas Helbig. Hedwig-Krankenhaus, Berlin, Germany. Find articles by Simon Reiche. Find articles by Roman Marek. Find articles by Amy Romanello. Find articles by Daa Un Moon. Find articles by Rosa Elisa Gross. Find articles by Dario Jalilzadeh Masah. Find articles by Stefan Gutwinski. Find articles by Inge Mick. Find articles by Christiane Montag. Find articles by Ricarda Evens. Find articles by Felix Betzler. Issue date Apr. All rights reserved. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Changing mood … feel better when I'm sad or in a bad mood … escape from a problem … relax … feel exhilarated and euphoric … just to get high or buzzed. Physical effects … enhance my sexual feelings or for pleasure … stay awake … sleep … lose weight. Social purposes … enjoy the company of my friends … to put myself in other people's shoes … be more self-confident in social situations … ease my anxiety. 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