The drug epidemic and the covid-19 pandemic: effects on drug- and opioid use disorders from a primary health care perspective

In this project at Lund University, we will elucidate drug use (DUD) and opioid use disorder (OUD) pathways and associations during two ongoing epidemics, i.e., the opioid epidemic and the covid-19 pandemic. For this purpose, we will utilize nationwide population and health data, including primary health care data. Aim 1 will use a newly developed genetic risk score for the entire Swedish population to explore boundaries of the DUD/OUD phenotypes, model gene x environment interactions and clarify origins of DUD/OUD-related comorbidities; Aim 2 will clarify the etiologic role of opiate prescriptions in opioid use disorder (OUD) including the pathways from an injury/pain diagnoses to opiate prescription and OUD. Aim 3 will evaluate the spread of DUD/OUD in the actual Swedish population utilizing FRED (A Framework for Reconstructing Epidemiological Dynamics) developed by our collaborators at University of Pittsburgh. Aim 4 will explore the association between COVID-19 exposure at the individual, family and regional level on DUD/OUD onset and recurrence, which has not been done so far. In these aims, we will attempt to clarify the causal nature of the observed associations. The knowledge obtained from this proposal will be important to counteract the potential effects on DUD/OUD of two ongoing epidemics, the opioid epidemic and the covid-19 pandemic, both of which are relevant for prevention and diagnosis in primary health care settings.