Changing Addiction Problems and Care Responses During and After a Major Crisis: Emergence of a ‘New Normal'

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Background

Despite its lifesaving role, addiction treatment and care are often among the first domains to lose resources when a crisis strikes. Across the world disruptions in addiction-related care during the Covid-19 pandemic, armed conflict, or radical political change have been documented. But what happens after the crisis is typically unknown. How do addiction-related problems change during a crisis, and what are the responses at individual and societal level? How do crises affect causes, prevalence, incidence, or severity of addiction in different regions and populations? Does the addiction care system permanently collapse or is the breakdown temporary and reversible? How does a crisis evolve and what happens to addiction care services and their beneficiaries over time? Is residual damage to addiction care services inevitable or can a crisis create opportunities for positive change at individual, organizational, and/or system level? Are harms and benefits (un)equally distributed among different addiction stakeholder groups? And finally, what does a ‘new normal’ look like in addiction and addiction care, and what (new) norms underpin it? These questions not only encompass the importance of such a topic, but also the implications on public health that are applicable worldwide that need to be addressed.

This Research Topic will map out new landscapes of addiction and addiction care following major crises across the world. It will examine the lessons from both ongoing crises (e.g., Covid-19, wars in Ukraine and Nigeria) and past crises (e.g., the American war in Vietnam, the ‘war on terror’ in Afghanistan and Iraq). This topic will explore how crises may change determinants, experiences, incidence, prevalence, and severity of addiction problems for various groups (e.g., combatants, non-combatants, civilians, pandemic survivors), and how a so-called 'new normal' emerges in addiction care services. The distinctive feature of this Research Topic is the focus on both residual damage from a crisis, and opportunities for addiction care development and improvement post-crisis. It will consider whether emergency solutions to providing addiction care services during a crisis may be sustainable over time and changes they may set in motion. The articles within this collection will throw light on which factors at the individual (patients and clinicians), organizational, and system level during and after a crisis shape a new status quo in addiction care. The articles may (re-)examine historically relevant questions (e.g., why risk of opioid use disorder differed among US troops deployed in Vietnam depending on their conscription status) or engage with emerging questions (e.g., how suspension of methadone treatment in regions overtaken by Russia may affect trust in the uptake and scale-up of methadone in other regions of Ukraine). The articles will further the knowledge of immediate and long-term crisis outcomes for addiction problems and care and reflect on what indicates the emergence of a ‘new normal’ after a crisis. This Research Topic will also advance understanding of how crises may challenge old and create new cultural understandings of addiction, of who deserves treatment (e.g., ‘victims’ versus ‘perpetrators’ of an armed conflict), and of what treatment is appropriate.

Addiction is defined broadly, with substance use disorders including alcohol as well as behavioral addictions (e.g., gaming, gambling), as potential foci of attention. This Research Topic welcomes themes including, but not limited to:

-Changes in addiction problems during and after a crisis and how people and societies respond to them;

-Breakdown vs resilience of addiction care services during a crisis;

-Factors which shape residual damage to addiction care at individual, organizational, and system-level;

-Opportunities for improving addiction care after the crisis is over;

-Post-crisis cultural shifts in understanding addiction and treatment priorities.

Original research employing qualitative, quantitative, and/or mixed methods, as well as policy analyses, meta-analyses, or systematic reviews are welcome. There is no geographical restriction, and we encourage submissions focusing on marginalized and disadvantaged social groups in both low-middle income countries and high-income countries. Analyses of both recent/ongoing and past crises will be considered.

Keywords: major crisis, pandemic, war, natural disaster, policy change, changes in addiction-related problems, causes, experiences, severity, prevalence, resolution, care responses, care breakdown vs resilience, residual damage to addiction treatment/care

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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