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Dual diagnosis in older drinkers during the COVID-19 pandemic

Rahul Rao (Psychological Medicine and Older Adult Directorate, South London and Maudsley Mental Health NHS Trust, London, UK and Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK)
Christoph Mueller (Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK)
Matthew Broadbent (Bioinformatics Unit, South London and Maudsley Mental Health NHS Trust, London, UK)

Advances in Dual Diagnosis

ISSN: 1757-0972

Article publication date: 17 May 2021

Issue publication date: 22 July 2021




There is a dearth of literature examining the impact of the COVID-19 pandemic on older people with dual diagnosis referred to mental health services. The purpose of this study was to compare dual diagnosis before and after lockdown in people aged between 55 and 74 with alcohol use.


Data were collected for people referred to mental health services using an anonymised database of de-identified records to identify people with both substance use disorder alone, or accompanied by co-existing mental disorders.


In total, 366 older people were assessed with the Alcohol Use Disorders Identification Test (AUDIT), 185 before and 181 after lockdown. People with dual diagnosis were more likely to be referred than those without, after compared to before lockdown (13 and 6%, respectively, p < 0.05). People with any substance use disorder with and without dual diagnosis showed an even greater likelihood of referral after, compared with before, lockdown (61 and 34%, respectively, p < 0.0001). Opioid use more than once a month was more likely to be reported after, compared with before, lockdown (66 and 36%, respectively, p < 0.005).

Research limitations/implications

The finding of a higher likelihood of opioid use after compared with before lockdown during the COVID-19 pandemic warrants further exploration. There is also further scope for further studies that involve older non-drinkers.


A greater likelihood of both dual diagnosis and substance use disorder alone after, compared with before lockdown has implications for both mental health and addiction service provision during a pandemic.



The authors are grateful for the support of Professor Robert Stewart and Megan Pritchard in the provision of access to the CRIS database.Conflict of Interest: One of the authors is the editor for the themed issue for which this paper is being submitted.


Rao, R., Mueller, C. and Broadbent, M. (2021), "Dual diagnosis in older drinkers during the COVID-19 pandemic", Advances in Dual Diagnosis, Vol. 14 No. 2, pp. 70-79.



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