The societal and economic impacts of the Covid-19 pandemic included a variety of downstream effects on health endpoints worldwide. Among them, one widely recorded phenomenon was the increase in substance abuse, which has been attributed to coping with feelings of insecurity and extended periods of social isolation due to shelter-in-place or quarantine policies.
In the January 2026 edition of The Lancet Regional Health – Americas, Lucas Almeida Andrade and colleagues explored the proliferation of substance abuse before and after the Covid-19 pandemic in Brazil through a population-based study of deaths attributable to drugs and alcohol during these periods. The authors found an overall increase in related mortality in the immediate aftermath of the pandemic but noted that different age cohorts and regions of the country varied in impact. GlobalData epidemiologists forecast that between 2026 and 2028, the 12-month prevalent cases of alcohol and opioid use disorder combined will increase from 9,552,690 to 9,671,328. In the absence of mitigation, the effects of the Covid-19 pandemic will likely lead to a higher caseload than originally projected.
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Andrade and colleagues analysed recent patterns in alcohol- and drug-related mortality in Brazil through a population-based ecological study of the Ministry of Health’s Brazilian Mortality Information System data from 2015 to 2022. The database provides a comprehensive record of deaths nationwide using International Classification of Diseases, 10th edition (ICD-10) codes to denote cause of death. The authors selected ICD-10 codes with alcohol or drug abuse specified as underlying causes of death, which were then segmented by geographic region, age, and sex to analyse geographic and demographic segmentation. Trending analysis was performed on the data to identify significant trends and annual percentage changes (APCs) in deaths over time.
From 2020 to 2022, the observed number of drug- and alcohol-related deaths was 75,355, significantly outnumbering the expected value at 61,636. Furthermore, temporal analysis showed a significant trend toward a higher number of deaths, with an APC of 8.9% in the 2015 to 2022 period compared to the 2015 to 2019 period APC of 0.1%. The authors noted this trend among both men and women. Additionally, APCs were particularly pronounced in the 20 to 39 years and 60 years and older age groups at 7.4% and 5.3%, respectively.
The work of Andrade and colleagues highlights the stark changes in substance abuse-related mortality in Brazil during the Covid-19 pandemic. The authors attribute the spike in deaths not only to the precarious social and economic conditions faced by individuals during this period, but also to the pandemic’s disruptive effects on the timely diagnosis and treatment of alcohol and drug dependence. As time progresses beyond the pandemic period, it has yet to be determined if these trends have held steady, inviting speculation into the necessity of more aggressive intervention. In Brazil and on a global scale, the monitoring of post-Covid-19 era substance abuse patterns will be critical to subvert future morbidity and mortality.
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By GlobalData
