The results of a recent study suggest patients with a substance use disorder (SUD), especially an opioid use disorder (OUD), are at a much higher risk of contracting COVID-19.1

Investigators studied data from the IBM Watson Health Explorys EMR database, which includes medical record information of more than 73 million people treated at 360 hospitals across all 50 states.

After adjusting for age, race, gender, and insurance type, the authors found patients with an OUD were 10.2 times more likely than the general population to contract COVID-19, followed by those with tobacco use disorder (8.2 times more likely), alcohol use disorder (7.8 times more likely), cocaine use disorder (6.5 times more likely), and cannabis use disorder (5.3 times more likely).

Patients with a SUD also exhibited much higher rates of hospitalization and death from COVID-19. Further, those with a recent diagnosis of a SUD had a higher prevalence for many conditions when compared with the general population. For example, 22% of patients with a recent SUD diagnosis had asthma vs. 6.89% of the general population, 18.86% had COPD vs. 4.64% of the general population, and 72.67% had cardiovascular disease vs. 23.34% of the general population.

The findings also uncovered evidence of racial disparities. The authors noted the prevalence of many of these chronic conditions was higher in African American patients than it was in white patients. Hospitalization and mortality rates were significantly higher among African American patients diagnosed with a SUD vs. white patients who were diagnosed with a SUD. “It is incumbent upon clinicians to meet the unique challenges of caring for this vulnerable population, just as they would any other high-risk group,” Nora D. Volkow, MD, study co-author and director of the National Institute on Drug Abuse, said in a statement.2


  1. Wang QQ, Kaelber DC, Xu R, Volkow ND. COVID-19 risk and outcomes in patients with substance use disorders: Analyses from electronic health records in the United States. Mol Psychiatry 2020; Sep 14. doi: 10.1038/s41380-020-00880-7. [Online ahead of print].
  2. National Institutes of Health. Substance use disorders linked to COVID-19 susceptibility. Sept. 14, 2020.