Prescription of Psychotropic Drugs in Persons With Concurrent Severe Mental Illness and Substance Use Disorders Before and During the COVID-19 Pandemic in Norway — A Nationwide Register Study

Abstract The pandemic worsened mental health conditions, especially for those with concurrent severe mental illness and substance use disorders (SMI/SUD). Studies have noted increased rates of psychotropic drugs prescription in the general population during the pandemic, serving as a proxy for worsened mental health. Investigating prescription trends among individuals with SMI/SUD would be of interest due to their high morbidity and high reliance of these drugs. This study aimed to examine the impact of the COVID-19 pandemic on the prescribing of psychotropic drugs in this group of patients. We conducted a retrospective cohort study using national register data from 2019 to 2021. A graphical approach and descriptive statistics were employed to analyse the prescribing of seven psychotropic drugs over time. Negative binominal regression analysis compared changes in prescriptions from pre-pandemic to pandemic periods. Prescription patterns among individuals with SMI/SUD remained generally stable during the pandemic, except for marginally increased prescription of antipsychotics (IRR 1.06, 95% CI 1.04–1.13) and anxiolytics (IRR 1.08, 95% CI 1.03–1.14) compared to pre-pandemic levels. The stability indicates efficient management and possibly changes in health behaviours amidst the COVID-19 pandemic. The findings indicate that despite the challenges of adapting health services during a global crisis, patients in Norway were able to maintain stable levels of psychotropic drug use among individuals with SMI/SUD.