Greater impact of COVID-19 on peer-supported addiction services than government-owned services for addiction in Japan: A nationwide 3-year longitudinal cohort study

Aim: This study aims to investigate how the coronavirus disease (COVID-19) pandemic impacted service provision of peer-supported addiction services, such as self-help groups or recovery houses and government-owned addiction healthcare services, in Japan, as well as the quality of their interaction.

Methods: An online survey was distributed to all 69 public regional healthcare facilities (Mental Health and Welfare Centers [MHWCs]) across the 47 prefectures of Japan annually from 2021 to 2023, totaling three surveys. The survey asked about: (1) the current status of addiction healthcare services at each center, (2) the current status of peer-supported addiction services within each center's area, and (3) changes in connectivity between centers and peer-supported addiction services.

Results: All 69 centers participated in the survey each year. Following the second year of the pandemic, both MHWCs and peer-supported services experienced service closures and restrictions; however, peer-supported services were notably more affected nationwide, such as downsizing of services, decreased number of users, shortage of operation funds, and inability to connect with other services being widely reported (p < 0.0001). Despite the easing of most restrictions by the fourth year, MHWCs in 18 out of 47 prefectures reported at least one sustained negative impact on their service provision, while peer-supported services struggled to recover, with 40 out of 47 prefectures still observing difficulties.

Conclusion: The COVID-19 pandemic significantly affected both types of service, with peer-supported services facing greater challenges in recovery. Additional support is essential to restore these services to normal operation.