Substance use, homelessness and pregnancy in COVID-19 era

Christos Ch. Liapis MD, MSc, PhD

Psychiatrist, President of the Board of Directors of the Therapy Center for Dependent Individuals


Contact details: Therapy Center for Dependent Individuals, President’s Office, Sorvolou 24 – 11636 Athens Greece, email:




Pregnant women with substance use disorder are among most vulnerable populations in COVID-19 era, since they also have to face the burden of homelessness and insufficient or even violent companions. This additional psychological stress may lead to relapses in the therapeutic processes being also precipitated by the transition to telehealth therapeutic services that had to be implemented in order to confine the spreading of SARS-CoV-2. As fetal brain faces neurodevelopmental challenges in a cytotoxic environment of possible inflammation, increased catecholamine levels, psychoactive substances and psychotropic drugs, mother also has to cope with a hostile environment of uncertainty, rich in bio-social threats, toxic distancing, stigmatizing homelessness and dangerous for both maternal and fetal health, as well as for Public Health, wandering and overcrowding in places of drug use and trafficking. Those unprecedented circumstances of the Pandemic threat especially towards population groups that comprise multiple vulnerabilities, like pregnant women with substance use problems, require the reevaluation of our therapeutic innervations.


Key words: homelessness, pregnancy, substance use, COVID-19, SARS-CoV-2

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