COVID-19 pandemic's impact on French Health Students' consumption of substances - a mixed analysis of their substance use.

Objectives: The COVID-19 pandemic had a huge impact on global mental health. Health care students, both as young people and regarding their student condition, were a more at-risk population. During the first and the third waves, two national surveys already found high levels of psychological distress (21 to 83% of severe psychological distress). This nationwide study focused on health care student changes in substance or treatment use during the pandemic.

Methods: We did an online national cross-sectional study addressing all health care students in France from April 4 to May 11, 2021. The questionnaire included sociodemographic and work conditions questions, Kessler 6 scale, and simple questions about psychotropic treatments or substance use.

Results: We obtained 16,937 answers, including 54% nurses and 16% medical students. Increased psychoactive substance use (alcohol, tobacco and cannabis) was associated with males, older students, those having financial difficulties and using more psychotropic treatments. Nursing students were more at risk than others. Increased psychotropic treatment use (anxiolytics, hypnotics) was associated with being a woman, older, having financial difficulties, having high psychological distress, and using more psychoactive substances. Medical, pharmacy, dental and midwife students were more at risk than others. The response rate was low (5,6%), and nursing students represented more than half of the respondents.

Conclusions: Compared to our first national survey, substance use (21% versus 13%) and psychotropic treatment use (18% versus 7.3%) increased hugely. These results highlight the need to identify the specific causes of substance use by health care students to better support them. As future health professionals, this is a major public health issue.