(WHDH) — A new study has found an increased risk for breakthrough COVID-19 infections in people with substance use disorders, including those who smoke marijuana, drink alcohol, and use tobacco products.

Vaccine effectiveness in people with an SUD might be reduced by the heavy use of marijuana, alcohol, cocaine, opioids, and tobacco, according to findings published last week by the Official Journal of the World Psychiatrics Association.

“Individuals with substance use disorders are at increased risk for COVID-19 infection and for adverse outcomes of the infection,” researchers wrote. “Though vaccines are highly effective against COVID-19, their effectiveness in individuals with SUDs might be curtailed by compromised immune status and a greater likelihood of exposures, added to the waning vaccine immunity and the new SARS-CoV-2 variants.”

People with an SUD had about a 7 percent rate of breakthrough infections compared to about a 3.6 percent rate in people without an SUD, according to the study.

Those with a marijuana disorder were most at risk for breakthrough infections with a rate of 7.8 percent, followed by cocaine use at 7.7 percent, and alcohol use at 7.2 percent.

“Patients with cannabis use disorder, who were younger and had less comorbidities than the other SUD subtypes, had higher risk for breakthrough infection even after they were matched for adverse socioeconomic determinants of health and comorbid medical conditions with non-SUD patients,” researchers wrote.

The rate of severe COVID outcomes in vaccinated individuals with breakthrough infections is known to be much lower than in infected unvaccinated individuals, researchers noted.

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