Substance use disorders such as alcohol and opioid addiction predispose fully vaccinated people to COVID-19 breakthrough infection, hospitalization, and death, although the overall risk is low, according to a US study yesterday in World Psychiatry.Researchers from Case Western Reserve University and the National Institute on Drug Abuse (NIDA) analyzed the electronic health records of 579,372 coronavirus-naïve patients 12 years and older fully vaccinated from December 2020 to August 2021.The patients, who received care at one of 64 US healthcare systems, had received two doses of either the Pfizer/BioNTech or Moderna vaccine or one dose of the Johnson & Johnson vaccine at least 14 days before enrollment.