Globally, the pattern of substance use varied across different countries, for example, the proportion of substance use had increased in the United States, while Canada reported a decreasing trend during the pandemic. 27 The pandemic also saw an apparent increase in the number of deaths due to suicides, particularly in the remote areas of Bhutan. 28 The annual number of deaths by suicides between 2017 and 2019 stands at 12 per 100,000 populations.
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