Subsequent time, after declaration of COVID-19 pandemic, witnessed variable changes in various aspects due to COVID circumstances around the globe. We report and reflect here over the observation regarding substance use and use disorder scenario in initial COVID year 2020 in reference to 2019 (year preceding COVID-19 pandemic). It is an observation in psychiatry in-patient service of a teaching hospital of eastern Nepal. There were 420 (284 male, 136 female) and 279 (194 male and 85 female) admissions in 2019 and 2020 respectively. The most striking and significant change was seen for Nicotine, both overall and use disorder-wise. Over all, the proportion increased for Nicotine (34.05 to 48.03%) and Cannabis (16.67 to 17.92%) whereas decreased for Alcohol (38.33 to 31.18%), Opiote (7.62 to 6.81%), Benzodiazepine (6.43 to 5.73%) and other substance (0.71% to nil) among the in-patients in 2020. Categorically, both the Use and Dependence syndrome (ICD-10) increased for Nicotine (8.81 to 21.86%% and 25.24 to 26.17%) and Cannabis (10.71 to 11.47% and 5.72 to 6.45%). Proportion of Alcohol use and Harmful use decreased whereas Alcohol dependence increased, Opiote use increased whereas Harmful use and Dependence decreased, Benzodiazepine use and Dependence decreased and other substances decreased too. The observation shows various changes in the pattern of substance among the psychiatry in-patients which indicates the need for some strategic and policy changes to tackle this pandemic situation.