The impact of COVID-19 on people who inject drugs in New York City: increased risk and decreased access to services

Harm Reduction Journal, Journal Year: 2021, Volume and Issue: 18(1)

Published: Nov. 24, 2021

Abstract Background While people who inject drugs (PWID) are vulnerable to the adverse outcomes of events like COVID-19, little is known regarding impact current pandemic on PWID. We examine how COVID-19 has affected PWID in New York City across four domains: substance use, risk behaviors, mental health, and service utilization. Methods As part a randomized trial improve access HCV treatment for PWID, we recruited 165 participants. Eligibility criteria included detectable RNA recent drug injection. The present cross-sectional analysis based subsample 106 compared responses between two separate samples: 60 participants interviewed prior (pre-COVID-19 sample) 46 during (COVID-19 sample). also assessed differences by study group [accessible care (AC) usual (UC)]. Results Compared pre-COVID-19 sample, those reported higher levels health issues, syringe reuse, alcohol consumption greater reductions syringe-service programs buprenorphine In conducted group, UC significantly injection behaviors lower while same period, AC use behaviors. Conclusion provides insight negatively Placing dispensing machines harm-reduction supplies communities where live increasing secondary exchange, mobile services, mail delivery may help maintain lifesaving big events, such as COVID-19. Trial registration ClinicalTrials.gov NCT03214679. Registered July 11 2017. https://clinicaltrials.gov/ct2/show/NCT03214679 .

Language: Английский

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Impact of COVID-19 among people who use drugs: A qualitative study with harm reduction workers and people who use drugs

Harm Reduction Journal, Journal Year: 2022, Volume and Issue: 19(1)

Published: July 2, 2022

Abstract Background Fatal drug overdoses in the USA hit historical records during COVID-19 pandemic. Throughout pandemic, people who used drugs had greater odds of contracting COVID-19, increased use due to COVID-related stress, and heightened levels anxiety depression. This qualitative study examined specific ways pandemic negatively impacted drugs. Methods Qualitative interviews with 24 20 substance harm reduction workers were conducted. Data from analyzed using applied thematic analysis identify emergent themes based on a priori research goals. Results Thematic identified several common experiences among These included mental distress financial strain social isolation; use; risky drug-seeking behaviors changes markets; reduced access reduction, treatment, recovery support services. Conclusions Our highlighted critical systemic failures that contributed rise overdose deaths Addressing these challenges through policy reform improved funding models will ensure sustainability services increase treatment highly vulnerable

Language: Английский

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The impact of relaxing restrictions on take-home doses during the COVID-19 pandemic on program effectiveness and client experiences in opioid agonist treatment: a mixed methods systematic review

Substance Abuse Treatment Prevention and Policy, Journal Year: 2023, Volume and Issue: 18(1)

Published: Sept. 30, 2023

Abstract Background The COVID-19 pandemic led to an unprecedented relaxation of restrictions on take-home doses in opioid agonist treatment (OAT). We conducted a mixed methods systematic review explore the impact these changes program effectiveness and client experiences OAT. Methods protocol for this was registered PROSPERO (CRD42022352310). From Aug.–Nov. 2022, we searched Medline, Embase, CINAHL, PsycInfo, Web Science, Cochrane Register Controlled Trials, grey literature. included studies reporting quantitative measures retention treatment, illicit substance use, overdose, health, quality life, or satisfaction using qualitative examine with during pandemic. critically appraised Mixed Appraisal Tool. synthesized data vote-counting by direction effect presented results harvest plots. Qualitative were analyzed thematic synthesis. used convergent segregated approach integrate findings. Results Forty included. Most from North America (23/40) United Kingdom (9/40). synthesis limited potential confounding, but suggested association between increased treatment. There no evidence use overdose. findings indicated that reduced clients’ exposure unregulated substances stigma minimized work/treatment conflicts. Though some clients reported challenges managing their medication, dominant narrative one appreciation, anxiety, renewed sense agency identity. integrated analysis burden as explanation improved revealed variation individual relationships use. identified critical gap patient-important outcomes. Conclusion associated experience found despite expansion previously ineligible groups. Including outcome policy, development, planning is essential ensuring decisions around accurately reflect value clients.

Language: Английский

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A qualitative study exploring the impact of the COVID-19 pandemic on People Who Inject Drugs (PWID) and drug service provision in the UK: PWID and service provider perspectives

International Journal of Drug Policy, Journal Year: 2022, Volume and Issue: 106, P. 103752 - 103752

Published: May 27, 2022

People Who Inject Drugs (PWID) are subject to distinct socio-structural inequalities that can expose them high risks of COVID-19 transmission and related health social complications. In response mitigation strategies, these vulnerabilities being experienced in the context adapted drug treatment service provision, including reduced in-person support increased regulatory flexibility opioid substitution therapy (OST) guidelines. This study aimed explore longer-term impact pandemic on wellbeing PWID UK, provider client experiences changes.Interviews were conducted with 19 17 providers between May September 2021, recruited from homelessness charities providing services healthcare UK. Data analysed using reflexive thematic analysis.Most participants expressed ongoing fears transmission, although limited contexts which physical distancing could be practised. addition, virus strategies altered risk environment for PWID, resulting (e.g. changing use patterns, transitions crack cocaine, benzodiazepine pregabalin use) socio-economic harms opportunities sex work engagement income generation). Finally, whilst clients reported some favourable adaptations prompted by COVID-19, OST guidelines, there was continued scepticism caution among toward sustaining any changes beyond period.Whilst our findings emphasize importance accessible harm reduction measures attending indices drug-related during this period, is a need additional structural supports ensure pre-existing disparities impacting not exacerbated further conditions pandemic. sustained policy delivery will require attention if they acceptable both users providers.

Language: Английский

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Methadone and buprenorphine-related deaths among people prescribed and not prescribed Opioid Agonist Therapy during the COVID-19 pandemic in England

International Journal of Drug Policy, Journal Year: 2022, Volume and Issue: 110, P. 103877 - 103877

Published: Oct. 4, 2022

The coronavirus pandemic resulted in many changes which had the potential to impact mortality related opioid agonist therapy (OAT; methadone, buprenorphine), including prescribing and dispensing of OAT patterns drug availability use. We aimed assess first lockdown (initiated March 23rd 2020) on methadone- buprenorphine-related deaths England people both prescribed not using data from National Programme Substance Abuse Deaths.This was a retrospective post-mortem toxicology study OAT-related occurred 3-month period June 22nd years 2016-2020. Provisional regarding numbers accessing treatment for use disorder provided by Drug Treatment Monitoring System.We found 64% increase methadone-related 2020 compared 2019 (2019 n = 96; projected 157). There were increases rate in-treatment decedents (22% increase; 45; an exponential smoothing model 2016-19 trend [α=0.5] predicted 44 2020, 55 reported) methadone (74% 46; 43 80 reported). no 9/529; 11/566). where other opioids or multiple substances detected, levels detected. Numbers did decrease relative previous (p >0.05).Methadone-related non-prescribed individuals, but increased considerably above annual forecast during COVID-19 England. Further studies are thus needed understand this difference.

Language: Английский

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“It’s just a perfect storm”: Exploring the consequences of the COVID-19 pandemic on overdose risk in British Columbia from the perspectives of people who use substances

BMC Public Health, Journal Year: 2023, Volume and Issue: 23(1)

Published: April 3, 2023

Abstract Background Despite the implementation and expansion of public health harm reduction strategies aimed at preventing reversing overdoses, rates overdose-related events fatalities continue to rise in British Columbia. The COVID-19 pandemic created a second, concurrent emergency that further exacerbated illicit drug toxicity crisis, reinforced existing social inequities vulnerabilities, highlighted precariousness systems place are meant protect communities. By exploring perspectives people with recent experience substance use, this study sought characterize how associated measures influenced risk protective factors related unintentional overdose by altering environment which live use substances, influencing ability who substances be safe well. Methods One-on-one semi-structured interviews were conducted phone or in-person (n = 62) across province. Thematic analysis was performed identify shaping environment. Results Participants pointed increased overdose, including: [1] physical distancing isolation led more alone without bystanders nearby able respond event an emergency; [2] early price spikes supply chain issues inconsistencies availability; [3] increasing impurities unregulated substances; [4] restriction services distribution sites; [5] additional burden placed on peer workers frontlines crisis. these challenges, participants protected against substance-related harm, including emergence new programs, resiliency communities expanded their outreach efforts, existence established relationships, ways individuals consistently prioritized response over concerns about transmission care for one another. Conclusions findings from illustrate complex contextual shape highlight importance ensuring needs addressed future responses.

Language: Английский

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Examining the impact of the first wave of COVID-19 and associated control measures on interventions to prevent blood-borne viruses among people who inject drugs in Scotland: an interrupted time series study

Drug and Alcohol Dependence, Journal Year: 2022, Volume and Issue: 232, P. 109263 - 109263

Published: Jan. 31, 2022

Language: Английский

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Responding to a surge in overdose deaths: perspectives from US syringe services programs

Harm Reduction Journal, Journal Year: 2022, Volume and Issue: 19(1)

Published: July 19, 2022

US overdose deaths have reached a record high. Syringe services programs (SSPs) play critical role in addressing this crisis by providing multiple to people who use drugs (PWUD) that help prevent death. This study examined the perspectives of leadership and staff from geographically diverse sample SSPs on factors contributing surge, their organization's response, ongoing barriers preventing

Language: Английский

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Health service utilisation and access for people who inject drugs during COVID‐19

Drug and Alcohol Review, Journal Year: 2022, Volume and Issue: 41(6), P. 1304 - 1310

Published: March 9, 2022

Abstract Introduction The wide‐spread implementation of interventions to limit transmission and public health consequences COVID‐19 in the Australian state Victoria had flow‐on for people who use inject drugs. Consequences included interruption illicit drug supply procurement, disruption delivery services. To inform strategies that can minimise adverse outcomes similar future disruptive events, this study explored how restrictions impacted access harm reduction treatment services drugs Melbourne, Victoria. Methods Qualitative semi‐structured interviews were conducted via an online calling app, with 11 participants a broader cohort (the SuperMIX study) April 2020. Interviews focused on experiences accessing using Data thematically analysed process blended coding. Results Findings revealed disruptions services—in response restrictions—created barriers sterile injecting equipment, increased risk arrest by police exacerbated social isolation. Participants reported difficulties adapting changes access, some increases behaviours. However, improvements opioid agonist therapy prescriptions noted as beneficial outcome. Discussion By examining impacts resultant drugs' Victoria, findings provide guidance responses unanticipated large‐scale effects pandemic, events.

Language: Английский

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Analysis of the UK Government’s 10-Year Drugs Strategy—a resource for practitioners and policymakers

Journal of Public Health, Journal Year: 2022, Volume and Issue: 45(2), P. e215 - e224

Published: Oct. 29, 2022

In 2021, during a drug-related death crisis in the UK, Government published its ten-year drugs strategy. This article, written collaboration with Faculty of Public Health and Association Directors Health, assesses whether this Strategy is evidence-based consistent international calls to promote public health approaches drugs, which put 'people, human rights at centre'. Elements are welcome, including promise significant funding for drug treatment services, effects will depend on how it utilized by services local commissioners sustained. However, unevidenced harmful measures deter use means punishment continue be promoted, have deleterious impacts people who drugs. An effective approach should tackle population-level risk factors, may predispose patterns use, adverse childhood experiences socioeconomic deprivation, institute mitigate harm. would likely more effective, just, than continuation policies rooted enforcement. A dramatic re-orientation UK policy that offered overdue.

Language: Английский

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