Should I Stay or Should I Go? A Qualitative Exploration of Stigma and Other Factors Influencing Opioid Agonist Treatment Journeys

International Journal of Environmental Research and Public Health, Journal Year: 2023, Volume and Issue: 20(2), P. 1526 - 1526

Published: Jan. 14, 2023

(1) The harm-reduction benefits of opioid agonist treatment (OAT) are well-established; however, the UK government’s emphasis on “recovery” may be contributing to a high proportion people leaving and low retention rates. We wanted develop rich nuanced understanding factors that might influence journeys who use OAT. (2) explored at each level socioecological system considered ways these interact in carried out semi-structured interviews with OAT (n = 12) service providers 13) analysed data using reflexive thematic analysis. (3) developed three themes representing participant perceptions These were: System is Broken; Power Struggles; Filling Void. (4) Conclusions: suggest prioritisation important preserve Stigma systemic issue which presents multiple barriers living fulfilling lives. There an urgent need targeted interventions address stigma towards

Language: Английский

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Drug treatment and support service utilization amidst the COVID-19 pandemic among people who inject drugs in Baltimore, Maryland: An interrupted time-series analysis, 2015–2022

International Journal of Drug Policy, Journal Year: 2025, Volume and Issue: 138, P. 104746 - 104746

Published: March 3, 2025

Language: Английский

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Lessons from COVID-19: Perspectives of Senior Managers and Decision-Makers in Substance use Services in Wales

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: March 10, 2025

Background The COVID-19 pandemic significantly disrupted substance use services, potentially exacerbating existing inequities in access to treatment. This study examines the perspectives of senior managers and decision-makers Wales regarding equity issues services during pandemic. Methods Semi-structured interviews were conducted with fifteen from various organisations field Wales. Interviews autumn 2020. Data analysed using thematic analysis identify key themes related Results Key findings highlighted significant disparities between third sector statutory NHS particularly PPE, recognition as essential workers. rapid shift digital service provision exposed a divide, excluding vulnerable users. However, also accelerated innovations delivery, such introduction long-acting injectable buprenorphine revised take-home medication policies. Long-term concerns included economic impact on populations, potential increases mental health use, funding uncertainties for services. Conclusions exacerbated while driving innovation. Findings suggest need greater support strategies address sustained ensure equitable These insights can inform policy practice develop more resilient preparation any future crises.

Language: Английский

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Multi-level influences on increased overdose risk behaviors during the COVID-19 pandemic among people who use drugs in Rhode Island: a qualitative investigation

Harm Reduction Journal, Journal Year: 2023, Volume and Issue: 20(1)

Published: Feb. 4, 2023

Abstract Background The ongoing COVID-19 pandemic has disproportionately affected structurally vulnerable populations including people who use drugs (PWUD). Increased overdose risk behaviors among PWUD during the have been documented, with research underscoring role of influencing factors such as isolation and job loss in these behaviors. Here, we qualitative methods to examine impact pandemic-related response measures on drug a sample Rhode Island. Using social-ecological framework, highlight nested, interactive levels pandemic’s influence increased Methods From July October 2021, semi-structured interviews were conducted 18 self-reported any increase associated (e.g., use, change type and/or more solitary use) relative before pandemic. Thematic analysis was using codebook salient themes identified from interview guides those that emerged through close reading transcribed interviews. Guided by grouped into individual, network, institutional, policy-level influences Results Individual-level included anxiety depression, loneliness, boredom. Network-level changes local supply social network composition specific housing. At institutional level, patterns influenced reduced access harm reduction or treatment services. policy related financial changes, loss, business closures. All participants corresponded several nested levels. Conclusions Participants multi-level their behavior risk. These findings suggest effective large-scale crises, pandemic, must address concurrently.

Language: Английский

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Structural and social changes due to the COVID-19 pandemic and their impact on engagement in substance use disorder treatment services: a qualitative study among people with a recent history of injection drug use in Baltimore, Maryland

Harm Reduction Journal, Journal Year: 2024, Volume and Issue: 21(1)

Published: May 8, 2024

Abstract Background Substance use disorder treatment and recovery support services are critical for achieving maintaining recovery. There limited data on how structural social changes due to the COVID-19 pandemic impacted individual-level experiences with substance treatment-related among community-based samples of people who inject drugs. Methods People a recent history injection drug were enrolled in AIDS Linked IntraVenous Experience study Baltimore, Maryland participated one-time, semi-structured interview between July 2021 February 2022 about their living through (n = 28). An iterative inductive coding process was used identify themes describing affected participants’ services. Results The median age participants 54 years (range 24–73); 10 (36%) female, 16 (57%) non-Hispanic Black, 8 (29%) HIV. We identified several that acted as barriers facilitators engagement medications opioid (MOUD) (e.g., group meetings). New take-home methadone flexibility policies temporarily facilitated MOUD treatment, but other pre-existing rigid practices zero-tolerance) counteracting barriers. Changes illicit market both facilitator barrier treatment. Decreased availability pandemic-related adaptations in-person While telehealth expansion meetings some participants, faced digital technological These service provision also led diminished perceived quality virtual meetings. However, increased accessibility individual providers counselors Sponsors). Conclusions Structural across socioecological levels created new Multilevel interventions needed improve access high-quality

Language: Английский

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The impact of the COVID-19 pandemic on people who inject drugs accessing harm reduction services in a rural American state

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

Published: July 22, 2022

Abstract Background The impact of public health policies during the COVID-19 pandemic on people who inject drugs (PWID) has varied across regions. In other countries, recent research shown that PWID access to harm reduction services, despite rapid adaptations, been negatively impacted. Our study describes these impacts in a rural state. Methods We conducted semi-structured interviews with PWID, community partners, and healthcare providers state Maine (USA). explored how changes made impacted including basic services (i.e., shelter), syringe service programs, safe drug supply, low barrier treatment, peer support. Interviews were analyzed using framework method apply Penchansky’s model access, Saurman’s modification, which includes six dimensions access—accessibility, availability, acceptability, affordability, accommodation, awareness. Results interviewed thirty-six stakeholders ( N = 9 providers, 18 PWID). Policies such as mobile outreach expansion, mail delivery equipment, relaxed telemedicine regulations facilitated accessibility programs buprenorphine treatment. Public policies, social distancing screening reduced contact, subsequently acceptability awareness many services. Elimination one-for-one needle exchange some areas increased, perception service), affordability for PWID. However, actually began enforcing policy, Conclusions Changes resulting from have all among While barriers unavoidable pandemic, we found specific policy decisions mitigated barriers, while exacerbated them. Relaxing particularly helpful facilitating by giving organizations flexibility adapt evolving needs These results can inform optimally mitigate negative during, beyond, pandemic.

Language: Английский

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Homeless people’s experiences of the illicit drug supply during COVID-19

Housing Care and Support, Journal Year: 2024, Volume and Issue: 27(1), P. 64 - 76

Published: March 23, 2024

Purpose The COVID-19 pandemic has affected many industries, and reports indicate that this includes the illicit drug market. Recent research suggests homeless are particularly vulnerable during pandemic, UK Government acted to house rough sleepers. Research is scarce regarding people’s experiences of This study aims explore supply in COVID-19. Design/methodology/approach Eight people who use drugs, residing hostels for Southampton, participated semi-structured one-on-one telephone-based interviews. Findings A thematic analysis revealed five themes: availability presence dealers, quality finances personal experiences. Participants reported varying supply, with lockdown measures expressed as main reason reduced supplies, users found it difficult find dealers generate income purchasing drugs. limitations/implications results may lack generalisability wider population, such sleepers suggesting a need further into on topic could be more in-depth through methods convenient population. Practical implications Services should invest harm reduction services encourage drugs engage substitution treatment. Homeless provide psychological support Social changes behaviour following have their interactions rest society (e.g. begging town centres reduce). These also change way can best people. Originality/value partially consistent other findings about supply; however, they suggest some individuals experienced minimal supply.

Language: Английский

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Impact of the COVID-19 Pandemic on Hepatitis C Treatment Initiation in British Columbia, Canada: An Interrupted Time Series Study

Viruses, Journal Year: 2024, Volume and Issue: 16(5), P. 655 - 655

Published: April 23, 2024

We investigated the impacts of COVID-19 pandemic on hepatitis C (HCV) treatment initiation, including by birth cohort and injection drug use status, in British Columbia (BC), Canada. Using population data from BC Cohort, we conducted interrupted time series analyses, estimating changes HCV initiation following introduction pandemic-related policies March 2020. The study included a pre-policy period (April 2018 to 2020) three follow-up periods December 2020, January 2021, 2022). level decreased 26% April 2020 (rate ratio 0.74, 95% confidence interval [CI] 0.60 0.91). Overall, no statistically significant difference occurred over 2021 post-policy periods, an increase 34.4% (95% CI 0.6 75.8) 2022 (equating 321 additional people initiating treatment), relative expectation. Decreases for born between 1965 1974 (25.5%) who inject drugs (24.5%), In summary, was associated with short-term disruptions BC, which were greater drugs.

Language: Английский

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What's in Stock? Drug drought anticipation during COVID-19 among people who use drugs and service providers

International Journal of Drug Policy, Journal Year: 2023, Volume and Issue: 117, P. 104048 - 104048

Published: May 8, 2023

As with other areas of life, drug markets have been impacted by the COVID-19 pandemic and related restrictions. This article examines how structurally vulnerable people who use drugs (PWUD) experienced adapted to changes in street caused lockdown measures.The builds on ethnographic fieldwork two Danish cities 2020, including in-depth interviews 22 PWUD, 20 service providers, low-threshold providers outreach workers.The most consistently reported effect measures local increases cannabis prices. Accounts availability varied greatly, some participants reporting changing while others described situation as similar pre-lockdown conditions. Rather than a long-term shortage, anticipated disruption scarcity, restrictions access cash sellers seeking capitalize crisis.Although no scarcity was seen, anticipation shortage sufficient impact market dynamics. Heterogeneity PWUDs' experiences during can degree be explained terms their embeddedness social networks. While proved resilient measures, PWUD less embedded networks were more shifts sellers' over-pricing drugs.

Language: Английский

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Impacts of the COVID-19 pandemic on enrollment in medications for opioid use disorder (MOUD) in Vancouver, Canada: An interrupted time series analysis

International Journal of Drug Policy, Journal Year: 2023, Volume and Issue: 118, P. 104075 - 104075

Published: May 22, 2023

In anticipation of COVID-19 related disruptions to opioid use disorder (OUD) care, new provincial and federal guidance for the management OUD risk mitigation (RMG) prescription pharmaceutical opioids were introduced in British Columbia, Canada, March 2020. This study evaluated combined impacts pandemic counteracting policies on enrollment medications (MOUD). Using data from three cohorts people with presumed Vancouver, we conducted an interrupted time series analysis estimate effects impact prevalence MOUD overall, as well individual MOUDs (methadone, buprenorphine/naloxone, slow-release oral morphine) between November 2018 2021, controlling pre-existing trends. sub-analysis considered RMG together MOUD. We included 760 participants OUD. post-COVID-19 period, morphine rates showed estimated immediate increase level (+7.6%, 95% CI: 0.6%, 14.6% 1.8%, 0.3%, 3.3%, respectively), followed by a decline monthly trend (-0.8% per month, −1.4%, −0.2% −0.4, −0.1, respectively). There no significant changes trends methadone, or when Despite improvements this beneficial reversed over time. appeared have provided additional benefits sustain retention care.

Language: Английский

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