Identifying the impacts of the COVID-19 pandemic on service access for people who use drugs (PWUD): A national qualitative study.
Identifying the impacts of the COVID-19 pandemic on service access for people who use drugs (PWUD): A national qualitative study.
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DOI：
10.1016/j.jsat.2021.108374
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发表时间：
2021-10
影响因子：
3.9
通讯作者：
Elton-Marshall, Tara
中科院分区：
文献类型：
--
作者：
Russell, Cayley;Ali, Farihah;Nafeh, Frishta;Rehm, Juergen;LeBlanc, Sean;Elton-Marshall, Tara
为应对2019冠状病毒病大流行而关闭和削减特定卫生和社会服务的能力，可能使吸毒者（PWUD）遭受伤害的风险不成比例地增加，并导致严重的治疗中断。我们在一组PWUD中进行了当前的全国性研究，以了解COVID-19如何影响服务获取，包括PWUD可能经历的任何重大影响。研究结果将有助于为未来的流行病和脆弱人群的公共卫生政策规划提供依据。该项目涉及定性电话采访196成年人（18岁以上）PWUD来自加拿大各地。入选标准包括每日或每周使用精神活性物质和/或目前接受阿片类激动剂治疗（OAT）。数据收集于2020年5月至7月期间进行。对数据进行了专题分析，共同的专题为分析结果提供了依据。大多数参与者在COVID-19期间经历了有害的服务获取问题和治疗中断，包括减少获得减少伤害服务、OAT、戒断管理和治疗服务、医疗专业人员（例如，成瘾和心理健康咨询），庇护所/住房和食品银行。积极的影响包括更多地获得OAT带回家的“携带”和处方交付。服务能力的下降导致PWUD中的健康问题和危险物质使用行为增加，例如无人陪伴的物质使用，共享/重复使用用品和过量事件。在COVID-19期间，PWUD所依赖的关键服务的可及性减少，增加了PWUD中现有的物质使用和健康问题，同时降低了他们减轻与物质使用相关风险的能力。因此，扩大支助选择的深度和广度至关重要。在COVID-19期间，服务必须保持开放和灵活，以满足PWUD的独特需求，而在COVID-19后，新颖有效的适应和干预措施应仍然可用。
Closures and reductions in capacity of select health and social services in response to the COVID-19 pandemic may have placed people who use drugs (PWUD) at a disproportionately increased risk for experiencing harms, and resulted in critical treatment disruptions. We conducted the current national study among a cohort of PWUD to understand how COVID-19 has affected service access, including any significant impacts PWUD may have experienced. Results will contribute to the evidence base for informing future pandemic and public health policy planning for vulnerable populations. The project involved qualitative telephone-based interviews with 196 adult (aged 18+) PWUD from across Canada. Eligibility criteria included daily or weekly use of psychoactive substance(s), and/or current enrollment in opioid agonist treatment (OAT). Data collection took place between May and July 2020. Data underwent thematic analyses, and common themes informed the results. Most participants experienced detrimental service access issues and treatment disruptions during COVID-19, including reduced access to harm reduction services, OAT, withdrawal management and treatment services, medical professionals (e.g., addictions and mental health counseling), shelters/housing, and food banks. Positive impacts included greater access to OAT take-home ‘carries’ and prescription deliveries. Decreases in service capacity resulted in increased health issues and risky substance use behaviors among PWUD, such as unaccompanied substance use, sharing/re-use of supplies, and overdose events. Reductions in the accessibility of critical services PWUD rely on during COVID-19 has increased existent substance use and health issues among PWUD, while decreasing their ability to mitigate risks related to substance use. Thus, the expansion of the depth and breadth of support options is crucial. Services must remain open and flexible to the unique needs of PWUD during COVID-19, while novel and effective adaptations and interventions should remain available and accessible post-COVID-19.
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