Multi-level influences on increased overdose risk behaviors during the COVID-19 pandemic among people who use drugs in Rhode Island: a qualitative investigation.
Multi-level influences on increased overdose risk behaviors during the COVID-19 pandemic among people who use drugs in Rhode Island: a qualitative investigation.
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DOI：
10.1186/s12954-023-00741-w
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发表时间：
2023-02-04
影响因子：
4.4
通讯作者：
Macmadu, Alexandria
中科院分区：
文献类型：
--
作者：
Frueh, Lisa;Collins, Alexandra B. B.;Newman, Roxxanne;Barnett, Nancy P. P.;Rich, Josiah D. D.;Clark, Melissa A. A.;Marshall, Brandon D. L.;Macmadu, Alexandria
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 pandemic have been documented, with research underscoring the role of influencing factors such as isolation and job loss in these behaviors. Here, we use qualitative methods to examine the impact of the COVID-19 pandemic and pandemic-related response measures on drug use behaviors in a sample of PWUD in Rhode Island. Using a social-ecological framework, we highlight the nested, interactive levels of the pandemic’s influence on increased overdose risk behaviors. From July to October 2021, semi-structured interviews were conducted with 18 PWUD who self-reported any increase in behaviors associated with overdose risk (e.g., increased use, change in drug type and/or more solitary drug use) relative to before the pandemic. Thematic analysis was conducted using a codebook with salient themes identified from interview guides and those that emerged through close reading of transcribed interviews. Guided by a social-ecological framework, themes were grouped into individual, network, institutional, and policy-level influences of the pandemic on drug use behaviors. Individual-level influences on increased overdose risk behaviors included self-reported anxiety and depression, isolation and loneliness, and boredom. Network-level influences included changes in local drug supply and changes in social network composition specific to housing. At the institutional level, drug use patterns were influenced by reduced access to harm reduction or treatment services. At the policy level, increased overdose risk behaviors were related to financial changes, job loss, and business closures. All participants identified factors influencing overdose risk behaviors that corresponded to several nested social-ecological levels. Participants identified multi-level influences of the COVID-19 pandemic and pandemic-related response measures on their drug use behavior patterns and overdose risk. These findings suggest that effective harm reduction during large-scale crises, such as the COVID-19 pandemic, must address several levels of influence concurrently.
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影响因子：
13.8
作者：
Czeisler MÉ;Lane RI;Wiley JF;Czeisler CA;Howard ME;Rajaratnam SMW
通讯作者：
Rajaratnam SMW
影响因子：
4.4
作者：
Davitadze A;Meylakhs P;Lakhov A;King EJ
通讯作者：
King EJ
DOI：
10.1016/j.drugpo.2021.103391
发表时间：
2021-12
期刊：
The International journal on drug policy
影响因子：
--
作者：
Kesten JM;Holland A;Linton MJ;Family H;Scott J;Horwood J;Hickman M;Telfer M;Ayres R;Hussey D;Wilkinson J;Hines LA
通讯作者：
Hines LA
DOI：
10.1016/j.drugpo.2022.103626
发表时间：
2022-05
期刊：
The International journal on drug policy
影响因子：
--
作者：
Collins AB;Edwards S;McNeil R;Goldman J;Hallowell BD;Scagos RP;Marshall BDL
通讯作者：
Marshall BDL
DOI：
10.3390/ijerph19042230
发表时间：
2022-02-16
影响因子：
--
作者：
Bolinski RS;Walters S;Salisbury-Afshar E;Ouellet LJ;Jenkins WD;Almirol E;Van Ham B;Fletcher S;Johnson C;Schneider JA;Ompad D;Pho MT
通讯作者：
Pho MT