Structural and community changes during COVID-19 and their effects on overdose precursors among rural people who use drugs: a mixed-methods analysis. Walters, S. M., Bolinski, R. S., Almirol, E., Grundy, S., Fletcher, S., Schneider, J., Friedman, S. R., Ouellet, L. J., Ompad, D. C., Jenkins, W., & Pho, M. T. Addict Sci Clin Pract, 17(1):24, April, 2022. Edition: 20220425
Structural and community changes during COVID-19 and their effects on overdose precursors among rural people who use drugs: a mixed-methods analysis [link]Paper  doi  abstract   bibtex   
BACKGROUND: Drug overdose rates in the United States have been steadily increasing, particularly in rural areas. The COVID-19 pandemic and associated mitigation strategies may have increased overdose risk for people who use drugs by impacting social, community, and structural factors. METHODS: The study included a quantitative survey focused on COVID-19 administered to 50 people who use drugs and semi-structured qualitative interviews with 17 people who use drugs, 12 of whom also participated in the quantitative survey. Descriptive statistics were run for the quantitative data. Qualitative coding was line-by-line then grouped thematically. Quantitative and qualitative data were integrated during analysis. RESULTS: Findings demonstrate how COVID-19 disruptions at the structural and community level affected outcomes related to mental health and drug use at the individual level. Themes that emerged from the qualitative interviews were (1) lack of employment opportunities, (2) food and housing insecurity, (3) community stigma impacting health service use, (4) mental health strains, and (5) drug market disruptions. Structural and community changes increased anxiety, depression, and loneliness on the individual level, as well as changes in drug use patterns, all of which are likely to increase overdose risk. CONCLUSION: The COVID-19 pandemic, and mitigation strategies aimed at curbing infection, disrupted communities and lives of people who use drugs. These disruptions altered individual drug use and mental health outcomes, which could increase risk for overdose. We recommend addressing structural and community factors, including developing multi-level interventions, to combat overdose. Trial registration Clinicaltrails.gov: NCT04427202. Registered June 11, 2020: https://clinicaltrials.gov/ct2/show/NCT04427202?term=pho+mai&draw=2&rank=3.
@article{walters_structural_2022,
	title = {Structural and community changes during {COVID}-19 and their effects on overdose precursors among rural people who use drugs: a mixed-methods analysis},
	volume = {17},
	issn = {1940-0640 (Electronic) 1940-0632 (Linking)},
	url = {https://www.ncbi.nlm.nih.gov/pubmed/35468860},
	doi = {10.1186/s13722-022-00303-8},
	abstract = {BACKGROUND: Drug overdose rates in the United States have been steadily increasing, particularly in rural areas. The COVID-19 pandemic and associated mitigation strategies may have increased overdose risk for people who use drugs by impacting social, community, and structural factors. METHODS: The study included a quantitative survey focused on COVID-19 administered to 50 people who use drugs and semi-structured qualitative interviews with 17 people who use drugs, 12 of whom also participated in the quantitative survey. Descriptive statistics were run for the quantitative data. Qualitative coding was line-by-line then grouped thematically. Quantitative and qualitative data were integrated during analysis. RESULTS: Findings demonstrate how COVID-19 disruptions at the structural and community level affected outcomes related to mental health and drug use at the individual level. Themes that emerged from the qualitative interviews were (1) lack of employment opportunities, (2) food and housing insecurity, (3) community stigma impacting health service use, (4) mental health strains, and (5) drug market disruptions. Structural and community changes increased anxiety, depression, and loneliness on the individual level, as well as changes in drug use patterns, all of which are likely to increase overdose risk. CONCLUSION: The COVID-19 pandemic, and mitigation strategies aimed at curbing infection, disrupted communities and lives of people who use drugs. These disruptions altered individual drug use and mental health outcomes, which could increase risk for overdose. We recommend addressing structural and community factors, including developing multi-level interventions, to combat overdose. Trial registration Clinicaltrails.gov: NCT04427202. Registered June 11, 2020: https://clinicaltrials.gov/ct2/show/NCT04427202?term=pho+mai\&draw=2\&rank=3.},
	number = {1},
	journal = {Addict Sci Clin Pract},
	author = {Walters, S. M. and Bolinski, R. S. and Almirol, E. and Grundy, S. and Fletcher, S. and Schneider, J. and Friedman, S. R. and Ouellet, L. J. and Ompad, D. C. and Jenkins, W. and Pho, M. T.},
	month = apr,
	year = {2022},
	note = {Edition: 20220425},
	keywords = {*Drug Overdose/drug therapy/epidemiology, *Drug use, *Ecosocial theory, *Overdose, *Rural, *Social determinants of health, *Social ecological model, *Substance-Related Disorders, *covid-19, Covid-19, Drug use, Ecosocial theory, Humans, Overdose, Pandemics, Rural, Rural Population, Social determinants of health, Social ecological model, United States/epidemiology},
	pages = {24},
}

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