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Nygaard-Christensen M. "More Concerned About Mr. and Mrs. Denmark": Coping with Pandemic Crisis at the Intersection of Homelessness and Drug Use. Med Anthropol 2024; 43:17-30. [PMID: 37831438 DOI: 10.1080/01459740.2023.2266860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
This article builds on fieldwork conducted during lockdown in Denmark among users of services at the intersection of homelessness and drug use. The paper bridges two distinct approaches to understanding the relation between marginalization and crisis, with one focused on the impact of "big events" on marginalized populations, and another on everyday strategies employed to survive situations of homelessness and drug use. The paper shows how past experiences of hardship became relevant for coping with pandemic crisis. It further exploreshow, through critical engagement with dominant accounts of vulnerability, research participants carved out a space for negotiating their marginality in the Danish welfare state.
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McCurdy LY, Kong G, Krishnan-Sarin S, Kiluk BD, Potenza MN. A non-randomized pilot study protocol of a novel social support intervention for individuals in early recovery from hazardous alcohol use. PLoS One 2023; 18:e0292293. [PMID: 37796784 PMCID: PMC10553253 DOI: 10.1371/journal.pone.0292293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION Connecting individuals to recovery support services such as recovery community centers and mutual help organizations can be crucial for sustaining recovery from addiction. However, there may be barriers to engagement with recovery support services on individual (e.g., limited motivation) and structural (e.g., limited information on recovery resources) levels. This pilot study will determine the feasibility and acceptability of a novel online social support intervention (Let's Do Addiction Recovery Together!, abbreviated as LDART) that uses pre-recorded videos created by members from several recovery support services to help individuals in early recovery from hazardous alcohol use sustain motivation during recovery and introduce them to freely available recovery support services in the community. METHODS AND ANALYSIS This will be a non-randomized mixed-method pilot study. We will recruit 30 adults who engaged in past-year hazardous alcohol use and have some desire to cut down or quit to use LDART every night for a month. A subset of these participants will be invited to participate in a semi-structured qualitative interview after completing the study. Primary outcomes will be feasibility parameters such as recruitment and retention rates, and acceptability measures such as frequency of intervention use. Secondary outcomes will include self-reported changes in alcohol use, engagement in recovery support services, and quality of life at one-month post-intervention relative to baseline. DISCUSSION Results of this pilot study will inform a randomized controlled trial to examine efficacy of this intervention, with the goal of creating an accessible and scalable intervention that has direct benefits on individuals who want to cut down or quit problematic alcohol use. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT06022107.
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Affiliation(s)
- Li Yan McCurdy
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Suchitra Krishnan-Sarin
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Brian D. Kiluk
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Marc N. Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Neuroscience, Yale School of Medicine, New Haven, Connecticut, United States of America
- Wu Tsai Institute, Yale University, New Haven, Connecticut, United States of America
- Connecticut Mental Health Center, New Haven, Connecticut, United States of America
- Connecticut Council on Problem Gambling, Wethersfield, Connecticut, United States of America
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Rance J, Bryant J, Caruana T, Brener L. Practising care in a pandemic: Accounting for everyday life during COVID-19 among people who inject drugs. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:791-809. [PMID: 36738164 DOI: 10.1111/1467-9566.13612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 01/04/2023] [Indexed: 05/04/2023]
Abstract
From the outset of the COVID-19 pandemic, fears have been raised worldwide regarding the unique challenges facing socially marginalised people such as those who inject drugs. This article draws on in-depth interviews conducted during the first year of the pandemic with people who inject drugs living in urban and regional Australia. Perhaps the most surprising finding to emerge was the number of participants who reported minimal disruption to their everyday lives, even improved wellbeing in some instances. Attempting to make sense of this unanticipated finding, our analysis draws on the concept of 'care', not as a moral disposition or normative code but as something emergent, contingent and realised in practice. Working with Foucault's ethics and recent feminist insights on the politics of care from the field of Science and Technology Studies, we explore how care was enacted in the everyday lives of our participants. We examine how participants' daily routines became objects of care and changed practice in response to the pandemic; how their ongoing engagement with harm reduction services afforded not only clinical support but vital forms of social and affective connection; and how for some, care was realised through an ethos and practice of constrained sociality and solitude.
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Affiliation(s)
- Jake Rance
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Joanne Bryant
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Theresa Caruana
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Loren Brener
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
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Chavez MN, Marshall VK, Martinez Tyson D, Mason TM, Rechenberg K. Psychological Impact of COVID-19 on Oncology Patients: Perceptions of Oncology Health Care Providers. West J Nurs Res 2023; 45:152-160. [PMID: 35897163 PMCID: PMC10079896 DOI: 10.1177/01939459221114634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The COVID-19 pandemic profoundly impacted psychological well-being worldwide. Oncology health care professionals' (OHCPs') perceptions of psychological effects of COVID-19 among people in active cancer treatment were explored. Semi-structured interviews with a purposive sample of OHCPs actively providing care were conducted. Interviews were audio-recorded, transcribed, and coded using Atlas.ti v8 and thematic analysis. In total, 30 OHCPs participated. Most were registered nurses (70%), worked in outpatient setting (56.7%) and were in their current position 1-5 years (53.3%). Overarching themes are as follows: (a) cancer treatment disrupted due to patients' fear of exposure to COVID-19; (b) social distancing restrictions caused discontinued social support and supportive services that exacerbated psychological distress; (c) pandemic-related stressors led to overwhelmed coping skills; and (d) OHCPs played a vital role in providing emotional support and connecting patients with family/friends through technology. Behavioral health interventions should focus within the "new world of COVID-19" of reduced face-to-face support and increased online support for patients.
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Affiliation(s)
- Melody N. Chavez
- College of Public Health, University of
South Florida, Tampa, FL, USA
| | | | | | - Tina M. Mason
- H. Lee Moffitt Cancer Center &
Research Institute, Tampa, FL, USA
- Tina M. Mason, Department of Nursing
Research, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612,
USA.
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Lee JH. Still a threatening opioid wave: it is time for the protagonist to step up! Korean J Pain 2023; 36:1-3. [PMID: 36581596 PMCID: PMC9812690 DOI: 10.3344/kjp.22403] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 12/31/2022] Open
Affiliation(s)
- Joon-Ho Lee
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea,Correspondence: Joon-Ho Lee Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon 14584, Korea, Tel: +82-32-621-5340, Fax: +82-32-621-5322, E-mail:
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Falla-Aliabadi S, Heydari A, Fatemi F, Yoshany N, Lotfi MH, Sarsangi A, Hanna F. Impact of social and cultural factors on incidence, transmission and control of Coronavirus disease in Iran: a qualitative study. BMC Public Health 2022; 22:2352. [PMID: 36522718 PMCID: PMC9753076 DOI: 10.1186/s12889-022-14805-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/05/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION COVID-19 pandemic has had mixed reactions from nations, people and governments about ways to cope with, prevent and control the disease. The current study identifies social, cultural and policy factors affecting the incidence and control of Coronavirus disease in Iran. METHODS A qualitative study consists of content analysis as well as the views of 20 experienced and knowledgeable subjects specialized in social and cultural health management. The data were gathered using three semi-structured interviews and then continued by 17 semi-structured interviews. Data analysis was done using Graneheim approach. After each interview, the recorded audio files transcript and reviewed. Then codes extracted and divided to categories and sub-categories. RESULTS There are distinct social and cultural factors in coping with Coronavirus disease. These consisted of three categories of governance, individual and community related factors. A total of 17 subcategories and 215 primary codes that were extracted from the text of interviews as variables of the study and in relation to the research question. Ten subdomains of governance including vaccination, political issues, knowledge, support services, administrative services, transportation, health and treatment, culturalization, legislation and, managerial and financial policies impacted the spread and mitigation of the pandemic at various levels. CONCLUSION The management of pandemics requires a comprehensive capacity for identifying and determining social and cultural criteria. A healthy partnership between governments and the community may be required to remove unnecessary obstacles that hinder public health attempt to alleviate the risk. The obtained criteria and indicators from this study may be utilized by policy makers in an attempt to strengthen protocols for mitigating pandemics. Further studies may be warranted to confirm these findings.
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Affiliation(s)
- Saeed Falla-Aliabadi
- Department of Health in Emergencies and Disasters, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ahad Heydari
- Department of Health in Disaster and Emergencies, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farin Fatemi
- Social Determinant of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Nooshin Yoshany
- Department of Health education and Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hasan Lotfi
- Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Sarsangi
- GIS and Remote Sensing Department, University of Tehran, Tehran, Iran
| | - Fahad Hanna
- Program of Public Health, Torrens University Australia, Melbourne, VIC Australia
- Higher Education College, Chisholm Institute, Dandenong, VIC Australia
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Zhen‐Duan J, Gade N, Falgas‐Bagué I, Sue KL, DeJonckheere M, Alegría M. Using a structural vulnerability framework to understand the impact of COVID-19 on the lives of Medicaid beneficiaries receiving substance use treatment in New York City. Health Serv Res 2022; 57:1104-1111. [PMID: 35340033 PMCID: PMC9111318 DOI: 10.1111/1475-6773.13975] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To investigate how the COVID-19 pandemic impacted low-income individuals with substance use disorder (SUD) in New York City (NYC) during the beginning of the pandemic, using a structural competency and structural vulnerability theoretical framework and a qualitative research approach. DATA SOURCES Primary qualitative data were collected from racial/ethnic minority adults enrolled in Medicaid receiving outpatient substance use treatment (e.g., medication, counseling) in NYC. STUDY DESIGN Semi-structured in-depth qualitative interviews (N = 20) were conducted during "stay-at-home" orders in NYC, the first epicenter of the COVID-19 pandemic in the United States. Interviews were conducted over the phone during the earlier stages of the pandemic, between April 2020 and June 2020. DATA COLLECTION/EXTRACTION METHODS Semi-structured in-depth interviews were conducted and audio recorded, transcribed, and analyzed using a thematic analysis approach. PRINCIPAL FINDINGS Three themes were yielded from our thematic analysis: (1) COVID-19 heightened food insecurity and housing conditions increased risks of infection; (2) stay-at-home orders limited access to resources but had positive impacts in strengthening social relationships and reducing substance use triggers; and (3) although COVID-19 created challenges for treatment, most described that SUD care improved during the pandemic. CONCLUSIONS While COVID-19 exacerbated numerous structural vulnerabilities among low-income individuals with SUD, programmatic adaptations to COVID-19 SUD care, including telehealth and loosening restrictions around medications for opioid use disorders mitigated past difficulties that patients had faced. Reducing structural vulnerabilities for Medicaid patients will require continuation of telehealth treatment delivery, retaining flexible medication regulations, and mobilizing community resources to mitigate economic disparities.
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Affiliation(s)
- Jenny Zhen‐Duan
- Disparities Research Unit, Department of MedicineMassachusetts General HospitalBostonMassachusettsUSA,Department of MedicineHarvard Medical SchoolBostonMassachusettsUSA
| | - Neerav Gade
- Disparities Research Unit, Department of MedicineMassachusetts General HospitalBostonMassachusettsUSA,Department of Community HealthTufts UniversityMedfordMassachusettsUSA
| | - Irene Falgas‐Bagué
- Disparities Research Unit, Department of MedicineMassachusetts General HospitalBostonMassachusettsUSA,Department of MedicineHarvard Medical SchoolBostonMassachusettsUSA
| | - Kimberly L. Sue
- Department of Internal MedicineYale School of MedicineNew HavenConnecticutUSA
| | | | - Margarita Alegría
- Disparities Research Unit, Department of MedicineMassachusetts General HospitalBostonMassachusettsUSA,Department of MedicineHarvard Medical SchoolBostonMassachusettsUSA,Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
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Kelly EL, Reed MK, Schoenauer KM, Smith K, Scalia-Jackson K, Kay Hill S, Li E, Weinstein L. A Qualitative Exploration of the Functional, Social, and Emotional Impacts of the COVID-19 Pandemic on People Who Use Drugs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9751. [PMID: 35955107 PMCID: PMC9367729 DOI: 10.3390/ijerph19159751] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
Since 2020, people who use drugs (PWUD) experienced heightened risks related to drug supply disruptions, contamination, overdose, social isolation, and increased stress. This study explored how the lives of PWUD changed in Philadelphia over a one-year period. Using semi-structured interviews with 20 participants in a Housing First, low-barrier medication for opioid use (MOUD) program in Philadelphia, the effects of the first year of the COVID-19 pandemic on the daily lives, resources, functioning, substance use, and treatment of PWUD were explored. Interviews were analyzed using a combination of directed and conventional content analysis. Six overarching themes emerged during data analysis: (1) response to the pandemic; (2) access to MOUD and support services; (3) substance use; (4) impacts on mental health, physical health, and daily functioning; (5) social network impacts; and (6) fulfillment of basic needs. Participants reported disruptions in every domain of life, challenges meeting their basic needs, and elevated risk for adverse events. MOUD service providers offset some risks and provided material supports, treatment, social interaction, and emotional support. These results highlight how there were significant disruptions to the lives of PWUD during the first year of the COVID-19 pandemic and identified critical areas for future intervention and policies.
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Affiliation(s)
- Erin L. Kelly
- Department of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
- Center for Social Medicine and Humanities, Department of Psychiatry, Semel Institute, University of California, Los Angeles, CA 90024, USA
| | - Megan K. Reed
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Kathryn M. Schoenauer
- Center for Public Health Initiatives, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kelsey Smith
- Department of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | | | - Sequoia Kay Hill
- Project HOME Health Services, Pathways to Housing PA, Philadelphia, PA 19141, USA
| | - Erica Li
- Department of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Lara Weinstein
- Department of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
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COVID-19 and the opportunity for gender-responsive virtual and remote substance use treatment and harm reduction services. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 108:103815. [PMID: 35969920 PMCID: PMC9359504 DOI: 10.1016/j.drugpo.2022.103815] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/26/2022] [Accepted: 07/31/2022] [Indexed: 11/21/2022]
Abstract
The COVID-19 pandemic has increased the uptake of virtual and remote service delivery in the substance use field, which was previously uncommon. This swift uptake of virtual services provides an opportunity to improve service design to meet the diverse needs of women and gender-diverse people. Such services have the potential to better meet the needs of women and gender-diverse people by allowing for increased choice, control, and autonomy, enabling empowerment, facilitating greater considerations of power relations, violence, childcare responsibilities, and fostering greater inclusion of trans and non-binary people. This commentary aims to identify how virtual and remote delivery of substance use treatment and harm reduction services can be gender-responsive. We highlight the role gender transformative services play in meeting the unique needs of women and gender-diverse people who use drugs both during and after the COVID-19 pandemic. By using the unique window of opportunity COVID-19 has created to develop and deliver gender-transformative programs, we can help address the detrimental gaps in service accessibility and effectiveness that have persistently been experienced by women and gender-diverse people who use drugs.
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The Pattern of Substance Use among People Who Use Drugs (PWUD) Receiving Treatment at University Malaya Medical Centre (UMMC) during the COVID-19 Pandemic and the Associated Factors. Healthcare (Basel) 2022; 10:healthcare10081366. [PMID: 35893189 PMCID: PMC9332428 DOI: 10.3390/healthcare10081366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 01/09/2023] Open
Abstract
There was a change in the pattern of substance usage among people who use substances during the COVID-19 pandemic period. This study aims to determine the effects of the COVID-19 pandemic on the pattern of substance usage among people who use drugs (PWUD) receiving treatment at the University Malaya Medical Centre (UMMC) as well as levels of anxiety and depression together with coping mechanisms and the factors affecting the pattern of substance use during COVID-19 pandemic period. A cross-sectional study was applied. The questionnaire used was the Mini-European Web Survey on Drugs (EWSD): COVID-19, Hospital Anxiety and Depression Scale (HADS), and Brief COPE Scale. In total, 130 PWUD were recruited. Of the participants, 36.2% of PWUD had not used/stopped the usage of illicit drugs/alcohol, 26.2% increased their usage, 20% decreased, and 14.6% used the same amount of illicit substances/alcohol during the COVID-19 pandemic period/restrictions. In addition, 28.5% of PWUD had an increased intention to seek professional support for drug counseling/treatment during the COVID-19 pandemic period. The prevalence anxiety and depression symptoms in PWUD according to HADS was 33% and 41.5%, respectively, with depression (p = 0.05) and isolation status (adjusted OR = 2.63, p < 0.05) being associated with an increase in alcohol/illicit substance use during the COVID-19 pandemic. PWUD who had increased their intention to seek professional support had significantly higher odds (adjusted OR = 4.42, p < 0.01) of reducing their alcohol/illicit substance use during the COVID-19 pandemic period. There were increased odds of maintaining alcohol/illicit substance usage among PWUD who practiced dysfunctional coping (adjusted OR = 3.87, p < 0.025) during the COVID-19 pandemic period. In conclusion, depression, isolation status, dysfunctional coping, and intention to seek professional support affected the pattern of alcohol/illicit substance use during the COVID-19 pandemic period. Strategies, substance rehabilitation/counseling, and proper mental health screening and the associated risk factors must be emphasized to prevent a further epidemic of substance use during the pandemic.
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Miler JA, Foster R, Hnizdilova K, Murdoch H, Parkes T. ‘It maybe doesn’t seem much, but to me it’s my kingdom’: staff and client experiences of Housing First in Scotland. DRUGS: EDUCATION, PREVENTION AND POLICY 2022. [DOI: 10.1080/09687637.2021.1926429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Joanna Astrid Miler
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Rebecca Foster
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Kristina Hnizdilova
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Helen Murdoch
- Homelessness Services, The Salvation Army, Glasgow, UK
| | - Tessa Parkes
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
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12
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Compton P, St Marie B. Coexisting Substance Use Disorder and Chronic Pain During COVID-19. Pain Manag Nurs 2022; 23:17-25. [PMID: 34620549 PMCID: PMC8418911 DOI: 10.1016/j.pmn.2021.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/29/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Peggy Compton
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, 19104-4217.
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Kesten JM, Holland A, Linton MJ, Family H, Scott J, Horwood J, Hickman M, Telfer M, Ayres R, Hussey D, Wilkinson J, Hines LA. Living Under Coronavirus and Injecting Drugs in Bristol (LUCID-B): A qualitative study of experiences of COVID-19 among people who inject drugs. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 98:103391. [PMID: 34343945 PMCID: PMC8289673 DOI: 10.1016/j.drugpo.2021.103391] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND People who inject drugs (PWID) are a high-risk group for COVID-19 transmission and serious health consequences. Restrictions imposed in the UK in response to the pandemic led to rapid health and housing service alterations. We aimed to examine PWID experiences of: 1) challenges relating to the COVID-19 public health measures; 2) changes to opioid substitution therapy (OST) and harm reduction services; and 3) perceived effects of COVID-19 on drug use patterns and risk behaviour. METHODS Telephone semi-structured interviews were conducted with 28 PWID in Bristol, Southwest of England. Analysis followed a reflexive thematic analysis. RESULTS Concern about COVID-19 and adherence to public health guidance varied. Efforts made by services to continue providing support during the pandemic were appreciated and some changes were preferred, such as less frequent OST collection, relaxation of supervised consumption and needle and syringe programmes (NSP) home delivery. However, remote forms of contact were highlighted as less beneficial and more difficult to engage with than in-person contact. Public health guidance advising people to 'stay home' led to increased isolation, boredom, and time to ruminate which impacted negatively on mental health. Lockdown restrictions directly impacted on sources of income and routine. Changes in drug use were explained as a consequence of isolation and fewer interactions with peers, problems accessing drugs, reduced drug purity and reduced financial resources. CONCLUSION This study captures the significant impacts and challenges of the COVID-19 pandemic on the lives of PWID. While rapid adaptations to service delivery to help mitigate the risks of COVID-19 were appreciated and some changes such as relaxation of supervised daily OST consumption were viewed positively, barriers to access need further attention. Going forwards there may be opportunities to harness the positive aspects of some changes to services.
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Affiliation(s)
- Joanna M Kesten
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol, Medical School, University of Bristol, Oakfield Grove, Clifton, Bristol BS8 2BN, United Kingdom; NIHR Applied Research Collaboration (ARC) West, 9th Floor, Whitefriars, Lewins Mead, Bristol BS1 2NT, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield Grove, Clifton, Bristol BS8 2BN, United Kingdom
| | - Adam Holland
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield Grove, Clifton, Bristol BS8 2BN, United Kingdom
| | - Myles-Jay Linton
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield Grove, Clifton, Bristol BS8 2BN, United Kingdom; School of Education, 35 Berkeley Square, Bristol BS8 1JA, United Kingdom
| | - Hannah Family
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom; Dept Pharmacy & Pharmacology. University of Bath, Claverton Down, Bath BA2 7AY, United Kingdom
| | - Jenny Scott
- Dept Pharmacy & Pharmacology. University of Bath, Claverton Down, Bath BA2 7AY, United Kingdom
| | - Jeremy Horwood
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol, Medical School, University of Bristol, Oakfield Grove, Clifton, Bristol BS8 2BN, United Kingdom; NIHR Applied Research Collaboration (ARC) West, 9th Floor, Whitefriars, Lewins Mead, Bristol BS1 2NT, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield Grove, Clifton, Bristol BS8 2BN, United Kingdom
| | - Matthew Hickman
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol, Medical School, University of Bristol, Oakfield Grove, Clifton, Bristol BS8 2BN, United Kingdom; NIHR Applied Research Collaboration (ARC) West, 9th Floor, Whitefriars, Lewins Mead, Bristol BS1 2NT, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield Grove, Clifton, Bristol BS8 2BN, United Kingdom
| | - Maggie Telfer
- Bristol Drugs Project, 11 Brunswick Square, Bristol BS2 8PE, United Kingdom
| | - Rachel Ayres
- Bristol Drugs Project, 11 Brunswick Square, Bristol BS2 8PE, United Kingdom
| | - Deborah Hussey
- Bristol Drugs Project, 11 Brunswick Square, Bristol BS2 8PE, United Kingdom
| | - Jack Wilkinson
- Bristol Drugs Project, 11 Brunswick Square, Bristol BS2 8PE, United Kingdom
| | - Lindsey A Hines
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom; Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom.
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