Farihah Ali1, Cayley Russell2, Frishta Nafeh2, Jürgen Rehm3, Sean LeBlanc4, Tara Elton-Marshall5. 1. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada. Electronic address: farihah.ali@camh.ca. 2. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada. 3. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), 250 College St., Toronto, ON M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada; Institute of Medical Science (IMS), University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada; Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Bol'shaya Pirogovskaya Ulitsa, 19с1119146 Moscow, Russia. 4. Drug Users Advocacy League, #309-180 Bruyere, Ottawa, ON K1N 5E1, Canada; Canadian Association of People who Use Drugs (CAPUD), ON, Canada. 5. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), 250 College St., Toronto, ON M5T 1R8, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St., ON M6A 5C1, Canada; Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1, Canada.
Abstract
BACKGROUND: People who use drugs (PWUD) may be at an increased risk of experiencing negative effects related to COVID-19. Border and non-essential service closures may have placed PWUD at an increased risk of experiencing unintended consequences regarding drug consumption and supply patterns, as well as related outcomes. However, the extent of these effects upon this population is unknown. The current study examined how COVID-19 has impacted substance use supply and use characteristics among a national cohort of PWUD in Canada. METHODS: We conducted semi-structured one-on-one telephone-based interviews with 200 adult PWUD across Canada who were currently using a licit or illicit psychoactive substance at least weekly, and/or currently receiving opioid agonist treatment (OAT). Thematic analyses were conducted using qualitative software. RESULTS: PWUD attributed adverse changes to their substance use frequency, supply, use patterns, and risk behaviors and outcomes to COVID-19. Many participants noted supply disruptions with the majority indicating a decrease in potency and availability, and an increase in the price of substances since COVID-19. Nearly half of participants specified that they had increased their substance use, with some experiencing relapses. In terms of changes to risk level, many participants perceived they were at a greater risk for experiencing an overdose. CONCLUSION: This study demonstrated the impacts of COVID-19 on PWUD, including a significant disruption substance supply. For many, these changes led to increased use and substitution for toxic and adulterated substances, which ultimately amplified PWUD's risk for experiencing related harms, including overdoses. These findings warrant the need for improved supports and services, as well as accessibility of safe supply programs, take home naloxone kits, and novel approaches to ensure PWUD have the tools necessary to mitigate risk when using substances.
BACKGROUND:People who use drugs (PWUD) may be at an increased risk of experiencing negative effects related to COVID-19. Border and non-essential service closures may have placed PWUD at an increased risk of experiencing unintended consequences regarding drug consumption and supply patterns, as well as related outcomes. However, the extent of these effects upon this population is unknown. The current study examined how COVID-19 has impacted substance use supply and use characteristics among a national cohort of PWUD in Canada. METHODS: We conducted semi-structured one-on-one telephone-based interviews with 200 adult PWUD across Canada who were currently using a licit or illicit psychoactive substance at least weekly, and/or currently receiving opioid agonist treatment (OAT). Thematic analyses were conducted using qualitative software. RESULTS: PWUD attributed adverse changes to their substance use frequency, supply, use patterns, and risk behaviors and outcomes to COVID-19. Many participants noted supply disruptions with the majority indicating a decrease in potency and availability, and an increase in the price of substances since COVID-19. Nearly half of participants specified that they had increased their substance use, with some experiencing relapses. In terms of changes to risk level, many participants perceived they were at a greater risk for experiencing an overdose. CONCLUSION: This study demonstrated the impacts of COVID-19 on PWUD, including a significant disruption substance supply. For many, these changes led to increased use and substitution for toxic and adulterated substances, which ultimately amplified PWUD's risk for experiencing related harms, including overdoses. These findings warrant the need for improved supports and services, as well as accessibility of safe supply programs, take home naloxone kits, and novel approaches to ensure PWUD have the tools necessary to mitigate risk when using substances.
Authors: Ryan McNeil; Taylor Fleming; Samara Mayer; Allison Barker; Manal Mansoor; Alex Betsos; Tamar Austin; Sylvia Parusel; Andrew Ivsins; Jade Boyd Journal: Am J Public Health Date: 2022-03-09 Impact factor: 9.308
Authors: Max Ferguson; Andrea Medley; Katherine Rittenbach; Thomas D Brothers; Carol Strike; Justin Ng; Pamela Leece; Tara Elton-Marshall; Farihah Ali; Diane L Lorenzetti; Jane A Buxton Journal: Harm Reduct J Date: 2022-07-02