Structural and social changes due to the COVID-19 pandemic and their impact on engagement in substance use disorder treatment services: a qualitative study among people with a recent history of injection drug use in Baltimore, Maryland Article Swipe
Eshan U. Patel
,
Suzanne M. Grieb
,
Abigail K. Winiker
,
Jennifer Ching
,
Catherine Schluth
,
Shruti H. Mehta
,
Gregory D. Kirk
,
Becky L. Genberg
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1186/s12954-024-01008-8
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1186/s12954-024-01008-8
Background Substance use disorder treatment and recovery support services are critical for achieving and maintaining recovery. There are limited data on how structural and social changes due to the COVID-19 pandemic impacted individual-level experiences with substance use disorder treatment-related services among community-based samples of people who inject drugs. Methods People with a recent history of injection drug use who were enrolled in the community-based AIDS Linked to the IntraVenous Experience study in Baltimore, Maryland participated in a one-time, semi-structured interview between July 2021 and February 2022 about their experiences living through the COVID-19 pandemic (n = 28). An iterative inductive coding process was used to identify themes describing how structural and social changes due to the COVID-19 pandemic affected participants’ experiences with substance use disorder treatment-related services. Results The median age of participants was 54 years (range = 24–73); 10 (36%) participants were female, 16 (57%) were non-Hispanic Black, and 8 (29%) were living with HIV. We identified several structural and social changes due the pandemic that acted as barriers and facilitators to individual-level engagement in treatment with medications for opioid use disorder (MOUD) and recovery support services (e.g., support group meetings). New take-home methadone flexibility policies temporarily facilitated engagement in MOUD treatment, but other pre-existing rigid policies and practices (e.g., zero-tolerance) were counteracting barriers. Changes in the illicit drug market were both a facilitator and barrier to MOUD treatment. Decreased availability and pandemic-related adaptations to in-person services were a barrier to recovery support services. While telehealth expansion facilitated engagement in recovery support group meetings for some participants, other participants faced digital and technological barriers. These changes in service provision also led to diminished perceived quality of both virtual and in-person recovery support group meetings. However, a facilitator of recovery support was increased accessibility of individual service providers (e.g., counselors and Sponsors). Conclusions Structural and social changes across several socioecological levels created new barriers and facilitators of individual-level engagement in substance use disorder treatment-related services. Multilevel interventions are needed to improve access to and engagement in high-quality substance use disorder treatment and recovery support services among people who inject drugs.
Related Topics
Concepts
Pandemic
Health psychology
Coronavirus disease 2019 (COVID-19)
Social policy
Qualitative research
Social work
Public health
2019-20 coronavirus outbreak
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Substance abuse
Psychology
Substance use
Psychiatry
Medicine
Sociology
Virology
Political science
Nursing
Social science
Disease
Infectious disease (medical specialty)
Pathology
Law
Outbreak
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1186/s12954-024-01008-8
- https://harmreductionjournal.biomedcentral.com/counter/pdf/10.1186/s12954-024-01008-8
- OA Status
- gold
- Cited By
- 5
- References
- 129
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4396740503
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4396740503Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1186/s12954-024-01008-8Digital Object Identifier
- Title
-
Structural and social changes due to the COVID-19 pandemic and their impact on engagement in substance use disorder treatment services: a qualitative study among people with a recent history of injection drug use in Baltimore, MarylandWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-05-08Full publication date if available
- Authors
-
Eshan U. Patel, Suzanne M. Grieb, Abigail K. Winiker, Jennifer Ching, Catherine Schluth, Shruti H. Mehta, Gregory D. Kirk, Becky L. GenbergList of authors in order
- Landing page
-
https://doi.org/10.1186/s12954-024-01008-8Publisher landing page
- PDF URL
-
https://harmreductionjournal.biomedcentral.com/counter/pdf/10.1186/s12954-024-01008-8Direct link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://harmreductionjournal.biomedcentral.com/counter/pdf/10.1186/s12954-024-01008-8Direct OA link when available
- Concepts
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Pandemic, Health psychology, Coronavirus disease 2019 (COVID-19), Social policy, Qualitative research, Social work, Public health, 2019-20 coronavirus outbreak, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Substance abuse, Psychology, Substance use, Psychiatry, Medicine, Sociology, Virology, Political science, Nursing, Social science, Disease, Infectious disease (medical specialty), Pathology, Law, OutbreakTop concepts (fields/topics) attached by OpenAlex
- Cited by
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5Total citation count in OpenAlex
- Citations by year (recent)
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2025: 4, 2024: 1Per-year citation counts (last 5 years)
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129Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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