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© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background: The COVID-19 pandemic has worsened the opioid overdose crisis in the US. Rural communities have been disproportionately affected by opioid use and people who use drugs in these settings may be acutely vulnerable to pandemic-related disruptions due to high rates of poverty, social isolation, and pervasive resource limitations. Methods: We performed a mixed-methods study to assess the impact of the pandemic in a convenience sample of people who use drugs in rural Illinois. We conducted 50 surveys capturing demographics, drug availability, drug use, sharing practices, and mental health symptoms. In total, 19 qualitative interviews were performed to further explore COVID-19 knowledge, impact on personal and community life, drug acquisition and use, overdose, and protective substance use adaptations. Results: Drug use increased during the pandemic, including the use of fentanyl products such as gel encapsulated “beans” and “buttons”. Disruptions in supply, including the decreased availability of heroin, increased methamphetamine costs and a concomitant rise in local methamphetamine production, and possible fentanyl contamination of methamphetamine was reported. Participants reported increased drug use alone, experience and/or witness of overdose, depression, anxiety, and loneliness. Consistent access to harm reduction services, including naloxone and fentanyl test strips, was highlighted as a source of hope and community resiliency. Conclusions: The COVID-19 pandemic period was characterized by changing drug availability, increased overdose risk, and other drug-related harms faced by people who use drugs in rural areas. Our findings emphasize the importance of ensuring access to harm reduction services, including overdose prevention and drug checking for this vulnerable population.

Details

Title
The Impact of the COVID-19 Pandemic on Drug Use Behaviors, Fentanyl Exposure, and Harm Reduction Service Support among People Who Use Drugs in Rural Settings
Author
Bolinski, Rebecca S 1 ; Walters, Suzan 2 ; Salisbury-Afshar, Elizabeth 3   VIAFID ORCID Logo  ; Ouellet, Lawrence J 4 ; Jenkins, Wiley D 5 ; Almirol, Ellen 6   VIAFID ORCID Logo  ; Brent Van Ham 7 ; Fletcher, Scott 8 ; Johnson, Christian 9 ; Schneider, John A 9 ; Ompad, Danielle 10 ; Pho, Mai T 9 

 Department of Sociology, Southern Illinois University, 475 Clocktower Drive, Room 323A, Carbondale, IL 62901, USA 
 Center for Drug Use and HIV|HCV Research, School of Global Public Health, New York University, New York, NY 10003, USA; [email protected] (S.W.); [email protected] (D.O.) 
 Department of Family Medicine and Community Health, Madison School of Medicine and Public Health, University of Wisconsin, Madison, WI 53792, USA; [email protected] 
 Division of Epidemiology and Biostatistics/COIP (MC 923), School of Public Health, University of Illinois Chicago, 1603 W. Taylor, Chicago, IL 60607, USA; [email protected] 
 Epidemiology and Biostatistics, Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL 62794, USA; [email protected] 
 Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA; [email protected] 
 Center for Rural Health and Social Service Development, Southern Illinois University School of Medicine, Carbondale, IL 62901, USA; [email protected] 
 The Community Action Place, Inc., 1400 N. Wood Road Suite 7, Murphysboro, IL 62966, USA; [email protected] 
 Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago, Chicago, IL 60637, USA; [email protected] (C.J.); [email protected] (J.A.S.); [email protected] (M.T.P.) 
10  Center for Drug Use and HIV|HCV Research, School of Global Public Health, New York University, New York, NY 10003, USA; [email protected] (S.W.); [email protected] (D.O.); Department of Epidemiology, School of Global Public Health, New York University, New York, NY 10003, USA 
First page
2230
Publication year
2022
Publication date
2022
Publisher
MDPI AG
ISSN
1661-7827
e-ISSN
1660-4601
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2632969443
Copyright
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.