Navigating intersecting public health crises: a qualitative study of people with opioid use disorders' experiences during the COVID-19 pandemic

Background

The long-running opioid epidemic and the more recent COVID-19 pandemic are two interrelated events with major public health implications for people who use opioids (OUD). The majority of studies on the interaction of these two public health concerns have employed pre-existing data to focus on community, state, or national patterns. Complementary qualitative research is needed to determine how persons with opioid use disorder (OUD) comprehend, experience, and navigate this unique period. The current study investigates people with OUD's perceptions and experiences as they negotiated these crises.

Methods

The study was guided by a pragmatic lens. We conducted brief semi-structured qualitative interviews with 25 individuals in Chicago, the majority of which had received methadone treatment during the pandemic. Thematic inductive analysis was guided by primary interview questions.

Results

The sample represents a high-risk group, being composed mostly of older non-Hispanic African American males and having considerable socioeconomic barriers. Themes demonstrate how individuals are keeping safe despite limited knowledge of COVID-19, how the pandemic has increased treatment motivation for some, how adaptations impacted treatment and recovery supports, how the availability social support had been reduced, and difficulties individuals had keeping or obtaining financial support.

Conclusions

The findings could be beneficial in guiding future public health responses to guarantee optimal treatment availability and support. Treatment providers must ensure that patients with OUD receive adequate and clear health crisis-related information, as well as that finances are allocated correctly to address the mental health effects of social isolation. Finally, sufficient financial and infrastructure supports are required to ensure that health and treatment inequities are not worsened for those who are most in need.