Isolation, Solitude and Social Distancing for People Who Use Drugs: An Ethnographic Perspective

Roe, Laura; Proudfoot, Jesse; Teck, Joseph Tay Wee; Irvine, Richard D. G.; Frankland, Stan; Baldacchino, Alex

doi:10.3389/fpsyt.2020.623032

Cited by 23 publications

(22 citation statements)

References 42 publications

(58 reference statements)

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“…Isolation is a prominent theme that emerges in qualitative accounts of HF experiences (see Stergiopoulos et al, 2014) and this may particularly be the case for those who have intentionally distanced themselves from former drug-or alcohol-related peer networks, or whose family ties were weak or severed (Johnsen, 2014). This sense of isolation has also been reported in Scottish research with older people who use drugs (Matheson et al, 2019), an issue recently compounded by the COVID-19 pandemic (Roe et al, 2021). While we have not found evidence directly comparing the scattered and congregate HF approaches on experiences of isolation and loneliness, findings regarding isolation are predominantly reported in respect of scattered, HF programs.…”

Section: Discussionsupporting

confidence: 42%

‘It maybe doesn’t seem much, but to me it’s my kingdom’: staff and client experiences of Housing First in Scotland

Miler

Foster

Hnizdilova

et al. 2021

Drugs: Education, Prevention and Policy

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Housing First (HF) represents a significant shift in the way that the problem of homelessness and cooccuring challenges including problem substance use, is addressed. HF interventions have been the focus of much research. Quantitative studies have consistently shown positive findings regarding housing outcomes, with results regarding health and well-being outcomes more mixed. To date, limited attention has been paid to the experiences and perspectives of HF service providers, and few studies have explored the views of those HF recipients. In enabling providers and recipients to share their professional and personal experiences of HF, qualitative insights can help inform, and improve, service provision and practice. Semi-structured interviews were conducted with seven HF staff members and 11 clients in a single third sector service in Scotland. Overall, clients experienced HF positively and described how involvement in HF had enabled positive changes in their lives. Service providers reported positive views on HF alongside ways to maximize the effectiveness of the model. While our findings provide support for current efforts to promote HF as an approach to help end homelessness, a number of challenges exist. To address these, we propose a set of recommendations for those planning and implementing HF services.Glossary:

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Section: Discussionsupporting

confidence: 42%

‘It maybe doesn’t seem much, but to me it’s my kingdom’: staff and client experiences of Housing First in Scotland

Miler

Foster

Hnizdilova

et al. 2021

Drugs: Education, Prevention and Policy

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“…Risk to family members was a reason to isolate from significant others; this social influence, and moral obligation towards others were found to modestly predict intention to socially distance in an Australian survey, which tested an integrated social cognition model ( Hagger et al, 2020 ). Recent ethnographic research of populations of PWID during COVID-19 has highlighted the importance of considering the dynamics of relatedness, isolation, and solitude in experiences of both substance use and social distancing ( Roe et al, 2021 ). In combination with existing evidence, the present findings indicate specific support may be required for PWID in maintaining connection and ensuring adherence to public health guidance.…”

Section: Discussionmentioning

confidence: 99%

Living Under Coronavirus and Injecting Drugs in Bristol (LUCID-B): A qualitative study of experiences of COVID-19 among people who inject drugs

Kesten¹,

Holland²,

Linton³

et al. 2021

International Journal of Drug Policy

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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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“…As previously mentioned, substance misuse is also associated with a number of physical disorders that impact on health outcomes. COVID-19 prevention measures such a lockdown is also likely to increase loneliness and limit access to treatment services (Roe et al, 2021). These restrictions may be exacerbated in older people, who often have poor health and pre-existing social isolation and may also restrict their ability to seek help for their substance misuse.…”

Section: Discussionmentioning

confidence: 99%

Dual diagnosis in older drinkers during the COVID-19 pandemic

Rao

Mueller

Broadbent

2021

ADD

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Purpose There is a dearth of literature examining the impact of the COVID-19 pandemic on older people with dual diagnosis referred to mental health services. The purpose of this study was to compare dual diagnosis before and after lockdown in people aged between 55 and 74 with alcohol use. Design/methodology/approach Data were collected for people referred to mental health services using an anonymised database of de-identified records to identify people with both substance use disorder alone, or accompanied by co-existing mental disorders. Findings In total, 366 older people were assessed with the Alcohol Use Disorders Identification Test (AUDIT), 185 before and 181 after lockdown. People with dual diagnosis were more likely to be referred than those without, after compared to before lockdown (13 and 6%, respectively, p < 0.05). People with any substance use disorder with and without dual diagnosis showed an even greater likelihood of referral after, compared with before, lockdown (61 and 34%, respectively, p < 0.0001). Opioid use more than once a month was more likely to be reported after, compared with before, lockdown (66 and 36%, respectively, p < 0.005). Research limitations/implications The finding of a higher likelihood of opioid use after compared with before lockdown during the COVID-19 pandemic warrants further exploration. There is also further scope for further studies that involve older non-drinkers. Originality/value A greater likelihood of both dual diagnosis and substance use disorder alone after, compared with before lockdown has implications for both mental health and addiction service provision during a pandemic.

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Isolation, Solitude and Social Distancing for People Who Use Drugs: An Ethnographic Perspective

Cited by 23 publications

References 42 publications

‘It maybe doesn’t seem much, but to me it’s my kingdom’: staff and client experiences of Housing First in Scotland

‘It maybe doesn’t seem much, but to me it’s my kingdom’: staff and client experiences of Housing First in Scotland

Living Under Coronavirus and Injecting Drugs in Bristol (LUCID-B): A qualitative study of experiences of COVID-19 among people who inject drugs

Dual diagnosis in older drinkers during the COVID-19 pandemic

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