Temporal association of pre-pandemic perceived social support with psychological resilience and mental well-being during the COVID-19 pandemic among people with a history of injection drug use

Patel, Eshan U.; Astemborski, Jacquie; Feder, Kenneth A.; Rudolph, Jacqueline E; Winiker, Abigail K.; Sosnowski, David W.; Kirk, Gregory D.; Mehta, Shruti H.; Genberg, Becky L.

doi:10.1016/j.drugalcdep.2023.109802

Cited by 2 publications

(4 citation statements)

References 74 publications

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“…Support from peers and allies is a guiding principle for achieving and maintaining recovery. Indeed, social support has been associated with a myriad of health outcomes among PWID, including mental and emotional well-being [ 69 , 111 ], injection cessation [ 112 , 113 ], and a reduced risk of overdose [ 114 ]. We previously reported that the early COVID-19 pandemic period led to perceived stress from social isolation and a perceived increase in loneliness among PWID in Baltimore [ 69 ].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, social support has been associated with a myriad of health outcomes among PWID, including mental and emotional well-being [ 69 , 111 ], injection cessation [ 112 , 113 ], and a reduced risk of overdose [ 114 ]. We previously reported that the early COVID-19 pandemic period led to perceived stress from social isolation and a perceived increase in loneliness among PWID in Baltimore [ 69 ]. PWID in other settings have also reported decreased social support and increased feelings of social isolation because of the pandemic [ 62 , 115 ].…”

Section: Discussionmentioning

confidence: 99%

“…Other structural changes associated with the onset of the COVID-19 pandemic include increased awareness of harm reduction principles in the context of the pandemic [59], strained healthcare systems [60,61], decreased access to general health services [62,63], changes in public transportation systems [64], global supply chain interruptions [65], and changes to the illicit drug market with reduced availability of illicit drugs in some settings [66,67]. In addition to these structural changes, there have been many social consequences of the COVID-19 pandemic for PWID, such as resource loss including financial resources and increased social isolation [66,68,69]. Many of these structural and social consequences of the COVID-19 pandemic have also been reported by people who use drugs, including PWID, globally [53,[70][71][72][73][74], highlighting the need to understand the downstream health-related impacts of these changes.…”

Section: Introductionmentioning

confidence: 99%

“…Many of these structural and social consequences of the COVID-19 pandemic have also been reported by people who use drugs, including PWID, globally [53,[70][71][72][73][74], highlighting the need to understand the downstream health-related impacts of these changes. Indeed, the dynamic structural and social context of the COVID-19 pandemic has been linked to increased negative emotional and mental health symptoms among PWID [62,66,68,69]. Furthermore, the COVID-19 pandemic has been associated with changes in individual-level behaviors, including substance use and injection practices [67,75].…”

Section: Introductionmentioning

confidence: 99%

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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

Patel,

Grieb,

Winiker

et al. 2024

Harm Reduct J

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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.

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