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

Joanna Kesten*, Adam R G Holland*, Myles-Jay Linton*, Hannah E Family*, Jenny Scott*, Jeremy Horwood*, Matt Hickman*, Maggie Telfer*, Rachel Ayres*, Deborah Hussey*, Jack Wilkinson*, Lindsey A Hines*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

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.

Original languageEnglish
Article number103391
Number of pages10
JournalInternational Journal of Drug Policy
Volume98
Early online date20 Jul 2021
DOIs
Publication statusE-pub ahead of print - 20 Jul 2021

Bibliographical note

Funding Information:
LH is funded by the Wellcome Trust (209158/Z/17/Z). AH is a Public Health Specialty Registrar employed by Hampshire Hospitals Foundation Trust. M-JL is funded by the Elizabeth Blackwell Institute, University of Bristol and the Development and Alumni Relations Office, University of Bristol. JS is employed by the University of Bath on a substantive academic contract.

Funding Information:
JK and JH are partly funded by National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) and NIHR HPRU in Behavioural Science and Evaluation. MH is funded by NIHR HPRU in Behavioural Science and Evaluation.

Funding Information:
This work is funded by the Elizabeth Blackwell Institute Rapid Response COVID-19 scheme and supported by the National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West) and NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation. The views expressed in this article are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care, Public Health England, the Wellcome Trust or the Elizabeth Blackwell Institute.

Funding Information:
HF is employed by the University of Bristol and her work is funded by BaNES Swindon and Wiltshire NHS Clinical Commissioning Group. She is also employed at the University of Bath on a temporary academic contract.

Publisher Copyright:
© 2021

Keywords

  • COVID-19
  • Drug users
  • Harm reduction
  • Injecting
  • Opioid Substitution Therapy
  • PWID

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