TY - JOUR
KW - Analgesics, Opioid/therapeutic use
KW - COVID-19/epidemiology
KW - Drug Overdose/drug therapy/epidemiology
KW - Fentanyl
KW - Harm Reduction
KW - Humans
KW - Pandemics
KW - Pharmaceutical Preparations
KW - Rural Population
KW - SARS-CoV-2
KW - COVID-19
KW - PWID
KW - fentanyl beans
KW - fentanyl buttons
KW - Methamphetamine
KW - rural
AU - R. S. Bolinski
AU - S. Walters
AU - E. Salisbury-Afshar
AU - L. J. Ouellet
AU - W. D. Jenkins
AU - E. Almirol
AU - B. Van Ham
AU - S. Fletcher
AU - C. Johnson
AU - J. A. Schneider
AU - D. Ompad
AU - M. T. Pho
A1 - 
AB - 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.
AD - 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.; Department of Family Medicine and Community Health, Madison School of Medicine and Public Health, University of Wisconsin, Madison, WI 53792, USA.; Division of Epidemiology and Biostatistics/COIP (MC 923), School of Public Health, University of Illinois Chicago, 1603 W. Taylor, Chicago, IL 60607, USA.; Epidemiology and Biostatistics, Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL 62794, USA.; Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA.; Center for Rural Health and Social Service Development, Southern Illinois University School of Medicine, Carbondale, IL 62901, USA.; The Community Action Place, Inc., 1400 N. Wood Road Suite 7, Murphysboro, IL 62966, USA.; Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago, Chicago, IL 60637, USA.; Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago, Chicago, IL 60637, USA.; Center for Drug Use and HIV|HCV Research, School of Global Public Health, New York University, New York, NY 10003, USA.; Department of Epidemiology, School of Global Public Health, New York University, New York, NY 10003, USA.; Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago, Chicago, IL 60637, USA.
BT - International journal of environmental research and public health
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 4
DO - 10.3390/ijerph19042230
IS - 4
JF - International journal of environmental research and public health
LA - eng
M1 - Journal Article
N2 - 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.
PY - 2022
SN - 1660-4601; 1661-7827; 1660-4601
SP - 2230
T1 - 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
T2 - International journal of environmental research and public health
TI - 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
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 35206421
U3 - 10.3390/ijerph19042230
VL - 19
VO - 1660-4601; 1661-7827; 1660-4601
Y1 - 2022
Y2 - Feb 16
ER -