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

Rebecca S. Bolinski, Suzan Walters, Elizabeth Salisbury-Afshar, Lawrence J. Ouellet, Wiley D. Jenkins, Ellen Almirol, Brent Van Ham, Scott Fletcher, Christian Johnson, John A. Schneider, Danielle Ompad and Mai T. Pho
Additional contact information
Rebecca S. Bolinski: Department of Sociology, Southern Illinois University, 475 Clocktower Drive, Room 323A, Carbondale, IL 62901, USA
Suzan Walters: Center for Drug Use and HIV|HCV Research, School of Global Public Health, New York University, New York, NY 10003, USA
Elizabeth Salisbury-Afshar: Department of Family Medicine and Community Health, Madison School of Medicine and Public Health, University of Wisconsin, Madison, WI 53792, USA
Lawrence J. Ouellet: Division of Epidemiology and Biostatistics/COIP (MC 923), School of Public Health, University of Illinois Chicago, 1603 W. Taylor, Chicago, IL 60607, USA
Wiley D. Jenkins: Epidemiology and Biostatistics, Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL 62794, USA
Ellen Almirol: Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA
Brent Van Ham: Center for Rural Health and Social Service Development, Southern Illinois University School of Medicine, Carbondale, IL 62901, USA
Scott Fletcher: The Community Action Place, Inc., 1400 N. Wood Road Suite 7, Murphysboro, IL 62966, USA
Christian Johnson: Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago, Chicago, IL 60637, USA
John A. Schneider: Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago, Chicago, IL 60637, USA
Danielle Ompad: Center for Drug Use and HIV|HCV Research, School of Global Public Health, New York University, New York, NY 10003, USA
Mai T. Pho: Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago, Chicago, IL 60637, USA

IJERPH, 2022, vol. 19, issue 4, 1-12

Abstract: 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.

Keywords: fentanyl beans; fentanyl buttons; methamphetamine; COVID-19; rural; PWID; harm reduction (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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