The Covid-19 pandemic has disrupted the lives of people who use drugs in ways that hurt their mental health and changed drug use behaviours, increasing their risk for overdose, according to a study.
Drug overdoses have soared during the Covid-19 pandemic, with US overdose deaths topping 100,000 during the 12-month period ending in April 2021.
Researchers noted that the pandemic and strategies for preventing the spread of the virus, such as stay-at-home orders, may have contributed to this increase in deaths, from interruptions to harm reduction programs to isolation and worsening mental health.
Further, people who use drugs and live in rural areas may be disproportionately impacted by changes brought on during the pandemic, given that many rural areas have higher rates of opioid and methamphetamine use and already have limited drug treatment and harm reduction services.
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People who use drugs in rural areas may also experience higher levels of stigma about their drug use, which may contribute to a greater likelihood of using drugs alone and a reluctance to seek medical care.
"We know that there has been a tragic increase in overdose deaths during the pandemic. Our study provides insight into why and how there have been more overdose deaths," said Suzan Walters, research assistant professor at New York University's School of Global Public Health.
In a series of surveys and interviews with people who use drugs in rural southern Illinois, the researchers sought to understand their experiences during the Covid-19 pandemic and how disruptions at the structural and community level could affect individuals' overdose risk.
Between August 2020 and May 2021, the researchers conducted surveys with 50 individuals who use opioids (without a prescription) or inject drugs, and did in-depth interviews with a subset of 17 participants.
The study is published in the journal Addiction Science and Clinical Practice.
Only 38 per cent of participants felt confident that they could maintain a stable income during the pandemic, thanks to layoffs, disruptions to their work in service industries, and fewer available jobs. Moreover, participants reported that the pandemic exacerbated housing and food insecurity.
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Three-quarters of the survey respondents felt more anxious or on edge during the pandemic, more than half felt more depressed, and nearly half felt lonelier. Anxiety and depression are associated with increased substance use, which in turn can increase the risk for overdose.
Participants also described how the pandemic changed their everyday drug use behaviours. Half of the survey respondents said they were currently more likely to use drugs alone than prior to the pandemic, which can increase overdose risk.