The Kirby Institute, UNSW Sydney, Sydney, Australia.
Centre for Social Research in Health, UNSW Sydney, Sydney, Australia.
Drug Alcohol Rev. 2023 Jan;42(1):203-212. doi: 10.1111/dar.13531. Epub 2022 Aug 31.
People receiving opioid agonist treatment (OAT) are at higher risk of comorbidities, poverty and discrimination, which Big Events like the COVID-19 pandemic may exacerbate. The behaviours of people receiving OAT do not always align with normative behaviours as conceived by ruling institutions and laws, and so the group becomes a counterpublic, not imagined in mainstream public discourse. The aim of this study was to understand how people receiving OAT, as a counterpublic, implemented practises of care to mitigate negative health outcomes during COVID-19.
Participants were recruited via eight peer-led organisations across Australia. In-depth, semi-structured interviews were completed between August and December 2020 with 40 people receiving OAT. The analysis centres practises of care, allowing interactions that influence the health of participants, to be understood in their unique contexts.
Aspects of the COVID-19 state response were designed for an idealised public, demonstrated by the increased policing that accompanied enforcement of restrictions which was detrimental to the wellbeing of people receiving OAT. Counterpublic health strategies employed by people receiving OAT were disrupted, but participants were often able to adapt to the changing context.
This study elucidates how practises of care among people receiving OAT are enacted and disrupted during a Big Event, with implications beyond the COVID-19 pandemic for future Big Events. The study findings evidence the need for policies that mitigate the impact of Big Events such as supporting re-groupment within the counterpublic, legitimising counterpublic health strategies and stopping the criminalisation of people who use drugs.
接受阿片类激动剂治疗（OAT）的人患合并症、贫困和歧视的风险更高，而像 COVID-19 大流行这样的重大事件可能会使这些问题恶化。接受 OAT 治疗的人的行为并不总是与统治机构和法律所设想的规范行为一致，因此该群体成为一个反公众，而不是主流公共话语中想象的那样。本研究旨在了解接受 OAT 治疗的人作为一个反公众，如何实施护理实践，以减轻 COVID-19 期间的负面健康结果。
参与者通过澳大利亚各地的八个同伴领导组织招募。2020 年 8 月至 12 月期间，对 40 名接受 OAT 治疗的人进行了深入的半结构化访谈。该分析以护理实践为中心，允许在其独特的背景下理解影响参与者健康的互动。
COVID-19 国家应对措施的某些方面是为理想的公众设计的，这表现在加强执法以执行限制措施，这对接受 OAT 治疗的人的福祉造成了不利影响。接受 OAT 治疗的人采用的反公众健康策略受到干扰，但参与者通常能够适应不断变化的环境。
本研究阐明了 COVID-19 大流行期间，接受 OAT 治疗的人在重大事件中的护理实践是如何实施和中断的，这对未来的重大事件具有超越 COVID-19 大流行的意义。研究结果表明，需要制定政策来减轻重大事件的影响，例如支持反公众内部的重新组合，使反公众健康策略合法化，并停止对吸毒者的定罪。
