Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Canadian Association of People Who Use Drugs, Dartmouth, Nova Scotia, Canada.
PLoS One. 2023 Apr 5;18(4):e0283979. doi: 10.1371/journal.pone.0283979. eCollection 2023.
To learn about the experiences of people who use drugs, specifically opioids, in the Halifax Regional Municipality (HRM), in Nova Scotia, Canada during the COVID-19 pandemic through qualitative interviews with people who use drugs and healthcare providers (HCP). This study took place within the HRM, a municipality of 448,500 people [1]. During the pandemic many critical services were interrupted while overdose events increased. We wanted to understand the experiences of people who use drugs as well as their HCPs during the first year of the pandemic.
We conducted a qualitative study using semi-structured interviews with 13 people who use drugs and 6 HCPs, including physicians who work in addiction medicine (3), a pharmacist, a nurse, and a community-based opioid agonist therapy (OAT) program staff member. Participants were recruited within HRM. Interviews were held via phone or videoconference due to social distancing directives. Interviews focused on the challenges people who use drugs and HCPs faced during the pandemic as well as elicited perspectives on a safe supply of drugs and the associated barriers and facilitators to the provision of a safe supply.
Of the 13 people who use drugs who participated in this study, ages ranged from 21-55 years (mean 40). Individuals had spent on average 17 years in HRM. Most people who use drugs (85%, n = 11) utilized income assistance, the Canadian Emergency Response Benefit, or disability support. Many had experienced homelessness (85%, n = 11) and almost half (46%, n = 6) were currently precariously housed in the shelter system. The main themes among interviews (people who use drugs and HCPs) were housing, accessing healthcare and community services, shifts in the drug supply, and perspectives on safe supply.
We identified several challenges that people who use drugs face in general, but especially during the COVID-19 pandemic. Access to services, housing support, and interventions to use safely at home were limited. As many challenges faced by people who use drugs exist outside of COVID-19, we concluded that the formal and informal interventions and changes in practice that were made to support people who use drugs should be sustained well past the end of the pandemic. The need for enhanced community supports and a safe supply of drugs, despite its complicated nature, is essential for the health and safety of people who use drugs in HRM, especially during COVID-19.
通过对加拿大新斯科舍省哈利法克斯地区（HRM）的吸毒者和医疗保健提供者（HCP）进行定性访谈，了解 COVID-19 大流行期间该地区吸毒者的经历。这项研究在一个拥有 448500 人的自治市进行。大流行期间，许多关键服务中断，同时过量事件增加。我们想了解大流行第一年吸毒者及其 HCP 的经历。
我们进行了一项定性研究，对 13 名吸毒者和 6 名 HCP 进行了半结构化访谈，包括从事成瘾医学的医生（3 名）、药剂师、护士和社区阿片类药物激动剂治疗（OAT）项目工作人员。参与者是在 HRM 招募的。由于社会隔离指令，访谈通过电话或视频会议进行。访谈重点是吸毒者和 HCP 在大流行期间面临的挑战，以及对安全药物供应的看法，以及提供安全药物供应的相关障碍和促进因素。
在参与这项研究的 13 名吸毒者中，年龄从 21 岁到 55 岁不等（平均 40 岁）。个人在 HRM 的平均居住时间为 17 年。大多数吸毒者（85%，n=11）使用收入援助、加拿大紧急响应福利或残疾支持。许多人无家可归（85%，n=11），近一半（46%，n=6）目前在庇护系统中不稳定地居住。访谈（吸毒者和 HCP）的主要主题是住房、获得医疗保健和社区服务、毒品供应的转变以及对安全供应的看法。
我们确定了吸毒者普遍面临的一些挑战，但特别是在 COVID-19 大流行期间。服务、住房支持和在家安全使用的干预措施受到限制。由于吸毒者面临的许多挑战都存在于 COVID-19 之外，我们得出的结论是，为支持吸毒者而采取的正式和非正式干预措施和实践中的改变，应该在大流行结束后持续下去。尽管毒品供应的安全问题很复杂，但加强社区支持和提供安全的毒品供应对 HRM 吸毒者的健康和安全是必要的，尤其是在 COVID-19 期间。
