Bauman Palma, Moreau Lilly, Hall Joshua, Dong Shangjia, Horney Jennifer A
Department of Epidemiology, University of Delaware, Newark, DE, USA.
Department of Civil and Environmental Engineering, University of Delaware, Newark, DE, USA.
Disaster Med Public Health Prep. 2025 May 8;19:e113. doi: 10.1017/dmp.2025.125.
A public health emergency was declared for the opioid crisis in 2017 and remains in place. Between 2017-2024, there were 164 billion dollar disasters. People who use drugs (PWUDs) are highly susceptible to disasters; however adaptive capacity of opioid treatment programs (OTP) is not well understood. Identifying and addressing gaps to increase resilience and reduce morbidity and mortality among PWUDs is critical.
A semi-structured interview guide with 8 questions was developed to assess how disasters impact service provision and other aspects of OTPs. OTP leaders, government officials, community health navigators, and advocates received an email invitation to complete an interview via Zoom. Transcripts were independently hand coded to inductively identify themes.
Eleven interviews were completed. Four themes were identified including client challenges securing housing and reliable transportation, disaster-related communication barriers, stigma around help seeking, and issues related to policies and practices such as regulations and insurance coverage that are inflexible during a disaster.
Disruptions to OTPs during disasters require preparedness planning adaptations like more flexible guest dosing. The ongoing public health emergency of the opioid epidemic and the increasing frequency and severity of climate and weather emergencies requires adaptations to a highly regulated system to address vulnerabilities.
2017年宣布阿片类药物危机为公共卫生紧急事件，该声明至今仍然有效。2017年至2024年间，发生了造成1640亿美元损失的灾难。吸毒者极易受到灾难影响；然而，阿片类药物治疗项目（OTP）的适应能力却尚未得到充分了解。识别并填补差距以增强吸毒者的恢复力，降低其发病率和死亡率至关重要。
制定了一份包含8个问题的半结构化访谈指南，以评估灾难如何影响OTP的服务提供及其他方面。向OTP负责人、政府官员、社区健康导航员及倡导者发送电子邮件邀请，通过Zoom完成访谈。对访谈记录进行独立手工编码，以归纳确定主题。
共完成11次访谈。确定了四个主题，包括客户在获得住房和可靠交通方面面临的挑战、与灾难相关的沟通障碍、寻求帮助时的耻辱感，以及与政策和实践相关的问题，如在灾难期间缺乏灵活性的法规和保险覆盖范围等。
灾难期间OTP的中断需要进行备灾规划调整，比如采用更灵活的临时给药方式。阿片类药物流行这一持续的公共卫生紧急事件，以及气候和天气紧急情况的频率和严重程度不断增加，要求对高度规范的系统进行调整，以应对各种脆弱性。
