A rapid ethnographic study of risk negotiation during the COVID-19 pandemic among unstably housed people who use drugs in Rhode Island.
Int J Drug Policy
; 103: 103626, 2022 05.
Article
in English
| MEDLINE | ID: covidwho-1693691
ABSTRACT
BACKGROUND:
The COVID-19 pandemic has greatly exacerbated the United States' overdose crisis. However, the overlapping impacts of COVID-19 and the overdose crisis have not been experienced equally, with unstably housed people who use drugs (PWUD) disproportionately impacted. Amid these changes, there is a need to understand how risk is experienced and managed among unstably housed PWUD to address health and social needs more effectively.METHODS:
This project draws on ethnographic research conducted from June 2020 to April 2021 in Rhode Island. Data include 39 in-depth interviews with unstably housed PWUD and approximately 50 h of ethnographic fieldwork conducted alongside street-based outreach workers.RESULTS:
COVID-19 risks were primarily contextualized in relation to participants' prior experiences of overdose events and adverse health outcomes. However, participants had varying levels of risk tolerance that were managed in ways that allowed them to reassert control and agency within the uncertainty of overlapping public health crises. Given participants' level of structural vulnerabilities, COVID-19 risk was managed alongside meeting their basic needs to survive.CONCLUSIONS:
Findings demonstrate how COVID-related public health measures (e.g., stay-at-home orders, service closures) reinforced participants' structural vulnerabilities in ways that increased their risk of health and social harms. Implementing and scaling up programs that meet the basic needs of individuals, including permanent housing, social supports, and overdose prevention interventions (e.g., supervised consumption sites) is critically needed to address intersecting risks faced by unstably housed PWUD.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Drug Overdose
/
COVID-19
Type of study:
Observational study
/
Prognostic study
/
Qualitative research
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Int J Drug Policy
Journal subject:
Public Health
/
Substance-Related Disorders
Year:
2022
Document Type:
Article
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