“It’s Also Pushed People to a New Level of Desperation:” COVID-19 Impacts on Experiences of Persons Who Use Illicit Opioids

ABSTRACT

The purpose of this qualitative study is to characterize the impacts of the COVID-19 pandemic on drug use experiences among persons who use illicit opioids (PWUO) in Arizona. Between 12/2020 and 05/2021, interviews were conducted via Zoom with 22 PWUO from across Arizona. Participants were recruited through Craigslist and social media ads, referrals by a local harm reduction organization, and other participants. The interviews were transcribed and analyzed using NVivo. Participants were 25–51 years of age, 36% were female, and 55% non-Hispanic White. Most reported past month use of heroin, and/or counterfeit (pressed) non-pharmaceutical fentanyl (NPF) pills. Nearly all reported changes in their drug use during the pandemic. Participants discussed profound negative impacts of social isolation with escalating mental health problems, boredom, and ease of hiding drug use from others, leading to increases in drug use. Loss of daily routines, employment difficulties, and challenges of accessing treatment due to COVID-19 restrictions were also driving factors for increased drug use. The growing availability of NPF pills during the pandemic led many individuals to transition from heroin to more frequent NPF pill use. The results emphasize the need for quality behavioral care services with an increased focus on economic and social support systems.

KEYWORDS:

• Opioid use disorder
• heroin
• fentanyl
• COVID-19
• qualitative research

Acknowledgments

This study was supported by the Arizona State University College of Health Solution COVID-19 seed grant (Daniulaityte/Mendoza, PIs). The funding source had no further role in the study design, in the collection, analysis and interpretation of the data, in the writing of the report, or in the decision to submit the paper for publication.

We want to thank our study participants for connecting and sharing their stories with us. We also want to thank Sonoran Prevention Works, a leading harm reduction organization in Arizona, for assistance with participant recruitment.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The work was supported by the Arizona State University College of Health Solution COVID-19 seed grant .