The impact of COVID-19 on people who inject drugs in New York City: increased risk and decreased access to services

Yesenia Aponte-Melendez,Shashi Kapadia,Pedro Mateu-Gelabert,Kristen Marks,Benjamin Eckhardt,Chunki Fong

doi:10.1186/s12954-021-00568-3

Yesenia Aponte-Melendez, Shashi Kapadia + Show 4 more

Open Access

https://doi.org/10.1186/s12954-021-00568-3

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Abstract

BackgroundWhile people who inject drugs (PWID) are vulnerable to the adverse outcomes of events like COVID-19, little is known regarding the impact of the current pandemic on PWID. We examine how COVID-19 has affected PWID in New York City across four domains: substance use, risk behaviors, mental health, and service utilization.MethodsAs part of a randomized trial to improve access to HCV treatment for PWID, we recruited 165 participants. Eligibility criteria included detectable HCV RNA and recent drug injection. The present cross-sectional analysis is based on a subsample of 106 participants. We compared responses between two separate samples: 60 participants interviewed prior to the pandemic (pre-COVID-19 sample) and 46 participants interviewed during the pandemic (COVID-19 sample). We also assessed differences by study group [accessible care (AC) and usual care (UC)].ResultsCompared to the pre-COVID-19 sample, those interviewed during COVID-19 reported higher levels of mental health issues, syringe reuse, and alcohol consumption and greater reductions in syringe-service programs and buprenorphine utilization. In the analysis conducted by study group, the UC group reported significantly higher injection risk behaviors and lower access to buprenorphine treatment during COVID-19, while during the same period, the AC group reported lower levels of substance use and injection risk behaviors.ConclusionThe current study provides insight on how COVID-19 has negatively affected PWID. Placing dispensing machines of harm-reduction supplies in communities where PWID live and increasing secondary exchange, mobile services, and mail delivery of supplies may help maintain access to lifesaving supplies during big events, such as COVID-19.Trial registration ClinicalTrials.gov NCT03214679. Registered July 11 2017. https://clinicaltrials.gov/ct2/show/NCT03214679.

Highlights

While people who inject drugs (PWID) are vulnerable to the adverse outcomes of events like COVID-19, little is known regarding the impact of the current pandemic on PWID
A recent research report suggests that individuals with a history of drug use are at a higher risk for COVID-19 infection and its adverse outcomes than people without history of substance use [14], possibly related to pulmonary and cardiovascular medical conditions that have been associated with long-term drug use and with COVID-19’s worst outcomes [15]
The sample for the analysis consisted of 106 PWID who were interviewed over a two-year period

Summary

Introduction

While people who inject drugs (PWID) are vulnerable to the adverse outcomes of events like COVID-19, little is known regarding the impact of the current pandemic on PWID. We examine how COVID-19 has affected PWID in New York City across four domains: substance use, risk behaviors, mental health, and service utilization. As of June 2021, COVID-19-related deaths have exceeded the 600,000 mark, and New York state ranks third in fatalities [5, 6]. A recent research report suggests that individuals with a history of drug use are at a higher risk for COVID-19 infection and its adverse outcomes (death and hospitalizations) than people without history of substance use [14], possibly related to pulmonary and cardiovascular medical conditions that have been associated with long-term drug use and with COVID-19’s worst outcomes [15]

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