Experiences of People Who Use Drugs in Rural Southeastern Ohio During the COVID-19 Pandemic: Harm Reduction, Substance Use Treatment, and Trusted Information Sources.

OBJECTIVE

The purpose of this study was to describe COVID-19 pandemic experiences among people who use drugs (PWUD) in rural southeastern Ohio in varying geographies and time since the start of the pandemic.

METHOD: We used two cross-sections of data from the Ohio Opioid Project to describe shifts in PWUDs' service accessibility and in their perceived trustworthiness of COVID-19-related information sources. Participants in the cross-section "Rural2020-22" were surveyed from September 2020 to January 2022 in a rural area. Participants in the cross-section "Micropolitan2022-23" were surveyed from January 2022 to February 2023 in a micropolitan area. Our total sample included 408 participants (50% male).

RESULTS

Early in the COVID-19 pandemic, 36% of participants reported increased drug use. Rural2020-22 participants reported that services were at least "a little harder" to access than before the pandemic more often than Micropolitan2022-23 participants (local harm reduction services: 34% vs. 30%; substance use treatment programs: 49% vs. 26%). Most participants reported news media as a source of COVID-19 information in both samples (Rural2020-22: 75%; Micropolitan2022-23: 51%). Local harm reduction programs and health authorities had the highest levels of trust in their information among participants (Rural2020-22: 46%, 22%; Micropolitan2022-23: 37%, 30%, respectively, trusted them "a lot").

CONCLUSIONS

In the context of the COVID-19 pandemic, many PWUD reported increased substance use, yet struggled to access services. Local harm reduction programs, health authorities, and news media may be valuable outlets for disseminating timely health information, such as program changes and availability, to PWUD during a future emergency.