The COVID-19 pandemic has highlighted health disparities for people of color, who have been disproportionately affected by the pandemic. People with opioid use disorder (OUD) faced unique challenges when many mental health and addiction services were forced to scale back operations or temporarily close when social distancing guidelines were put in place.
A group of researchers in the College of Agriculture, Health and Natural Resources recently published their findings in the Journal of Substance Abuse and Treatment about the experiences of racial-ethnic minorities during the COVID-19 pandemic among people with OUD.
Doctoral candidate Colleen Mistler, professor Michael Copenhaver, and assistant professor Roman Shrestha, all from the Department of Allied Health Sciences, collaborated with colleagues at Yale University and Drexel University, as well as the UConn Institute for Collaboration on Health, Intervention and Policy (InCHIP) on this research.
This population was of particular interest to the research group, since people with OUD and of a racial/ethnic minority group are particularly vulnerable to COVID-19 and its adverse health outcomes. Additionally, the group was already working with this population on studies related to improving HIV and substance use prevention outcomes as part of research efforts led by Copenhaver and Shrestha.
"As the pandemic unfolded, experts started raising concerns about both the direct and indirect impacts of COVID-19 on people with OUD," Shrestha says.
The researchers distributed a survey to 110 patients taking medication for opioid use disorder - methadone in this sample - to treat opioid addiction. They asked respondents about their substance use, sexual behavior, mental health, economic impacts of the pandemic, and experience with COVID-19 and preventative measures. The researchers collected their data from May 2020 through June 2020.
This broad range of variables allowed the researchers to craft a more expansive view of the pandemic's impact on participants' lives.
"We wanted to see the whole picture of how it was affecting the individual," Mistler says.
The researchers found people of color were more likely to know someone who died from COVID-19, and were more likely to be concerned about COVID-19. Racial-ethnic minorities also reported more difficulty accessing COVID-19 testing than white participants.
The researchers also found increases in depression, anxiety, and frustration across all groups during the pandemic, which has cut many people off from friends and family due to social distancing and travel restrictions.
Participants of color reported greater reductions in substance use behavior during the pandemic than white participants, which was a positive finding for the researchers.
Respondents did not report changes in number of sexual partners or how often they have unprotected sex, which raises concerns about contracting COVID-19 as well as sexually transmitted infections, like HIV.
"When you're supposed to be social distancing, you still want those behaviors to change, to reduce. And a majority of people didn't change those behaviors," Mistler says.
The group published another paper, on which Mistler is the lead author, in the Journal of Community Health, highlighting how the pandemic led to a reduction in the proportion of people in this population taking pre-exposure prophylaxis (PrEP), a drug that protects against HIV infection. However, they did not find any significant reduction in people getting tested for HIV.
The researchers found participants were still accessing methadone treatment. The clinics they sampled from, including the syringe services program, in the New Haven area established services such as telehealth, mobile-clinics, take-home bottles of methadone, and remained open at a safely limited capacity.
"The continued availability of these services, although in a limited capacity, were really helpful, and may be the reason why we're not seeing a significant difference in the use of addiction treatment and HIV prevention services," Shrestha says.
These findings will hopefully guide clinics in serving their patients using innovative strategies, such as telehealth and mobile clinics, during the current, and future, public health crises.
"These are essential services we should definitely advocate for," Mistler says.
Journal of Substance Abuse Treatment