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Appears in Collections:Faculty of Social Sciences Journal Articles
Peer Review Status: Refereed
Title: The impact of COVID-19 on access to harm reduction, substance use treatment and recovery services in Scotland: a qualitative study
Author(s): Schofield, Joe
Dumbrell, Joshua
Matheson, Catriona
Parkes, Tessa
Bancroft, Angus
Keywords: COVID-19
Substance use
Harm reduction
Opioid replacement treatment
Issue Date: Dec-2022
Date Deposited: 15-Mar-2022
Citation: Schofield J, Dumbrell J, Matheson C, Parkes T & Bancroft A (2022) The impact of COVID-19 on access to harm reduction, substance use treatment and recovery services in Scotland: a qualitative study. BMC Public Health, 22 (1), Art. No.: 500.
Abstract: Introduction People who use drugs (PWUD) are considered vulnerable to COVID-19 exposure and the sequelae of infection due to their social circumstances, health conditions, drug purchasing, and substance use. They can depend on access to services that provide harm reduction, substance use treatment, recovery and support, and general healthcare. Social distancing measures and service restrictions posed significant challenges to the health and wellbeing of PWUD. Methods Ethical approvals were secured. PWUD were recruited from voluntary sector homeless and housing, harm reduction, and recovery organisations across central Scotland. Data was collected via semi-structured interviews and analysed using the Framework Method. Results Twenty nine PWUD participated and reported mixed experiences of the impacts of COVID-19 lockdown. Several benefitted from policy and practice developments designed to sustain or increase access to harm reduction services. Some PWUD reported improved access to substitute prescribing and/or appreciated being trusted to manage multiple take-home doses. Others noted the loss of regular in-person contact with treatment providers and dispensers. Access to recovery support was challenging for many, especially those unable to access or uncomfortable with online provision who experienced greater isolation. Lack of access to general healthcare services was common, and especially problematic for PWUD with chronic physical and mental health conditions. Conclusions This qualitative research describes the impacts of COVID-19 social and service restrictions on PWUD in Scotland. These impacts were anticipated by policy makers and service providers. Effective and acceptable developments were shown to maintain and even increase service provision for PWUD. Developments were geographically dependent and significant challenges remained for many people. The learning generated can inform responses to increase service access and uptake in post-pandemic times.
DOI Link: 10.1186/s12889-022-12873-y
Rights: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
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