Theme: Epidemiology & Public Health Research Year: 2022
Background:
Two-thirds of justice-involved individuals have substance use disorders (SUD). While correctional
facilities can stabilize residents on various forms of SUD treatment including pharmaco- and
behavioral therapy, little is known about how pandemic-related service disruptions impacted
motivation for and access to SUD treatment.
Methods:
We conducted semi-structured interviews with 20 adults incarcerated in a U.S. correctional facility
between March 2020 and May 2021. We asked participants about facility enforcement of the
Centers for Disease Control and Prevention COVID-19 guidelines. We conducted a secondary analysis
examining how this affected access to SUD treatment among those reporting SUD treatment in the
last five years. We analyzed qualitative data thematically using an iterative process.
Results:
Of the 20 participants, 10 (50%) reported receiving SUD support in the last five years. Most
participants were male (90%) with a median age of 51 years, and non-Hispanic white (50%). Overall,
perceptions were discordant on whether COVID-19 positively or negatively impacted SUD services.
The first theme was resiliency to pursue treatment despite facility limitations. Despite COVID-19’s
adverse impacts on service access, some remained motivated to pursue treatment: “I’m trying to
really work on my sobriety. Because if not, I may end up dying.” Another theme was peer support
filling gaps in services, which for some, was more effective. Others hosted their own SUD meetings:
“While we was inside, … because there was no counselor … we’d bring the books in and yeah. So, we
conducted our own meetings.”
Conclusion:
Participants described resiliency in pursing SUD treatment despite COVID-19-related program
changes. Given the high rate of SUD among justice-involved individuals, it is imperative that
correctional facilities have contingency plans to provide SUD treatment amidst a pandemic. This is
especially important as the lack of control over one’s environment may adversely impacted one’s
desire to start or continue.
Disclosure of Interest Statement:
ACS reports grants through her institution from the National Science Foundation, Cellex, and Gilead
Sciences. She has received personal fees from, and served on an advisory board for, Gilead Sciences.
She reports the following: honoraria through third parties funded by Gilead, AbbVie, and Merck;
personal fees from the National Commission on Correctional Health Care, National Sheriff’s
Association, Harris County Sheriff’s Office, and California Department of Corrections and
Rehabilitation; and travel expenses from bioLytical Sciences and Guardian. MJA reports grants
through his institution from the National Institutes of Health via Centers for AIDS Research
(5P30AI124414) and National Institute on Drug Abuse (4R00DA043011-04).