Impacts of COVID-19 on people who use and inject drugs in Australia

Author: Shelley Walker Paul Dietze Peter Higgs Brendan Quinn Bernadette Ward Keith Sutton Mark Stoové Sione Crawford Joseph Doyle Anna Wilkinson Margaret Hellard Lisa Maher Joseph

Theme: Epidemiology & Public Health Research Year: 2022

The COVID-19 pandemic has impacted people who use/inject drugs globally. In Australia
international/domestic border closures temporarily interrupted drug supply chains, impacting illicit
drug prices, quality and availability. On the other hand, economic stimulus packages to mitigate
financial hardship during COVID-19 lockdowns, meant many people who use/inject drugs also
received increases in government payments in 2020. Little is known about the impacts of these
measures on the lives of people who use/inject drugs.
Using ethno-epidemiological random stratified sampling, we recruited 75 participants (August 2021 –
May 2022) from two longitudinal cohort studies of people who inject drugs and/or use
methamphetamine, in Victoria, Australia. In-depth interviews were conducted that focused on
experiences of drug use/treatment, health outcomes/service use, and housing and income following
COVID-19 measures introduced in 2020. Interviews were audio-recorded, transcribed, and
thematically analysed using Iterative Categorisation.
Findings suggest initial increases in illicit drug prices in response to border closures/travel bans
created uncertainty/financial stress. For some, restrictions on movement during lockdowns,
especially in Melbourne, impacted access to services and interactions with police. Accessing
emergency economic/housing support was difficult for some due to increased demand. Subsequent
government income support during 2020 created opportunities to relieve financial stressors, with
some eligible participants saving money for the first time and having more for essential items such
as rent, food and household bills.
Findings provide important insights into the unintended consequences of the COVID-19 pandemic
and associated public health/policy measures, on the lived experience of people who use/inject
drugs. We reveal how these effects are non-linear, complex, and influenced by myriad factors,
including housing situations, income type, drug use, and available social/health supports. Results
emphasise the need for sensitive, population-specific human-rights based emergency law/responses
to public health emergencies, such as a pandemic, to avoid adverse outcomes for people who
use/inject drugs.
Disclosure of Interest Statement
This project received funding (No. 2003255) from the National Health and Medical Research Council
(NHMRC). Lisa Maher, Paul Dietze, and Mark Stoové are funded by NHMRC Senior Research
Fellowships, and Margaret Hellard by an NHMRC Investigator Grant. Paul Dietze has received
funding from Gilead Sciences and Indivior for work unrelated to this study and was an unpaid
member of an advisory board for an intranasal naloxone product. Paul Dietze, Peter Higgs and Mark
Stoové have received investigator-driven research funding from Gilead Sciences for work on
hepatitis C unrelated to this work. Paul Dietze has served as an unpaid member of an Advisory Board
for an intranasal naloxone product. Peter Higgs and Mark Stoové have received funding from Abbvie
for work on hepatitis C unrelated to this work. Margaret Hellard has received unrestricted and
unrelated speaker fees and travel expenses in the past 3 years from Gilead and MSD. Joseph Doyle,
Margaret Hellard, and Mark Stoové receive investigator-initiated research funding support from
Gilead Sciences, Abbvie and Bristol-Myers Squibb and Merck. Joseph Doyle and his institution have
received consultancies from Gilead, AbbVie and Merck.

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