COVID-19 virus behind yellow, police style lockdown tape Credit: Jasmine Nongrum, iStock

Determining the impacts of COVID-19 restrictions on people who use drugs (CODE)

The challenge

The COVID-19 pandemic has resulted in unparalleled, widespread interventions to close borders and limit physical and social interactions. These interventions have profound implications for illicit drug supply, procurement and use practices, as well as prevention, treatment and harm reduction responses. People who inject drugs (PWID) are not only at increased risk of COVID-19 infection and associated morbidity and mortality but may be negatively impacted by the consequences of COVID-19 measures such as reduced service access and increased policing.

The project

This study will look at people who inject drugs, a group largely ignored in the COVID-19 public health policy response to date. The study will:

  1. Characterise the impact of COVID-19 restrictions on patterns of drug use, drug using networks and drug market functioning, including availability, purity and prices;
  2. Measure changes in health service utilisation among PWID as services adapt to COVID-19 restrictions and;
  3. Examine how these changes in drug use/drug markets and health service utilisation affect risk behaviour and health, social and economic outcomes.
The method

This study leverages our ongoing longitudinal studies of PWID – SuperMIX (PWID, n>1300) and VMAX (people who smoke methamphetamine, n>840) – to compare drug use practices and consequences before, during and after the COVID-19 interventions. The quantitative arm captures structured data on the effects of COVID-19 interventions on key behaviours to test how these impacts vary across key variables while the qualitative arm employs a novel ethno-epidemiological stratified random sampling approach to explore the impacts of the pandemic on lived experience.

The impact

Little is known about the impacts of pandemics on vulnerable and marginalised communities. Our study provides a robust platform from which to determine the impacts of COVID-19 and related interventions on the lives of people who use and inject drugs. As the first study internationally to provide a comprehensive account of how the pandemic and associated mitigation measures affected this vulnerable population, results will inform strategies for future pandemic prevention and management.

Project collaborators

Burnet Institute; Monash University; University of Bristol; Harm Reduction Victoria.

Project funding

NHMRC Ideas Grant.