Conceptualizing the COVID-19, Opioid Use, and Racism Syndemic and Its Associations With Traumatic Stress.

Individually, the COVID-19 pandemic and opioid epidemic have each been responsible for hundreds of thousands of deaths. Systemic racism, including public perceptions about people who use opioids, inadequate substance abuse prevention and treatment efforts, heightened risks for COVID-19 exposure, and inadequate access to testing and health care, has contributed to the ongoing disparities underlying these health crises. Thus, the authors propose an integrative framework for conceptualizing the COVID-19, opioid use, and racism (COR) syndemic, with traumatic stress as a critical underpinning of this model. Action is needed to address trauma and the COR syndemic. Implications for research, practice, and policy are discussed.

Perspectives on trauma and the design of a technology-based trauma-informed intervention for women receiving medications for addiction treatment in community-based settings.

BACKGROUND: Despite national calls to develop gender-specific interventions for women with opioid use disorder (OUD) with co-occurring trauma and post-traumatic stress disorder (PTSD) symptoms, there remains a dearth of research on what modalities or treatment components would be most feasible for this population. This study interviewed women with OUD receiving medication assisted treatment and addiction treatment providers to explore (a) experiences of barriers to receiving trauma treatment, and (b) both the perceptions and desired design of a prospective technology-delivered, trauma-informed treatment for women with OUD. METHODS: Women with lifetime OUD (n = 11) and providers (n = 5) at two community substance use clinics completed semi-structured interviews. Interviews were transcribed, coded, and analyzed in NVivo v11 using a grounded theory approach. Women also completed a demographic form and clinical measures. RESULTS: Clients were primarily women with children reporting histories of multiple trauma exposures, high PTSD symptoms, and polysubstance use. Two themes emerged among clients and one among providers regarding barriers to trauma treatment. Regarding the feasibility and desired attributes of a technology-based intervention, six themes emerged among clients and providers, respectively. CONCLUSIONS: Themes suggest a high interest by clients and providers for a technology-delivered, trauma informed treatment available by smartphone. Utilizing technology as an adjunct to care, without reducing face-to-face therapy, was important to both clients and providers.