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Provider perspectives on the impact of COVID-19 on treatment of substance use and opioid use disorders among American Indian and Alaska Native adults.
Richardson, Meenakshi; Hirchak, Katherine; Bajet, Kelsey; Brigman, Mariah; Shaffer, Racquel; Keyes, Beverly; Oliver, Karen Anderson; Kropp, Frankie; McDonell, Michael G; Venner, Kamilla L; Campbell, Aimee N C.
Affiliation
  • Richardson M; Human Development, Washington State University Vancouver, Vancouver, WA, United States.
  • Hirchak K; Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University Spokane, Spokane, WA, United States.
  • Bajet K; Promoting Research Initiatives in Substance Use and Mental Health (PRISM) Collaborative, Elson S. Floyd College of Medicine, Washington State University Spokane, Spokane, WA, United States.
  • Brigman M; College of Education, Washington State University, Pullman, WA, United States.
  • Shaffer R; Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University Spokane, Spokane, WA, United States.
  • Keyes B; Promoting Research Initiatives in Substance Use and Mental Health (PRISM) Collaborative, Elson S. Floyd College of Medicine, Washington State University Spokane, Spokane, WA, United States.
  • Oliver KA; College of Education, Washington State University, Pullman, WA, United States.
  • Kropp F; Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University Spokane, Spokane, WA, United States.
  • McDonell MG; Promoting Research Initiatives in Substance Use and Mental Health (PRISM) Collaborative, Elson S. Floyd College of Medicine, Washington State University Spokane, Spokane, WA, United States.
  • Venner KL; College of Education, Washington State University, Pullman, WA, United States.
  • Campbell ANC; Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University Spokane, Spokane, WA, United States.
Front Public Health ; 12: 1356033, 2024.
Article in En | MEDLINE | ID: mdl-38898893
ABSTRACT

Introduction:

American Indian/Alaska Native (AI/AN) communities are more likely to suffer negative consequences related to substance misuse. The COVID-19 pandemic exacerbated the opioid poisoning crisis, in combination with ongoing treatment barriers resulting from settler-colonialism, systemic oppression and racial discrimination. AI/AN adults are at greatest risk of COVID-19 related serious illness and death. In collaboration with an Indigenous community advisory board and Tribal leadership, this study explored AI/AN treatment provider perceptions of client-relatives' (i.e., SUD treatment recipients) experiences during the pandemic from 2020 to 2022.

Methods:

Providers who underwent screening and were eligible to participate (N = 25) represented 6 programs and organizations serving rural and urban areas in Washington, Utah, and Minnesota. Participants engaged in audio-recorded 60-90 min semi-structured individual interviews conducted virtually via Zoom. The interview guide included 15 questions covering regulatory changes, guidance for telemedicine, policy and procedures, staff communication, and client-relatives' reactions to implemented changes, service utilization, changes in treatment modality, and perceptions of impact on their roles and practice. Interview recordings were transcribed and de-identified. Members of the research team independently reviewed transcripts before reaching consensus. Coding was completed in Dedoose, followed by analyses informed by a qualitative descriptive approach.

Results:

Five main domains were identified related to client-relative experiences during the COVID-19 pandemic, as observed by providers (1) accessibility, (2) co-occurring mental health, (3) social determinants of health, (4) substance use, coping, and harm reduction strategies, and (5) community strengths. Providers reported the distinctive experiences of AI/AN communities, highlighting the impact on client-relatives, who faced challenges such as reduced income, heightened grief and loss, and elevated rates of substance use and opioid-related poisonings. Community and culturally informed programming promoting resilience and healing are outlined.

Conclusion:

Findings underscore the impact on SUD among AI/AN communities during the COVID-19 pandemic. Identifying treatment barriers and mental health impacts on client-relatives during a global pandemic can inform ongoing and future culturally responsive SUD prevention and treatment strategies. Elevating collective voice to strengthen Indigenous informed systems of care to address the gap in culturally-and community-based services, can bolster holistic approaches and long-term service needs to promote SUD prevention efforts beyond emergency response efforts.
Subject(s)
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Indians, North American / Substance-Related Disorders / COVID-19 / Opioid-Related Disorders Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: America do norte Language: En Journal: Front Public Health Year: 2024 Document type: Article Affiliation country: United States Country of publication: Switzerland

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Indians, North American / Substance-Related Disorders / COVID-19 / Opioid-Related Disorders Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: America do norte Language: En Journal: Front Public Health Year: 2024 Document type: Article Affiliation country: United States Country of publication: Switzerland