"The Drug Use Unfortunately isn't all Bad": Chronic Disease Self-Management Complexity and Strategy Among...

Area of Science:

• Public Health
• Addiction Medicine
• Sociology

Background:

• Self-management programs are vital for chronic disease management but are underutilized by people who use drugs (PWUD).
• Marginalized PWUD face unique challenges in managing co-occurring chronic conditions and drug use.
• Understanding the self-management experiences of this population is essential for developing effective interventions.

Purpose of the Study:

• To explore the self-management experiences of marginalized people who use drugs (PWUD).
• To identify existing self-management strategies employed by PWUD with chronic conditions.
• To inform the development of culturally sensitive and effective self-management support for PWUD.

Main Methods:

• Community-based participatory research methods were employed.
• Qualitative in-depth interviews were conducted with participants self-identifying as marginalized PWUD with chronic conditions.
• Reflexive thematic analysis was used to analyze interview data.

Main Results:

• Participants viewed drug use as a chronic health issue and used non-prescribed drugs for self-medication to manage other health conditions.
• PWUD employed a range of cognitive and behavioral self-management strategies beyond drug use.
• Participants highlighted the need for a safe supply of pharmaceutical-grade drugs as a self-management tool.

Conclusions:

• Self-management among marginalized PWUD is complex, often integrating drug use as a coping mechanism.
• Future self-management supports must incorporate harm reduction, withdrawal management, and creative activities.
• Interventions should prioritize and preserve the agency of PWUD in their health management journey.