Experiences of People Who Use Drugs in Rural Southeastern Ohio During the COVID-19 Pandemic: Harm Reduction,...

To describe COVID-19 pandemic experiences among people who use drugs (PWUD) in rural southeastern Ohio in varying geographies and time since start of pandemic.

We used two cross-sections of data from the Ohio Opioid Project to describe shifts in PWUD's service accessibility and perceived trustworthiness of COVID-19-related information sources. Participants in the cross-section "Rural2020-22" were surveyed from September 2020 to January 2022 in a rural area. Participants in the cross-section "Micropolitan2022-23" were surveyed from January 2022 to February 2023 in a micropolitan area. Our total sample included 408 participants (50% male).

Early in the COVID-19 pandemic, 36% of participants reported increased drug use. Rural2020-22 participants reported services were at least "a little harder" to access than before the pandemic more commonly than Micropolitan2022-23 (local harm reduction services: 34% versus 30%; substance use treatment programs: 49% versus 26%). Most participants reported news media as a source of COVID-19 information in both samples (Rural2020-22: 75%; Micropolitan2022-23: 51%). Local harm reduction programs and health authorities had the highest level of trust for information among participants (Rural2020-22: 46%, 22%; Micropolitan2022-23: 37%, 30%, respectively, trusted them "a lot").

In the context of the COVID-19 pandemic, many PWUD reported increased substance use, yet struggled to access services. Local harm reduction programs, health authorities, and news media may be valuable outlets through which to disseminate timely health information, such as program changes and availability, to PWUD during a future emergency.