The impact of COVID-19 on access to harm reduction, substance use treatment and recovery services in Scotland: a qualitative study



Schofield J, Dumbrell J, Matheson C, Parkes T & Bancroft A (2022) The impact of COVID-19 on access to harm reduction, substance use treatment and recovery services in Scotland: a qualitative study. BMC Public Health, 22 (1), Art. No.: 500.

Introduction People who use drugs (PWUD) are considered vulnerable to COVID-19 exposure and the sequelae of infection due to their social circumstances, health conditions, drug purchasing, and substance use. They can depend on access to services that provide harm reduction, substance use treatment, recovery and support, and general healthcare. Social distancing measures and service restrictions posed significant challenges to the health and wellbeing of PWUD. Methods Ethical approvals were secured. PWUD were recruited from voluntary sector homeless and housing, harm reduction, and recovery organisations across central Scotland. Data was collected via semi-structured interviews and analysed using the Framework Method. Results Twenty nine PWUD participated and reported mixed experiences of the impacts of COVID-19 lockdown. Several benefitted from policy and practice developments designed to sustain or increase access to harm reduction services. Some PWUD reported improved access to substitute prescribing and/or appreciated being trusted to manage multiple take-home doses. Others noted the loss of regular in-person contact with treatment providers and dispensers. Access to recovery support was challenging for many, especially those unable to access or uncomfortable with online provision who experienced greater isolation. Lack of access to general healthcare services was common, and especially problematic for PWUD with chronic physical and mental health conditions. Conclusions This qualitative research describes the impacts of COVID-19 social and service restrictions on PWUD in Scotland. These impacts were anticipated by policy makers and service providers. Effective and acceptable developments were shown to maintain and even increase service provision for PWUD. Developments were geographically dependent and significant challenges remained for many people. The learning generated can inform responses to increase service access and uptake in post-pandemic times.

COVID-19; Substance use; Harm reduction; Opioid replacement treatment; Recovery

BMC Public Health: Volume 22, Issue 1

FundersCSO Chief Scientist Office
Publication date31/12/2022
Publication date online31/03/2022
Date accepted by journal24/02/2022
PublisherSpringer Science and Business Media LLC

People (4)


Mr Joshua Dumbrell
Mr Joshua Dumbrell

Research Assistant (Peer Research), Dementia and Ageing

Professor Catriona Matheson
Professor Catriona Matheson

Professor in Substance Use, Faculty of Social Sciences

Professor Tessa Parkes
Professor Tessa Parkes

Professor, Faculty of Social Sciences

Mr Joe Schofield
Mr Joe Schofield

Research Fellow, Faculty of Social Sciences

Projects (1)