Leveraging the Affordable Housing Sector to Respond to the Opioid Crisis

Pollack, Craig Evan; Saloner, Brendan; Lucas, Stephen O.; Warren, Emily; Chaubal, Manotri; Kennedy-Hendricks, Alene

doi:10.1177/00333549211007591

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…Housing is one of the most important factors in mitigating disease spread and improving health and well-being [40,48,49]. People experiencing street homelessness are likely to continue having difficulty practicing basic COVID-19 prevention strategies if their housing needs are not fulfilled.…”

Section: Discussionmentioning

confidence: 99%

Housing Status and COVID-19 Prevention Recommendations among People Who Use Drugs

Zaidi,

Jordan,

Jessell

et al. 2023

COVID

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Housing conditions can increase health risks for people who use opioids (PWUO). Little research documents the influence of housing on PWUO’s ability to practice disease prevention methods. This study examines associations between housing status of PWUO in NYC and their ability to practice COVID-19 prevention recommendations during the initial wave of the pandemic. Participants were recruited via convenience sampling and administered a survey. Eligibility required age ≥18 years, using opioids ≥3times in the prior 30 days, and accessing a health-related service in the prior year. Descriptive and bivariate statistics assessed relationships between housing and the ability to practice social distancing, access soap and running water or hand sanitizer (soap), and access face masks. Multivariable Poisson regression was used to examine relationships between housing and the potential to practice COVID-19 prevention recommendations. The 329 participants were grouped into stable housing (34.3%), unstable/shelter housing (31.9%), and street homeless (33.7%) categories. Street homeless PWUO were significantly less likely to have access to soap and face masks than those stably housed. There were no significant differences between PWUO experiencing unstable and stable housing. PWUO experiencing street homelessness may have had increased vulnerability to COVID-19. Providing low-threshold health-related resources and increasing linkages to housing opportunities could promote health of PWUO experiencing street homelessness during future emergencies.

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Section: Discussionmentioning

confidence: 99%

Housing Status and COVID-19 Prevention Recommendations among People Who Use Drugs

Zaidi,

Jordan,

Jessell

et al. 2023

COVID

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“…Other literature supporting a self-created definition of recovery can be seen with other social-justice and empowerment focused substance use disorders (SUD) treatment programs. These include housing not conditional on abstinence from substance use (Housing-first model; Cherner et al, 2017; Pollack et al, 2021; Tsemberis et al, 2004) and harm reduction solutions (Ciccarelli et al, 2021; Jenkins et al, 2017). As noted in Dressel et al, women were deemed “successful graduates” of the program if they participated in the aspects of the program and were deemed by themselves and the counselors as ready to leave the program and be successful on their own (2020).…”

Section: Study Purposementioning

confidence: 99%

Successful substance use disorder recovery in transitional housing: Perspectives from African American women.

Krueger¹,

Deal²,

Lopez³

et al. 2022

Experimental and Clinical Psychopharmacology

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Through the lens of Black Feminist Thought, the intersectionality of poverty, racism, and sexism in the lives of urban dwelling African American women was explored. Reflections on recovery among women previously enrolled in a transitional housing treatment program were gathered via semistructured interviews, using an instrumental case study design. Four major themes surrounding the context of recovery were identified and analyzed: Knowledge and awareness of addiction, importance of social support and support groups, peace of mind that resulted from a new lifestyle, and women's desire to maintain their recovery status. Many women did not realize that their drug use constituted an addiction prior to their enrollment in the program. Social support and support groups such as AA, NA, and AODA helped the women to maintain their recovery, and this newfound recovery resulted in additional stress relief. Finally, many women felt empowered to maintain their recovery, not only for themselves but also their children. Paradigm shifts in treatment and recovery processes are needed to better serve minority populations, specifically focusing on women and African Americans. Recovery services must shift from previously male centered, hegemonic, pathology-oriented treatment modalities to serve populations more efficiently and equitably. Furthermore, to create effective social change in recovery, programs must address the social determinants of substance misuse, addictive behaviors, and underlying structural inequalities resulting from the intersection of racism, sexism, and classism. Deeper understandings of complex social issues must be disseminated, particularly for women battling substance misuse who are homeless, racially discriminated against and marginalized. Public Health SignificanceShifts in recovery are needed to better serve Racial and Ethnic minority groups, including African American women who are addicted to drugs. To create effective social change, community programs must address both social determinants of substance use, addictive behaviors, and underlying structural inequalities due to racism and sexism. Prevention strategies, treatment rhetoric, and substance misuse services must recognize the intersecting and compounding realities dictating how African American women experience health and wellbeing.

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“…Several factors can limit the utilization and implementation of MOUD interventions, such as lack of access, lack of knowledge and awareness of resources, negative beliefs about the use of MOUD by both providers and patients, and social determinants of health (SDOH) and geographic location ( Abraham et al, 2013 ; Kelly & Daley, 2013 ; Knudsen et al, 2011 ; Magura & Marshall, 2020 ; Pollack et al, 2021 ; Probst & Rehm, 2018 ; Rhee & Rosenheck, 2019 ; Rigg & Monnat, 2015 ; Roman et al, 2011 ; Stevens et al, 2015 ; Volkow et al, 2014 ). Treatment outcomes also depend largely on the specific nature and degree of the client's issues, the appropriate fit of treatment services, and the quality of the interactions and communication between the client and their providers ( NIDA, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

When a pandemic and epidemic collide: Lessons learned about how system barriers can interrupt implementation of addiction research

Sharp,

Carlson,

Vroom

et al. 2023

Implementation Research and Practice

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Background Telehealth technologies are now featured more prominently in addiction treatment services than prior to the COVID-19 pandemic, but system barriers should be carefully considered for the successful implementation of innovative remote solutions for medication management and recovery coaching support for people with opioid use disorder (OUD). Method The Centers for Disease Control and Prevention funded a telehealth trial prior to the COVID-19 pandemic with a multi-institution team who attempted to implement an innovative protocol during the height of the pandemic in 2020 in Tampa, Florida. The study evaluated the effectiveness of a mobile device application, called MySafeRx, which integrated remote motivational recovery coaching with daily supervised dosing from secure pill dispensers via videoconference, on medication adherence during buprenorphine treatment. This paper provides a participant case example followed by a reflective evaluation of how the pandemic amplified both an existing research-to-practice gap and clinical system barriers during the implementation of telehealth clinical research intervention for patients with OUD. Findings Implementation challenges arose from academic institutional requirements, boundaries and role identity, clinical staff burnout and lack of buy-in, rigid clinical protocols, and limited clinical resources, which hampered recruitment and intervention engagement. Conclusions As the urgency for feasible and effective telehealth solutions continues to rise in response to the growing numbers of opioid-related deaths, the scientific community may use these lessons learned to re-envision the relationship between intervention implementation and the role of clinical research toward mitigating the opioid overdose epidemic.

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Leveraging the Affordable Housing Sector to Respond to the Opioid Crisis

Cited by 5 publications

References 17 publications

Housing Status and COVID-19 Prevention Recommendations among People Who Use Drugs

Housing Status and COVID-19 Prevention Recommendations among People Who Use Drugs

Successful substance use disorder recovery in transitional housing: Perspectives from African American women.

When a pandemic and epidemic collide: Lessons learned about how system barriers can interrupt implementation of addiction research

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