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Disease-related stigma among people who inject drugs in Toronto amidst the COVID-19 pandemic
Journal article   Open access   Peer reviewed

Disease-related stigma among people who inject drugs in Toronto amidst the COVID-19 pandemic

Jeanette M. Bowles, Gillian Kolla, Laramie R. Smith, Ayden Scheim, Zoe Dodd and Dan Werb
Drug and alcohol dependence reports, 100167
20 May 2023
DOI: https://doi.org/10.1016/j.dadr.2023.100167
url
https://doi.org/10.1016/j.dadr.2023.100167View
Published, Version of Record (VoR) Open

Abstract

COVID-19 disease-related stigma harm reduction People who inject drugs supervised consumption sites
•Disease-related stigma has led to discriminatory acts against people who use drugs•People who inject drugs [PWIDs] are especially prone to disease-related stigma•PWIDs reported hardships and life-threatening discrimination after COVID began•This was especially pronounced among those also facing structural vulnerabilities•Anti-stigma strategies are discussed to enhance the wellbeing of PWIDs Stigma overwhelmingly affects people who inject drugs. The COVID-19 pandemic posed unique challenges for people who inject drugs, who are already stigmatized as being “dangerous and spreading disease.” The present study explored ways in which stigma was experienced by a sample of people who inject drugs in Toronto, Canada following COVID-related public health precaution measures. Qualitative interviews were conducted with people who inject drugs (n=24) recruited from supervised consumption sites in Toronto, Canada. The semi-structured interview guide focused on the impact of COVID-19 on participants’ health and social well-being. Interviews took place six-months after initial COVID-19 precautions (September-October 2020). We used thematic analysis to examine findings, with stigma being an emergent theme. Participants described heightened acts of stigma after COVID-19 restrictions were implemented, including feeling treated as “diseased” and the cause of COVID-19’s spread. They reported being less likely to receive emergency care during events such as overdoses. Participants perceived increased disease-related stigma evident through actions of stigma, including amplified dehumanization by the public, others avoiding all contact with them, and more discrimination by police and hospital systems. Participants provided specific examples of how stigmatizing behaviors harmed them after COVID-19 precautions began. It is plausible that stigma contributed to the dramatic increase in fatal overdoses, difficulty accessing housing, and further difficulty accessing needed healthcare in our setting. Integrating evidence-based harm reduction approaches in areas where stigma is evident might offset harms stemming from disease-related stigma and mitigate these harms during future public health emergencies.

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6 citations in Scopus

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