A Cross-sectional study of Challenges Faced by Under-Resourced Women with Substance Use Disorders during the COVID-19 Pandemic: Implications for Treatment and Care Delivery

Abstract

Abstract Background: The COVID-19 pandemic has exacerbated existing disparities in access to mental health care and treatment for substance use disorders (SUD), particularly in under-resourced communities. This study aimed to understand the experiences of under-resourced women with substance use disorders during the COVID-19 pandemic, their knowledge and attitudes towards the pandemic, and its impact on their substance use and access to treatment. Methods: This is a cross-sectional study of 66 under-resourced women receiving medically managed withdrawal treatment in a community residential SUD treatment center. Data were collected from November 2021 to August 2022 through a 75-item instrument covering topics related to COVID-19 exposure, pandemic impact on health, substance use, and access to treatment, COVID-19 vaccination status and attitudes, as well as knowledge and beliefs about the virus and pandemic risk mitigation measures. Descriptive analyses were conducted to summarize the data. Results: Results revealed that participants faced numerous challenges during the pandemic. Many reported increased substance use, particularly alcohol, opioids, benzodiazepines, and nicotine. Mental health stability was also negatively impacted, with a majority reporting the exacerbation of existing mental health disorders and difficulties accessing mental health care. Job loss, housing instability, and financial strain were prevalent among the participants. Half of the respondents received at least one dose of a COVID-19 vaccine, while 27.3% did not receive the COVID-19 vaccine and were not considering it. Vaccine hesitancy was observed due to concerns about lack of knowledge and religious beliefs. The majority (62.1%) of participants felt that their greatest worry was about challenges to securing basic needs such as groceries or medication, and (64.6%) reported a desire to cope using alcohol or drugs. Conclusions: These findings highlight the need for gender-responsive and culturally appropriate approaches to substance use disorders treatment. Additionally, efforts should focus on improving access to mental health care, reducing stigma, and providing resources and support to individuals with co-occurring mental health conditions during and after the pandemic. This study provides valuable insights to refine substance use care delivery and recovery services for under-resourced women, both in the early post-pandemic period and in preparation for future global crises.