Barriers to Recovery from Opioid Use Disorder Reported by Women During 2020: Insights for the Next Public Health Emergency
Article
Ward, MK, Jafry, A, Coleman, S et al. (2026). Barriers to Recovery from Opioid Use Disorder Reported by Women During 2020: Insights for the Next Public Health Emergency
. International Journal of Environmental Research and Public Health, 23(3), 10.3390/ijerph23030409
Ward, MK, Jafry, A, Coleman, S et al. (2026). Barriers to Recovery from Opioid Use Disorder Reported by Women During 2020: Insights for the Next Public Health Emergency
. International Journal of Environmental Research and Public Health, 23(3), 10.3390/ijerph23030409
Highlights: Public health relevance—How does this work relate to a public health issue? This research describes how access to treatment and recovery services for opioid use disorder was disrupted in 2020, as reported by women in recovery in the United States. By understanding these challenges, communities can better prepare to protect vulnerable populations from interruptions in treatment and support that can lead to recurrence of substance use problems and overdose during crisis situations. Public health significance—Why is this work of significance to public health? The findings provide crucial insights for members of the recovery community, healthcare providers, treatment facilities, and decision makers. In the event of a future pandemic, these individuals should use a harm reduction approach to balance essential services for people with substance use disorders with important infection control measures. Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health? Harm reduction is critical for pandemic planning in substance use recovery settings. Lessons learned from 2020 can mitigate barriers to care and recovery in future public health emergencies. This study seeks to inform emergency preparedness efforts by summarizing the pandemic’s impacts on access to opioid use disorder (OUD) recovery support as reported by women in recovery. In-depth interviews were completed with adult women in recovery from OUD. We used a primarily deductive approach to coding and analysis. Two coders analyzed transcripts; discrepancies were resolved through discussion. Seventeen women completed interviews from June to October 2020. Pandemic impacts primarily focused on engagement in care and retention at community and interpersonal levels. Community-level barriers to engagement included facilities’ halting intake of patients and fear of COVID-19 infection in treatment settings. Interpersonal barriers to engagement included loss of childcare support and the sudden transition to virtual services. Community-level retention barriers included perception of facility staff’s lack of adherence to infection prevention protocols and strict enforcement of infection prevention protocols on residents within facilities. Interpersonal barriers to retention included reduced availability of mutual aid meetings. Participants also highlighted how the pandemic worsened the addiction crisis and increased women’s caretaking burden. Leaders and administrators must be prepared to simultaneously balance responses for two public health crises: a novel infectious disease and addiction. Lessons learned from the pandemic can mitigate barriers to care and recovery when future emergencies arise.
