Pandemic brings increased risk and decreased access to services for people who inject drugs

People who inject drugs are particularly vulnerable to the impacts of major events like pandemics, but there is little research to date that gauges the impact of the COVID-19 pandemic on this population.

For a study in the Harm Reduction Journal, CUNY SPH Accessible Care Project Director Yesenia Aponte-Melendez, Associate Professor Pedro Mateu-Gelabert, and colleagues examined how COVID-19 has affected people who inject drugs in New York City across four domains: substance use, risk behaviors, mental health, and service utilization.

As part of a randomized trial to improve access to hepatitis C treatment for people who inject drugs, the authors recruited 165 participants. For this analysis, the authors conducted follow up interviews with a subsample of 106 participants from March 2019 to March 2021. This time period was selected to ensure an equal duration between the pre-COVID-19 and COVID-19 periods to assess the impact of the pandemic.

Compared to the pre-COVID-19 sample, those interviewed during COVID-19 reported higher levels of mental health issues, syringe reuse, and alcohol consumption and greater reductions in syringe-service programs and the use of buprenorphine, a  medication used to treat opioid addiction.

Placing dispensing machines of harm-reduction supplies in communities where people who inject drugs live and increasing secondary exchange, mobile services, and mail delivery of supplies may help maintain access to lifesaving supplies during big events, such as COVID-19, the authors say.

“These findings highlight the need to support people who inject drugs and to expand mobile services to the communities where they live and congregate,” says Aponte-Melendez.

About the Institute for Implementation Science in Population Health at the City University of New York The CUNY Institute for Implementation Science in Population Health (ISPH) was founded on the notion that substantial improvements in population health can be efficiently achieved through better implementation of existing strategies, policies, and interventions across multiple sectors. We study how to translate and scale-up evidence-based interventions and policies within clinical and community settings in order to improve population health and reduce health disparities. CUNY ISPH. Pursuing population health gains through better implementation. Follow us on Twitter: @CUNYISPH.

About the CUNY Graduate School of Public Health and Health Policy The CUNY Graduate School of Public Health and Health Policy (CUNY SPH) is committed to promoting and sustaining healthier populations in New York City and around the world through excellence in education, research, and service in public health and by advocating for sound policy and practice to advance social justice and improve health outcomes for all. For more information, visit


The impact of COVID-19 on people who inject drugs in New York City: increased risk and decreased access to service,” Yesenia Aponte-Melendez, Pedro Mateu-Gelabert, Chunki Fong, Benjamin Eckhardt, Shashi Kapadia, Kristen Marks, Harm Reduction Journal, 18 (1): 118 (2021).