![]() ![]() Growing evidence indicates that these measures have had a disruptive impact on illicit drug markets, affecting the availability and accessibility of drugs. Restrictions on travel, physical distancing, business closures, and other measures affected many aspects of people’s lives. The COVID-19 pandemic led to introduction of infection containment measures on both global and national levels. Harm reduction and treatment services need to develop and implement protocols for ensuring uninterrupted service delivery during lockdowns, in anticipation of the similar epidemics or other emergency situations. While adjusting to the new environment, many PWUD would engage in activities that put them under increased risk of overdose and blood-borne infections. ConclusionsĬOVID-19-related restrictive measures mediated specific changes in supply models and drug-use behaviours. Harm reduction and treatment programs managed to adopt flexible strategies to recover services that were affected during the initial stage of the pandemic. When access to sterile injection equipment was limited, PWUD exercised risk-containing injection behaviours, such as buying drugs in pre-filled syringes (aOR 0.88 95% CI 0.80–0.96). PWUD cited fewer contacts with drug dealers, the lack of transportation, and the lack of conventional recreational environment as the main reasons for these changes. Consumption of cannabis products declined significantly (aOR 0.89 95% CI 0.84–0.95), likewise alcohol (aOR 0.94 95% CI 0.88–1.0), diverted medicinal methadone (aOR 0.85 95% CI 0.8–0.9) and diverted medicinal buprenorphine (aOR 0.91 95% CI 0.84–0.99). On average, participants used significantly fewer substances over the course of the study, from 3.5 substances in the preceding 14 days to 2.1 (aOR 0.92 95% CI 0.90–0.94). Perceived availability of drugs was reduced during the lockdown, and many PWUD switched to alternative substances when preferred drugs were not available. Mean age in the sample was 36 (range 18–60) 39 (78%) were males. In addition, four key informants (field experts) were interviewed monthly to assess their perceptions of changes in the illicit drug market and drug service delivery. They also took part in the qualitative telephone interviews at 12- and 24-week follow-up time points. ![]() ![]() In this mixed methods study, a cohort of 50 Georgian PWUD recruited through a snow-ball sampling participated in a bi-weekly online survey in April–September, 2020. This study examines the effects of COVID-19 related restrictions on the supply of illicit drugs, drug-use behaviour among people who use drugs (PWUD) regularly (at least weekly), and drug-related service provision in Tbilisi, Georgia. ![]()
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