Impact of COVID-19 on consumer practices and the use of specialised offers by high-risk drug users in the Grand Duchy of Luxembourg: findings from a quantitative study

Abstract

Living mostly in precarious conditions, high-risk drug users (HRDU) are exposed to increased risks during health crises such as the COVID-19 pandemic. In the frame of the current study, a quantitative survey was conducted among a sample of HRDU (n=120), beneficiaries of treatment and harm reduction offers, in the Grand Duchy of Luxembourg. The survey included questions on the use of psychoactive substances, consumption habits, living situation, access to and use of (low-threshold) substitution treatment and medical services set up in the framework of the COVID-19 pandemic, and risk behaviour before and since the implementation of the restrictive measures by the Luxembourg government in the context of the COVID-19 health crisis. Moreover, the impact of the crisis on the illicit drug market (availability, accessibility, quantity, quality and price of drugs), the perception of the availability and accessibility of health and social services, as well as emotional experiences, were assessed. The results of the study suggest that the COVID-19 restrictive measures did not affect the types of substances used, while it even led to a slight decrease in the frequency of use as well as of overdose episodes experienced by HRDUs. A minor impact with regard to the illicit drug market was observed (slight decrease in drug quality and slight increase in prices). Results further reveal that the offers of health, social and harm reduction services and aids available (including low threshold substitution treatment and medical care) are perceived to be generally sufficient by HRDUs. The offers that were judged most frequently to be "insufficient" were, by decreasing order, places that allow confinement, places for personal hygiene, and places to sleep. In terms of potential improvements, results reveal that the HRDUs would particularly welcome an increase in the housing offer, therapeutic care and psychological counselling. In sum, the current study contributes to an improved understanding of the impact of the COVID-19 crisis on different life spheres of HRDUs. Beyond monitoring, its results help to better identify the mental, physical and social needs of HRDUs in the Grand Duchy of Luxembourg in the context of a national health crisis and to optimize medium and long-term responses.