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Heroin Addiction and Related Clinical Problems: 2026, 28: 111-118

Impact and adaptation of social and medical care for people who use drugs during a period of system disruption (COVID-19): A Qualitative Study

Des Crowley, John Broughan, Nandakumar Ravichandran, Anita Whyte, and Walter Cullen

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2026-14

Summary: Background: The COVID-19 pandemic disrupted health services globally and necessitated rapid changes to addiction care delivery. People who use drugs (PWUD) were especially vulnerable due to high rates of physical and mental illness, homelessness, and social exclusion. While many emergency service adaptations were made, understanding which innovations may strengthen post-pandemic addiction care remains critical. This study explores the impact of COVID-19 and examines service adaptations perceived as beneficial by service users and providers within an inclusion health hub in Dublin’s North East Inner City (NEIC). Methods: A qualitative study using semi-structured interviews was conducted with service users (n = 9) and service providers (n = 8) attending a multidisciplinary drug treatment service. Interviews were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis as described by Braun and Clarke. Results: Five themes were identified: 1) Complex medical and psychosocial issues and barriers to mainstream healthcare, 2) Impact of COVID-19 and service adaptations, 3) Satisfaction with the inclusion health hub model and 4) Improving post-pandemic addiction care. Participants highlighted the hub’s role in reducing structural barriers and maintaining continuity of care during a period of significant disruption. Conclusions: Emergency service innovations implemented during this period of service disruption demonstrated the potential of multidisciplinary inclusion health models to support highly marginalised populations. Findings suggest that targeted outreach, integrated care, and flexible service delivery should be considered core components of post-pandemic addiction services.

Keywords: People who use drugs; PWUD; People who inject drugs; PWID; Inclusion; Health; continuity of care; barriers; service delivery; post-pandemic; addiction management