Risk environments of people who use drugs during the Covid-19 pandemic - the view of social workers and health care professionals in Sweden

Although research is emerging on how the Covid-19 pandemic has affected people who use drugs (PWUD), there is a lack of studies focusing on professionals' views on Covid-19 related risks and consequences for this group. The aim of this study was to analyze how social workers and health care professionals in the city of Malmo, Sweden viewed the effects of the Covid-19 pandemic on PWUD risk environments. We used a mixed methods approach including an online survey with social workers and three qualitative focus group sessions with social workers and health care professionals working with PWUD. The professionals defined PWUD as an especially vulnerable group that had difficulty protecting themselves from contracting Covid-19, and who risked severe consequences if infected. They described risks relating to lifestyle and marginalization, limited health literacy, and health-related problems. Reported consequences of the pandemic included reduced access to treatment and support, social isolation, anxiety, and increased drug use. Factors at both micro and meso levels of risk environments seemed to contribute to a particular vulnerability for PWUD during the Covid-19 pandemic. It is important to learn from this development in order to provide better support to at-risk groups in future crises.