How does the occurrence of a natural disaster impact the treatment plans and resources available to people who inject drugs (PWID) in rural communities?
This is the overarching research question guiding Roberto Abadie and Patrick Habecker’s project that was recently funded by an R21 grant from the National Institute of Health. Their project, “Assessing the effects of Hurricane Maria on Opioid Agonist Treatment Access among PWID in Rural Puerto Rico,” involves collecting data with PWID in four rural communities in Puerto Rico in an effort to both understand how hurricane Maria affected access and adherence to opioid agonist treatment (OAT) and how coping with the aftermath of the disaster impacted the ability and motivation to continue treatment. Abadie and Habecker describe this as a unique opportunity to contribute substantively to the literature on addiction and treatment as little is known about the impact of natural disasters on treatment-seeking or treatment adherence for PWID. We know that homelessness and high injection frequency are among the barriers to OAT, and we can surmise that transportation to treatment is a concern after the hurricane, says Abadie, but what we don’t know is how hurricane Maria may have exacerbated these issues and what new barriers it may have introduced.
Abadie will lead the ethnographic component which will provide an in-depth understanding of the cultural and structural dimensions of addiction treatment for PWID in the post-natural disaster context. “Sometimes treatment fails the people,” Abadie notes, and this research will help attune scholars to the motivations and barriers to participating in OAT. Habecker will lead the quantitative component which will facilitate demographic, epidemiological, and mental health comparisons from before and after hurricane Maria. Taken together, the work funded by this grant will enhance understanding of the impact of a natural disaster on the everyday experiences of PWID participating in OAT treatment, provide state and federal agencies with knowledge to plan and respond to future disasters, and enhance research capacity in rural areas.
“Addiction is not an individual problem,” Abadie emphasizes, “it is a serious social problem.” He goes on to describe the need for a more nuanced understanding of addiction and barriers to treatment–both of which are included in this NIH grant.