“The people who depended on us became expendable”: Experiences of frontline workers with lived and living expertise of drug use during the COVID-19 pandemic

Abstract Background This paper explores the perspectives of a group of people with lived and living expertise of unregulated drug use who worked as frontline harm reduction service providers and activists in Canada during the dual public health emergencies of COVID-19 and the toxic drug crisis. Spec...

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Main Authors: Kat Gallant, Kelsey A. Speed, Alex Betsos, Brandi Abele, Matthew Bonn, Frank Crichlow, Alexandra de Kiewit, Michael Nurse, Alex Sherstobitoff, Natasha Touesnard, Karen Turner, the National Working Group of People with Lived and Living Expertise, Jade Boyd
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Harm Reduction Journal
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Online Access:https://doi.org/10.1186/s12954-025-01221-z
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author Kat Gallant
Kelsey A. Speed
Alex Betsos
Brandi Abele
Matthew Bonn
Frank Crichlow
Alexandra de Kiewit
Michael Nurse
Alex Sherstobitoff
Natasha Touesnard
Karen Turner
the National Working Group of People with Lived and Living Expertise
Jade Boyd
author_facet Kat Gallant
Kelsey A. Speed
Alex Betsos
Brandi Abele
Matthew Bonn
Frank Crichlow
Alexandra de Kiewit
Michael Nurse
Alex Sherstobitoff
Natasha Touesnard
Karen Turner
the National Working Group of People with Lived and Living Expertise
Jade Boyd
author_sort Kat Gallant
collection DOAJ
description Abstract Background This paper explores the perspectives of a group of people with lived and living expertise of unregulated drug use who worked as frontline harm reduction service providers and activists in Canada during the dual public health emergencies of COVID-19 and the toxic drug crisis. Specifically, this paper explores their initial experiences at the onset of the COVID-19 pandemic, their reflections on how these experiences varied one year into the pandemic, and their perspectives on how shifting public health measures and policies shaped their work. Methods Drawing on collaborative research methods, this project was developed with a national working group of people with lived and living expertise of substance use. Three rounds of roundtable discussions along with two sets of semi-structured interviews were conducted with working group members from May 2020 to June 2021. A thematic analysis was co-developed by academic facilitators and the working group through deductive and indictive group coding and reflexive analysis. Results Four themes emerged from the interviews and roundtable sessions: (1) initial negative impacts of COVID-19-related public health measures; (2) societal abandonment, collective anger and grief; (3) navigating constantly shifting public health emergencies over time; and (4) leveraging lived expertise to create positive change. Conclusions The COVID-19 pandemic, in concert with the toxic drug crisis, presented many challenges for working group members on the frontlines to continue their work providing essential services to people who use unregulated drugs in Canada. The experiences shared by this unique group demonstrate these challenges, as well as how the immediate and long-term impacts of these dual public health emergencies provided opportunities for innovating and advocating for sustainable policy changes.
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spelling doaj-art-d0c550afbacc43e08c652e68c477484f2025-08-20T01:51:27ZengBMCHarm Reduction Journal1477-75172025-05-0122111510.1186/s12954-025-01221-z“The people who depended on us became expendable”: Experiences of frontline workers with lived and living expertise of drug use during the COVID-19 pandemicKat Gallant0Kelsey A. Speed1Alex Betsos2Brandi Abele3Matthew Bonn4Frank Crichlow5Alexandra de Kiewit6Michael Nurse7Alex Sherstobitoff8Natasha Touesnard9Karen Turner10the National Working Group of People with Lived and Living Expertise11Jade Boyd12British Columbia Centre On Substance UseBritish Columbia Centre On Substance UseDepartment of Science and Technology Studies, Rensselaer Polytechnic InstituteCanadian Research Initiative in Substance MattersCanadian Research Initiative in Substance MattersCanadian Research Initiative in Substance MattersCanadian Research Initiative in Substance MattersCanadian Research Initiative in Substance MattersCanadian Research Initiative in Substance MattersCanadian Research Initiative in Substance MattersCanadian Research Initiative in Substance MattersCanadian Research Initiative in Substance MattersBritish Columbia Centre On Substance UseAbstract Background This paper explores the perspectives of a group of people with lived and living expertise of unregulated drug use who worked as frontline harm reduction service providers and activists in Canada during the dual public health emergencies of COVID-19 and the toxic drug crisis. Specifically, this paper explores their initial experiences at the onset of the COVID-19 pandemic, their reflections on how these experiences varied one year into the pandemic, and their perspectives on how shifting public health measures and policies shaped their work. Methods Drawing on collaborative research methods, this project was developed with a national working group of people with lived and living expertise of substance use. Three rounds of roundtable discussions along with two sets of semi-structured interviews were conducted with working group members from May 2020 to June 2021. A thematic analysis was co-developed by academic facilitators and the working group through deductive and indictive group coding and reflexive analysis. Results Four themes emerged from the interviews and roundtable sessions: (1) initial negative impacts of COVID-19-related public health measures; (2) societal abandonment, collective anger and grief; (3) navigating constantly shifting public health emergencies over time; and (4) leveraging lived expertise to create positive change. Conclusions The COVID-19 pandemic, in concert with the toxic drug crisis, presented many challenges for working group members on the frontlines to continue their work providing essential services to people who use unregulated drugs in Canada. The experiences shared by this unique group demonstrate these challenges, as well as how the immediate and long-term impacts of these dual public health emergencies provided opportunities for innovating and advocating for sustainable policy changes.https://doi.org/10.1186/s12954-025-01221-zFrontlineCOVID-19People who use drugsOverdoseHarm reduction
spellingShingle Kat Gallant
Kelsey A. Speed
Alex Betsos
Brandi Abele
Matthew Bonn
Frank Crichlow
Alexandra de Kiewit
Michael Nurse
Alex Sherstobitoff
Natasha Touesnard
Karen Turner
the National Working Group of People with Lived and Living Expertise
Jade Boyd
“The people who depended on us became expendable”: Experiences of frontline workers with lived and living expertise of drug use during the COVID-19 pandemic
Harm Reduction Journal
Frontline
COVID-19
People who use drugs
Overdose
Harm reduction
title “The people who depended on us became expendable”: Experiences of frontline workers with lived and living expertise of drug use during the COVID-19 pandemic
title_full “The people who depended on us became expendable”: Experiences of frontline workers with lived and living expertise of drug use during the COVID-19 pandemic
title_fullStr “The people who depended on us became expendable”: Experiences of frontline workers with lived and living expertise of drug use during the COVID-19 pandemic
title_full_unstemmed “The people who depended on us became expendable”: Experiences of frontline workers with lived and living expertise of drug use during the COVID-19 pandemic
title_short “The people who depended on us became expendable”: Experiences of frontline workers with lived and living expertise of drug use during the COVID-19 pandemic
title_sort the people who depended on us became expendable experiences of frontline workers with lived and living expertise of drug use during the covid 19 pandemic
topic Frontline
COVID-19
People who use drugs
Overdose
Harm reduction
url https://doi.org/10.1186/s12954-025-01221-z
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