Recovery during Pandemic: Qualitative Analysis of Unique Challenges Experienced By Young People of Color Who Are in Recovery

Background Young adults have higher propensity for substance use than adolescents and older adults. Mitigation efforts in response to COVID-19 such as government sanctioned stay-at-home orders, infection control measures and modification of community services has additionally rendered people with substance use disorders (SUDs) at higher risk of encountering challenges to their recovery during the pandemic. Especially in New Jersey (NJ), the pandemic has disproportionately impacted low-income communities of color. The pandemic resulted in loss of employment, increased stress, and limited access to social and health systems. This qualitative study aims to identify the unique challenges that low-income young people of color have faced in maintaining their recovery efforts during the pandemic. This presentation focuses on findings from qualitative interviews that were part of the Recovery During Pandemic study, a community-based participatory research (CBPR) examining the impact of COVID-19 on disadvantaged and marginalized young adults recovering from SUDs.

Methods Purposive sampling was used to recruit participants. Participants were eligible for the study if they met the following criteria: resident of NJ, identify as a person of color, aged 18-29 years old self-reported with SUDs history and regularly active use of public assistance. Eight participants completed interviews at the recruitment site agency where they were provided with a tablet to complete the interview in a private room. The remaining participants (n=12) completed their interviews through Zoom, with their own device at a location of their choice. Researchers developed an interview guide in collaboration with the community board. Interviews ranged from 45-80 minutes and audio recordings of the interviews were cleaned and transcribed for analysis. Preliminary open-coding was conducted by three researchers who read transcripts independently and developed 132 initial codes in an iterative process. Thematic analysis yielded 39 unique codes.

Results Twenty NJ residents of color participated in the study. 75% (n=15) were self-reported as Black and were between the ages of 18-29 (M=26.16, SD=3.68). Participants reported an array of attitudes and perceptions related to macro-level challenges such as the influence of racism, classism and neighborhood factors impacting their likelihood to sustain access to social and community supports. Participants reported micro-level challenges that included: 1) disruptions in access to ongoing SUD treatment services; 2) complications related to substance withdrawal; 3) difficulty with emotional and cognitive coping; 4) sense of social isolation and lack of social support; and 5) fear and worry about the future leading to relapse.

Conclusion Personal recovery from SUDs is a "personal and unique process to change attitudes, values, goals, abilities or roles in order to achieve a satisfactory, hopeful and productive way of life.” This data reveals the unique challenges faced by disadvantaged young people of color in sustaining their personal recovery during the COVID-19 pandemic. Findings indicate the importance of targeted and sufficient access to social services and treatment during times of population health crisis. Additional research exploring the pathways through which young people of color in substance use recovery are impacted by systemic inequalities is needed to support more effective practice, policy and programming.