Theme: Social Science & Policy Research Year: 2022
People receiving opioid agonist treatment (OAT) are at higher risk of comorbidities, poverty, and
discrimination, which Big Events like the COVID-19 pandemic may exacerbate. The behaviours of
people receiving OAT do not always align with normative behaviours as conceived by ruling
institutions and laws, and so the group becomes a counterpublic, not imagined in mainstream public
Participants were recruited via eight peer-led organisations across Australia. In-depth, semistructured interviews were completed between August and December 2020 via telephone and
videocall with 40 people receiving OAT. The analysis centres practices of care, allowing interactions
that influence the health of participants to be understood in their unique contexts.
Aspects of the COVID-19 state response were designed for an idealised public,
demonstrated by the increased policing that accompanied enforcement of restrictions which was
detrimental to the wellbeing of people receiving OAT. Counterpublic health strategies employed by
people receiving OAT were disrupted, but participants were often able to adapt to the changing
This study is the first to elucidate how practices of care among people receiving OAT are enacted
and disrupted during a Big Event, with implications beyond the COVID-19 pandemic for future Big
Events. The study findings evidence the need for policies that mitigate the impact of Big Events such
as supporting regroupment within the counterpublic, legitimising counterpublic health strategies,
and stopping the criminalisation of people who use drugs.
Disclosure of Interest Statement:
CT has received speaker fees from Abbvie and Gilead and has received a research grant from Merck
outside the submitted work. SC has received speaker fees from Abbvie outside the submitted work.
JG is a consultant/advisor and has received research grants from AbbVie, Camurus, Cepheid, Gilead,
Hologic, Indivior, and Merck outside the submitted work. AC and ADM have nothing to disclose.